在中国南京的一大群儿童中建立血清25-羟维生素D的年龄特异性参考区间。

Establishment of age-specific reference intervals for serum 25-hydroxyvitamin D in a large pediatric population of Nanjing, China.

作者信息

Xu Chenchen, Chen Xun, Chen Yajun, Wen Zhifa, Cheng Feng

机构信息

Department of Clinical Laboratory, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu, China.

Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210000, Jiangsu, China.

出版信息

Heliyon. 2024 Sep 3;10(17):e37409. doi: 10.1016/j.heliyon.2024.e37409. eCollection 2024 Sep 15.

DOI:10.1016/j.heliyon.2024.e37409

PMID:39296073

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11408806/

Abstract

BACKGROUND

The reference intervals (RIs) is defined as the central 95 % range of reference values from healthy individuals. The establishment of appropriate medical RIs for specific populations is crucial for accurate diagnosis and treatment of disease. However, the RIs for 25-hydroxyvitamin D (25(OH)D) in Chinese pediatric individuals are currently not available. This retrospective study aimed to establish pediatric RIs for serum 25-hydroxyvitamin D (25(OH)D) in the Nanjing area of China.

METHODS

After data filtering and deletion of outliers, 133,562 serum 25(OH)D records were finally included in this study. The effects of age, sex, and season on 25(OH)D levels were assessed, and the 2.5 % and 97.5 % percentile points were applied as the lower limit and upper limit of the RIs, respectively.

RESULTS

Age-distribution analysis of serum 25(OH)D levels revealed that children aged 4-12 months old hold the highest 25(OH)D levels, and levels subsequently decreased with age while remaining relatively stable in children aged 7-15 years old. An analysis of sex-specific differences demonstrated that serum 25(OH)D levels in girls were significantly higher than those of boys <4 years old ( < 0.001) and dropped to significantly lower than those of boys >7 years old ( < 0.001). Season distribution revealed the highest 25(OH)D levels in autumn, followed by summer and winter, and finally spring. Considering the practicability of clinical application and tests according to CLSI C28-A3 guidelines, age-specific RIs for serum 25(OH)D were established. The calculated RIs for children 0-3 months, 4-12 months, 1-3 years, 4-6 years, and 7-15 years old, respectively, were 18.62-42.18, 22.20-45.60, 21.12-45.20, 17.16-38.20, and 15.56-34.39 ng/mL, respectively.

CONCLUSIONS

The levels of serum 25(OH)D exhibited statistically significant age and season variations, and the establishment of age-specific RIs for serum 25(OH)D would be beneficial for clinical diagnosis and treatment.

摘要

背景

参考区间（RIs）定义为健康个体参考值的中央95%范围。为特定人群建立合适的医学参考区间对于疾病的准确诊断和治疗至关重要。然而，目前尚无中国儿童25-羟维生素D（25(OH)D）的参考区间。这项回顾性研究旨在建立中国南京地区儿童血清25-羟维生素D（25(OH)D）的参考区间。

方法

经过数据筛选和异常值删除后，本研究最终纳入133562条血清25(OH)D记录。评估年龄、性别和季节对25(OH)D水平的影响，并将第2.5百分位数和第97.5百分位数分别作为参考区间的下限和上限。

结果

血清25(OH)D水平的年龄分布分析显示，4至12个月大的儿童25(OH)D水平最高，随后随着年龄增长而下降，而7至15岁儿童的水平相对稳定。性别差异分析表明，4岁以下女孩的血清25(OH)D水平显著高于男孩（<0.001），而7岁以上女孩的血清25(OH)D水平降至显著低于男孩（<0.001）。季节分布显示秋季25(OH)D水平最高，其次是夏季和冬季，最后是春季。考虑到临床应用的实用性并根据CLSI C28-A3指南进行检测，建立了血清25(OH)D的年龄特异性参考区间。0至3个月、4至12个月、1至3岁、4至6岁和7至15岁儿童的计算参考区间分别为18.62至42.18、22.20至45.60、21.12至45.20、17.16至38.20和15.56至34.39 ng/mL。