Back to Search
Start Over
Continuous, complete and comparable NT-proBNP reference ranges in healthy children.
- Source :
- Clinical Chemistry & Laboratory Medicine; Sep2020, Vol. 58 Issue 9, p1509-1516, 8p
- Publication Year :
- 2020
-
Abstract
- Background: NT-proBNP is one of the most important biomarkers for the diagnosis and risk assessment of heart failure in adults. Age- and gender-independent reference intervals (RIs) have been reported. In contrast, RIs in children are strongly age-dependent, do not exist for all ages and reveal a right-skewed distribution. Accordingly, no common Z-score can be formed and a cross-age interpretive method, so far, is missing. Methods: Within the paper on hand, new evaluation techniques are applied to already published NT-proBNP study results and additionally to newly gained data. Upper limits (ULs), lower limits (LLs) and 50th percentiles are tested for power-like behavior as a function of age using linear regression analysis. Functions for continuous RIs are derived and reference limits are calculated on a per day basis. A corresponding Zlog formula is deduced and its usefulness is stated in two clinical examples. Results: The power-like behavior of NT-proBNP concentration from birth to 18 years is demonstrated. With age in days t and measured NT-proBNP value x in pg/mL, an age-specific Zlog value may directly be calculated using the equation: Zlog NT-proBNP = log x + 0.512 ⋅ log t − 3.417 1.489 + 0.014 ⋅ log t ⋅ 3.92 ${\rm{Zlo}}{{\rm{g}}_{{\rm{NT - proBNP}}}} = {{\log \;x + 0.512 \cdot \log \;t - 3.417} \over {1.489 + 0.014 \cdot \log \;t}} \cdot 3.92$ Conclusions: Using formulas for UL and LL, continuous RIs from 0 to 18 years may be obtained. Continuity corresponds to physiological changes in the body much better than discrete RIs. With the advent of an NT-proBNP-specific Zlog value, a cross-age Z-score equivalent is providing an easy interpretation aid in everyday pediatric practice. This new approach allows to identify clinical worsening much better, sooner and more clearly than previous absolute values. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14346621
- Volume :
- 58
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Clinical Chemistry & Laboratory Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 146176334
- Full Text :
- https://doi.org/10.1515/cclm-2019-1185