title: Plasma concentrations of N-terminal brain natriuretic peptide in healthy children, adolescents, and young adults: effect of age and gender.
abstract: Children with congenital heart disease need adequate diagnostic classification regarding their cardiovascular status (CVS). N-terminal brain natriuretic peptide (N-BNP) plasma concentration indicates dysfunction of the cardiovascular system and guides decisions concerning treatment and prognosis. Reference values are established for adults, with age-dependent increasing values and higher values in women. To avoid misclassification concerning the CVS, a large group of healthy children and adolescents can be used show the relationship between gender, age, and N-BNP and these can serve as reference values. N-BNP was measured in 434 healthy subjects (240 female and 194 male) with ages ranging from 0 to 32 years without any cardiovascular disease or renal or hepatic impairment. Measurements were performed with an electrochemiluminescence immunoassay from Roche Diagnostics. Mean N-BNP decreased from 12.6 fmol/ml (0-9 years; n = 79) to 9.41 fmol/ml (10-14 years; n = 154) and in adolescents from 6.1 (15-19 years; n = 99) to 4.8 fmol/ml (> 19 years; n = 102) in adults (p < 0.05). Mean N-BNP concerning gender did not differ in any age group younger than 19 years. In contrast, the adult female group had 78% higher N-BNP compared to the male group (p < 0.05). There was a significant peak in N-BNP at the age of 12-14 years. This study shows that reference values for N-BNP differed profoundly in children compared to adults and were up to 260% higher in children without any gender difference. Therefore, these reference values will help to avoid CVS misclassification in children for the biomarker N-BNP.
authors.affiliation: Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany. mir@uke.uni-hamburg.de.
authors.forename: T S
authors.initials: TS
authors.lastname: Mir
authors.affiliation: Zentrum für Experimentelle Medizin, Institut für Experimentelle und Klinische Pharmakologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Flato
authors.affiliation: Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Falkenberg
authors.affiliation: Zentrum für Klinisch-Theoretische Medizin I, Institut für Klinische Chemie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Haddad
authors.affiliation: Zentrum für Klinisch-Theoretische Medizin I, Institut für Klinische Chemie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Budden
authors.affiliation: Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Weil
authors.affiliation: Zentrum für Experimentelle Medizin, Institut für Experimentelle und Klinische Pharmakologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Albers
authors.affiliation: Zentrum für Experimentelle Medizin, Institut für Experimentelle und Klinische Pharmakologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Laer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012016:Reference Values; D012737:Sex Factors
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain