title: Complex reference value distributions and partitioned reference intervals across the pediatric age range for 14 specialized biochemical markers in the CALIPER cohort of healthy community children and adolescents.
abstract: BACKGROUND
  The CALIPER program has previously reported a comprehensive database of pediatric reference intervals for 63 biochemical and immunochemical markers. Here, covariate-stratified reference intervals were determined for a number of special assays not previously reported.
  
  
  METHODS
  A total of 1917 healthy children and adolescents were recruited and serum concentrations of 14 biochemical markers were measured using the Abbott Architect ci4100 system. Age and gender partitions were statistically determined, outliers removed and reference intervals calculated using CSLI C28-A3 guidelines.
  
  
  RESULTS
  Many analytes showed dynamic changes in concentration requiring at least 3 age partitions. Unique intervals were required within the first year of life for: pancreatic amylase, C-peptide, ceruloplasmin, insulin, β-2-microglobulin, cystatin C, dehydroepiandrosterone sulfate (DHEA-S), and α-1-glycoprotein. Cholinesterase, cholinesterase-dibucaine number, and immunoglobulin E required only 2 age partitions and α-1-antitrypsin required only one. Anti-CCP and anti-TPO levels were below the detection limit of the assay. Some analytes including insulin and DHEA-S required additional gender partitions for specific age groups.
  
  
  CONCLUSIONS
  Complex profiles were observed for endocrine and special chemistry markers, requiring establishment of age- and gender-specific reference intervals. These updated reference intervals will allow improved laboratory assessment of pediatric patients but should be validated for each analytical platform and local population as recommended by CLSI.
authors: CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors: Jacalyn
authors: J
authors: Kelly
authors: CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors: Joshua E
authors: JE
authors: Raizman
authors: CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors: Victoria
authors: V
authors: Bevilacqua
authors: CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors: Man Khun
authors: MK
authors: Chan
authors: CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors: Yunqi
authors: Y
authors: Chen
authors: Abbott Diagnostics, Abbott Park, IL, USA.
authors: Frank
authors: F
authors: Quinn
authors: Abbott Diagnostics, Abbott Park, IL, USA.
authors: Beth
authors: B
authors: Shodin
authors: Abbott Diagnostics, Abbott Park, IL, USA.
authors: David
authors: D
authors: Armbruster
authors: CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. Electronic address: khosrow.adeli@sickkids.ca.
authors: Khosrow
authors: K
authors: Adeli
mesh_terms: D000293:Adolescent; D000375:Aging / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001774:Blood Chemical Analysis / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D048788:Growth and Development; D006262:Health; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012016:Reference Values; D012111:Residence Characteristics
chemical_list: D015415:Biomarkers
keywords: Analyte; Biomarker; CALIPER; Pediatric; Reference intervals