Journal of the Formosan Medical Association
Volume 108, Issue 12 , Pages 957-963, December 2009

Pediatric Reference Intervals for Several Biochemical Analytes in School Children in Central Taiwan

  • Dong-Shang Lai

      Affiliations

    • Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
    • School of Medicine, Chung Shan Medical University, Taichung, Taiwan
    • ,
  • Shivan-Chih Chen

      Affiliations

    • School of Medicine, Chung Shan Medical University, Taichung, Taiwan
    • Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
    • ,
  • Yih-Hsin Chang

      Affiliations

    • School of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung, Taiwan
    • Department of Medical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
    • ,
  • Chien-Yi Chen

      Affiliations

    • School of Medical Imaging and Radiology Science, Chung Shan Medical University, Taichung, Taiwan
    • ,
  • Jye-Bin Lin

      Affiliations

    • School of Medical Imaging and Radiology Science, Chung Shan Medical University, Taichung, Taiwan
    • Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
    • ,
  • Yi-Jiun Lin

      Affiliations

    • Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
    • ,
  • Shun-Fa Yang

      Affiliations

    • Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
    • School of Medicine, Chung Shan Medical University, Taichung, Taiwan
    • ,
  • Chi-Chiang Yang

      Affiliations

    • School of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung, Taiwan
    • ,
  • Wen-Kang Chen

      Affiliations

    • National Tainan Institute of Nursing, Tainan, Taiwan
    • ,
  • Ding-Bang Lin

      Affiliations

    • Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
    • School of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung, Taiwan
    • Department of Medical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Ding-Bang Lin, School of Medical Technology, Chung Shan Medical University, 110, Section 1, Jianguo North Road, Taichung 402, Taiwan

Received 10 November 2008; received in revised form 20 March 2009; accepted 29 June 2009.

Article Outline

Background/Purpose

Reference intervals of biochemical tests for screening for diabetes mellitus and liver and renal function among school children in Central Taiwan have never been documented. Therefore, this study aimed to establish the reference intervals for the above mentioned biochemical tests for pediatric populations.

Methods

A total of 4326 subjects, including 2029 kindergarten children, 1624 elementary-school children, 325 junior-high-school children, and 348 teachers were selected randomly in Central Taiwan. All serum alanine aminotransferase (ALT), blood urea nitrogen (BUN), creatinine (Cr) and glucose levels were determined using a Beckman Synchron CX5 analyzer. The reference intervals reflected estimates of the 2.5th–97.5th percentiles of non-parametric distributions.

Results

Adults had significantly higher biochemical analyte values [except for BUN/creatinine (B/C) ratio] than children had. Multiple logistic regression analysis showed that biochemical analyte values were significantly higher in male than in female subjects. The concentrations of glucose and Cr increased with age. On the contrary, the B/C ratio decreased with age.

Conclusion

Our study provides new pediatric reference intervals (2.5th–97.5th percentiles) of 60–99 mg/dL for serum glucose concentrations, 8–38 IU/L for ALT, 0.4–1.1 mg/L for Cr, 8.7–18.0 mg/L for BUN, and 10–34 for B/C ratio. The B/C ratio in children was higher than those of adults, possibily due to that children had a higher intake of protein.

Key Words:  alanine transaminase , blood glucose , blood urea nitrogen , child , creatinine , Taiwan

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References 

  1. Sherman KE . Alanine aminotransferase in clinical practice: a review . Arch Intern Med . 1991;151:260–265
  2. Bjornsson TD . Use of serum creatinines to determine renal function . Clin Pharmacokinet . 1979;4:200–202
  3. Perrone RD , Madias NE , Levey AS . Serum creatinine as an index of renal function: new insights into old concepts . Clin Chem . 1992;38:1933–1953
  4. Baum N , Dichoso CC , Carlton CE . Blood urea nitrogen and serum creatinine: physiology and interpretations . Urology . 1975;5:583–588
  5. Hristova EN , Henry JB . Metabolic intermediates, inorganic ions and biochemical markers of bone metabolism . In:  Henry JB editors. Clinical Diagnosis and Management by Laboratory Methods . 12th edition. Philadelphia: WB Saunders; 2001;p. 180–210
  6. American Diabetes Association  . In: Direct and Indirect Cost of Diabetes in the United States in 1992 . Alexandria, VA: American Diabetes Association; 1993;p. 1–27
  7. Chou P , Li CL , Kuo HS , et al.   Comparison of the prevalence in two diabetes surveys in Pu-Li, Taiwan, 1987–1988 and 1991–1992 . Diab Res Clin Pract . 1997;38:61–67
  8. Chen LK , Lin MH , Chen ZJ , et al.   Metabolic characteristics and insulin resistance of impaired fasting glucose among the middle-aged and elderly Taiwanese . Diab Res Clin Pract . 2006;71:170–176
  9. Meites S . Pediatric Clinical Chemistry, Reference Values . Washington: American Association for Clinical Chemistry; 1989;
  10. Bureau of Health Promotion Database  . The Criteria of Metabolic Syndrome . Available at: http://www.bhp.doh.gov.tw/BHP/do/chinese/Announcement/View?n_No=2005125154090JP3WQ [Date accessed: December 25, 2007]
  11. International Diabetes Federation  . The IDF Consensus Worldwide Definition of the Metabolic Syndrome . Available at: http://www.idf.org/webdata/docs/IDF_Metasyndrome_definition.pdf [Date accessed: September 10, 2005]
  12. Tan CE , Ma S , Wai D , et al.   Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians? . Diabetes Care . 2004;27:1182–1186
  13. Chen W , Tsai CY , Chen AC , et al.   Growth charts of Taiwanese youth: norms based on health-related physical fitness . Mid Taiwan J Med . 2003;8(Suppl 2):S85–S93
  14. Gomez P , Coca C , Vargas C , et al.   Normal reference-intervals for 20 biochemical variables in healthy infants, children, and adolescents . Clin Chem . 1984;30:407–412
  15. Burritt MF , Slockbower JM , Forsman RW , et al.   Pediatric reference intervals for 19 biologic variables in healthy children . Mayo Clin Proc . 1990;65:329–336
  16. Jagarinec N , Flegar-Mestric Z , Surina B , et al.   Pediatric reference intervals for 34 biochemical analytes in urban school children and adolescents . Clin Chem Lab Med . 1998;36:327–337
  17. Mohamadnejad M , Pourshams A , Malekzadeeh R , et al.   Healthy ranges of serum alanine aminotransferase levels in Iranian blood donors . World J Gastroenterol . 2003;9:2322–2324
  18. Goldie DJ , McConnell AA . Serum alanine transaminase (ALT) reference ranges estimated from blood donors . J Clin Pathol . 1990;43:929–931
  19. Lockitch G , Halstead AC , Aldersheim S , et al.   Age-and sex-specific pediatric reference intervals for biochemistry analytes as measured with the Ektachem-700 Analyzer . Clin Chem . 1988;34:1622–1625
  20. Jones CA , McQuillan GM , Kusek JW , et al.   Serum creati-nine levels in the US population: third National Health and Nutrition Examination Survey . Am J Kidney Dis . 1998;32:992–999
  21. Nanji AA , Blank D . The serum urea nitrogen/creatinine ratio and liver disease . Clin Chem . 1982;28:1398–1399
  22. Heins M , Heil W , Withold W . Storage of serum or whole blood samples? Effects of time and temperature on 22 serum analytes . Eur J Clin Chem Clin Biochem . 1995;33:231–238
  23. Boyanton BL , Blick KE . Stability studies of twenty-four analytes in human plasma and serum . Clin Chem . 2002;48:2242–2247
  24. Hankinson SE , London SJ , Chute CG , et al.   Effect of transport conditions on the stability of biochemical markers in blood . Clin Chem . 1989;35:2313–2316
  25. Ghoshal AK , Soldin SJ . Evaluation of the Dade Behring Dimension RxL: integrated chemistry system-pediatric reference ranges . Clin Chim Acta . 2003;331:135–146
  26. Brinkworth RSA , Witham E , Nazeran H . Establishment of paediatric biochemical reference intervals . Ann Clin Biochem . 2004;41:321–329

PII: S0929-6646(10)60009-5

doi:10.1016/S0929-6646(10)60009-5

Journal of the Formosan Medical Association
Volume 108, Issue 12 , Pages 957-963, December 2009

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