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Related Experiment Videos

Regression-based reference limits for urinary amino acids in a pediatric population.

Rafael Venta1, Belén Prieto, Francisco V Alvarez

  • 1Servicio de Análisis Clínicos, Hospital San Agustin, Avilés, Asturias, Spain. rventa@hsag.insalud.es

Clinical Chemistry and Laboratory Medicine
|June 13, 2002
PubMed
Summary

Continuous reference limits for urinary amino acid excretion in children aged 0-12 years were developed using regression models. These novel limits offer a more practical approach for monitoring amino acid metabolism disorders.

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Area of Science:

  • Biochemistry
  • Pediatric Medicine
  • Clinical Chemistry

Background:

  • Urinary amino acid excretion exhibits significant age-related variations.
  • Conventional reference intervals are less practical during rapid developmental changes in infancy and childhood.
  • Continuous reference limits offer a more adaptable approach for pediatric age groups.

Purpose of the Study:

  • To establish regression-based continuous reference limits for urinary amino acid excretion in healthy children aged 0-12 years.
  • To compare regression-based limits with conventional reference intervals.
  • To provide a more practical tool for monitoring amino acid metabolism.

Main Methods:

  • Analyzed urinary excretion of 23 amino acids in 148 healthy individuals (0-12 years).

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  • Modeled urinary excretion and age-specific standard deviation using polynomial and piece-wise linear regression.
  • Employed residual analysis to select best-fitting models and calculate 95% reference limits and confidence intervals.

    • Main Results:

    • Urinary excretion of 19 amino acids decreased rapidly in the first year, followed by a slow decline, fitting a piece-wise model.
    • Four amino acids showed a steady decrease, fitting linear or quadratic models.
    • Regression-based limits differed from conventional limits, providing narrower confidence intervals and smoothly changing values.

    Conclusions:

    • Regression-based continuous reference limits provide a more accurate and practical method for assessing urinary amino acid excretion in children.
    • These novel limits facilitate the follow-up of patients with inborn errors of amino acid metabolism.
    • Smoothly changing limits avoid partitioning issues inherent in conventional methods.