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Establishment of reference intervals for bone markers in children and adolescents
Yun Huang1, Esther Eapen, Susan Steele
1Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
Objectives:
To determine age and gender specific reference intervals for bone markers.
Design And Methods:
Morning blood samples were collected after overnight fast from 356 healthy children (6 to 18 year-old) for the determination of bone marker levels, PTH and vitamin D(3). Multiple regression analysis was done to assess the effect of factors that could influence the bone marker levels; the central 95% reference interval and their 90% CI were calculated.
Results:
After excluding samples when BMI-z -scores were <-2 or >+2, both vitamin D(3) and PTH levels were abnormal and from children who used steroids the remainder were partitioned using Tanner stage based chronological age. As expected the reference intervals show a significant variation with age and gender. All the bone marker levels, except total alkaline phosphatase, were significantly higher in puberty with vitamin D(3) >75nmol/L.
Conclusion:
Vitamin D status, age and gender are important for establishing reference intervals of bone markers in healthy children.
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