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Redefining normal bone and mineral clinical biochemistry reference intervals for healthy infants in Canada

Sina Gallo1, Kathyrn Comeau2, Atul Sharma3

  • 1School of Dietetics and Human Nutrition, McGill University, Montréal, Québec H9X 3V9, Canada; Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA.

Clinical Biochemistry
|July 28, 2014
PubMed

Insights

Establishing infant reference intervals for clinical chemistry markers like calcium and creatinine is crucial. This study provides age-specific data for infants aged 1 to 12 months, aiding pediatric diagnostics.

Area of Science:

  • Pediatric Clinical Chemistry
  • Infant Physiology
  • Biochemical Reference Intervals

Background:

  • Limited normative data for routine clinical chemistry in healthy term infants hinders accurate diagnosis.
  • Physiological changes in infants significantly impact biochemical markers, necessitating age-specific reference ranges.

Purpose of the Study:

  • To establish reference intervals for key clinical chemistry analytes in infants aged 1 to 12 months.
  • Define age-specific values for calcium, phosphate, creatinine, and alkaline phosphatase in healthy term infants.

Main Methods:

  • Secondary analysis of 132 infants from a vitamin D3 supplementation trial (NCT00381914).
  • Serial collection of capillary and urine samples for biochemical analysis.
  • Measurements included plasma and whole-blood ionized calcium, phosphate, creatinine, and alkaline phosphatase.

Main Results:

  • Significant temporal changes observed in all measured analytes (p<0.05) with no sex-based differences.
  • Decreases in whole-blood ionized calcium, plasma calcium, phosphate, alkaline phosphatase, and urinary calcium:creatinine from 1 to 12 months.
  • Plasma creatinine levels increased; some values exceeded adult reference limits, highlighting the need for infant-specific data.

Conclusions:

  • Age-specific reference values are essential for infants due to significant analyte changes between 1 and 12 months.
  • The generated data and smoothed centile curves (LMS method) address gaps in normative data.
  • These findings will aid in creating new reference intervals, improving diagnostic accuracy and care for infants.
Abstract

Keywords:
BreastfedCalciumCreatinineGrowthInfantsMineralsNormativePhosphate

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