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Age- and sex-specific pediatric reference intervals and correlations for zinc, copper, selenium, iron, vitamins A and
G Lockitch1, A C Halstead, L Wadsworth
1Department of Pathology, B.C. Children's Hospital, Vancouver, Canada.
Insights
This study establishes pediatric reference intervals for key serum nutrients like zinc, copper, and iron. Results highlight age-related variations and correlations, crucial for assessing pediatric nutritional status.
Area of Science:
- Clinical Chemistry
- Pediatric Nutrition
- Trace Element Analysis
Background:
- Establishing accurate reference intervals for serum analytes in children is critical for diagnosing nutritional deficiencies.
- Pediatric populations exhibit unique physiological characteristics influencing nutrient metabolism and distribution.
- Existing reference ranges may not adequately account for age- and sex-specific variations in nutrient levels.
Purpose of the Study:
- To determine age- and sex-specific reference intervals for serum zinc, copper, selenium, iron, ferritin, retinol, and alpha-tocopherol in healthy children.
- To investigate the influence of age and sex on these analyte concentrations.
- To explore correlations between various serum nutrients and related proteins.
Main Methods:
- Serum samples from a healthy pediatric cohort were analyzed for target analytes.
- Statistical methods, including fractile calculations (0.025 and 0.975), were used to derive reference intervals.
- Covariate analysis was performed to assess the impact of age and sex.
- Correlation analyses were conducted to identify relationships between analytes.
Main Results:
- Age- and sex-specific reference intervals were established for serum zinc, copper, selenium, iron, ferritin, retinol, and alpha-tocopherol.
- Age was identified as a significant covariate for copper, selenium, retinol, tocopherol, and ferritin (in boys).
- Significant correlations were observed between retinol and retinol-binding protein, prealbumin, alpha-tocopherol, and selenium. Tocopherol also correlated with cholesterol and triglycerides. No correlation was found between serum zinc and retinol or retinol-binding protein.
- Iron levels, even after excluding children with anemia or related conditions, fell below optimal nutritional status indicators in several age groups.
Conclusions:
- The study provides essential, updated reference intervals for key serum nutrients in pediatric populations.
- Age and sex are important determinants of serum nutrient concentrations in children.
- The findings underscore potential challenges in iron status assessment in pediatric populations, necessitating careful interpretation of iron levels.
Abstract:
Age- and sex-specific reference intervals based on the 0.025 and 0.975 fractiles of data derived from a healthy pediatric population are presented for zinc, copper, selenium, iron, ferritin, retinol, alpha-tocopherol, and related analytes in serum. Age was an important covariate for copper, selenium, retinol, and tocopherol, and ferritin in boys. Strong correlations were found between retinol and retinol-binding protein, prealbumin (transthyretin), alpha-tocopherol, and selenium. Tocopherol was highly correlated with both cholesterol and triglycerides. We found no relationship between serum zinc and either retinol or retinol-binding protein. Despite exclusion of children in whom anemia, microcytosis, or variant hemoglobins were found, the 0.025 fractile for iron in several age groups was even less than the concentration considered to indicate poor iron nutritional status.