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Age-Dependent Reference Values for hs-Troponin T and NT-proBNP and Determining Factors in a Cohort of Healthy

Alexandra Kiess1,2, Jessica Green3, Anja Willenberg4

  • 1Heart Center Leipzig, Department of Pediatric Cardiology, Faculty of Medicine, University of Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany. alexandra.kiess@helios-gesundheit.de.

Pediatric Cardiology
|March 12, 2022
PubMed

Insights

This study established pediatric reference values for N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitive Troponin T (hsTnT) in healthy children. Findings reveal associations between these cardiac markers and factors like BMI and lipid levels.

Area of Science:

  • Pediatric Cardiology
  • Biomarker Research
  • Clinical Diagnostics

Background:

  • Establishing reliable pediatric reference ranges for cardiac biomarkers is crucial for accurate clinical interpretation.
  • Previous studies have lacked comprehensive data on N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitive Troponin T (hsTnT) in healthy children across a wide age spectrum.
  • Understanding the influence of physiological factors like puberty and metabolic status on these biomarkers is essential.

Purpose of the Study:

  • To establish pediatric reference values for NT-proBNP and hsTnT in a large cohort of healthy children.
  • To investigate the associations of NT-proBNP and hsTnT levels with sex, pubertal status, body mass index (BMI), and serum lipid profiles.
  • To provide data for improved clinical interpretation of cardiac biomarker testing in pediatric populations.

Main Methods:

  • Analysis of NT-proBNP and hsTnT from 4826 samples from 2522 children (0.25-18 years) in the prospective 'LIFE child' cohort study.
  • Statistical analysis to determine reference ranges and investigate associations with demographic, anthropometric, and metabolic variables.
  • Utilized data from a well-characterized, population-based cohort in Leipzig, Germany.

Main Results:

  • NT-proBNP values decreased with age, with rapid declines during puberty, and showed associations with higher BMI and elevated lipids (more pronounced in males).
  • hsTnT levels were often below detection limits but exceeded adult cut-offs in infants; levels varied by sex and pubertal stage, with associations to BMI and lipid profiles in boys.
  • Established age- and sex-specific reference ranges for NT-proBNP and hsTnT in healthy children.

Conclusions:

  • Reliable pediatric reference values for NT-proBNP and hsTnT have been established for clinical practice.
  • Significant associations between cardiac biomarkers, BMI, and lipid levels in children were identified, highlighting the importance of considering these factors.
  • The findings contribute to a better understanding of cardiac physiology and biomarker behavior during childhood and puberty.

Keywords:
Cardiac biomarkersNT-ProBNPPediatric percentilesTroponin T

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