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Serum GFAP - pediatric reference interval in a cohort of Danish children
Lea Tybirk1, Claus Vinter Bødker Hviid1,2,3,4, Cindy Soendersoe Knudsen1
1Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
Insights
This study establishes a reference interval for glial fibrillary acidic protein (GFAP) in children's blood. These findings are crucial for diagnosing brain injuries and neurological diseases in pediatric patients.
Area of Science:
- Biomarkers
- Pediatric Neurology
- Clinical Chemistry
Background:
- Glial fibrillary acidic protein (GFAP) is a key biomarker for brain injury and neurological conditions.
- Establishing a reliable reference interval (RI) for serum GFAP in children is essential for its clinical application.
- Current clinical use of GFAP in pediatric populations is hindered by the absence of age-specific RIs.
Purpose of the Study:
- To develop an age-dependent, continuous reference interval (RI) for serum glial fibrillary acidic protein (GFAP) in children.
- To provide a foundational dataset for the clinical interpretation of GFAP levels in pediatric patients.
- To address the limitations in using GFAP as a biomarker in children due to the lack of established RIs.
Main Methods:
- Serum samples from 391 children aged 0.4 to 17.9 years were analyzed using a single-molecule array (Simoa) assay.
- Non-parametric quantile regression was employed to model a continuous reference interval.
- The continuous RI was visualized graphically and presented in a tabulated format with discrete one-year intervals.
Main Results:
- Serum GFAP levels exhibited a significant age-dependent pattern, decreasing with age from infancy to adolescence.
- Median GFAP levels decreased by 66% between four months and five years of age, and by another 65% between five and 17.9 years of age.
- No statistically significant differences in serum GFAP levels were observed between genders.
Conclusions:
- This research successfully established an age-dependent reference interval for serum GFAP in children.
- The findings highlight elevated GFAP levels and greater variability during the early years of life.
- The developed RI will aid clinicians in the accurate interpretation of GFAP as a biomarker in pediatric neurological assessments.
Objectives:
Glial fibrillary acidic protein (GFAP) in blood is an emerging biomarker of brain injury and neurological disease. Its clinical use in children is limited by the lack of a reference interval (RI). Thus, the aim of the present study was to establish an age-dependent continuous RI for serum GFAP in children.
Methods:
Excess serum from routine allergy testing of 391 children, 0.4-17.9 years of age, was measured by a single-molecule array (Simoa) assay. A continuous RI was modelled using non-parametric quantile regression and presented both graphically and tabulated as discrete one-year RIs based on point estimates from the model.
Results:
Serum GFAP showed a strong age-dependency with declining levels and variability from infants to adolescents. The estimated median level decreased 66 % from four months to five years of age and another 65 % from five years to 17.9 years of age. No gender difference was observed.
Conclusions:
The study establishes an age-dependent RI for serum GFAP in children showing high levels and variability in the first years of life.
