Specific reference interval for high-sensitivity cardiac troponin I among healthy children in Wuhan, China
Qinzhen Cai1, Mei Liu2, Zhen Xie3
1Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Insights
This study established crucial age- and sex-specific reference intervals for high-sensitivity cardiac troponin I (hs-cTnI) in children. These findings aid in diagnosing pediatric myocardial injury and systemic diseases.
Area of Science:
- Clinical Biochemistry
- Pediatric Cardiology
- Diagnostic Biomarkers
Background:
- Cardiac troponin (Tn) is vital for diagnosing myocardial injury and assessing systemic diseases in children.
- Limited specific reference intervals (RIs) exist for high-sensitivity cardiac troponin I (hs-cTnI) in pediatric populations.
- Establishing pediatric hs-cTnI RIs is essential for accurate clinical assessment.
Purpose of the Study:
- To establish preliminary age- and sex-specific reference intervals for serum hs-cTnI in healthy newborns, children, and adolescents.
- To provide a foundational dataset for the interpretation of hs-cTnI levels in pediatric populations in Wuhan, China.
Main Methods:
- A cross-sectional study included 1,355 healthy participants aged 1 day to 19 years in Wuhan, China.
- Serum hs-cTnI levels were measured using the Mindray automated chemiluminescence immunoassay analyzer (CL-6000i).
- Reference intervals were determined following Clinical and Laboratory Standards Institute (CLSI) guidelines, defining P50 (median) and P2.5-P97.5 (95% interval).
Main Results:
- Overall hs-cTnI P50 (P2.5-P97.5) was 0.41 (0.00, 44.31) ng/L, higher in males (0.47 ng/L) than females (0.36 ng/L).
- Levels were highly variable in infants (<1 year), with a P50 (P2.5-P97.5) of 22.06 (1.04, 154.22) ng/L, decreasing with age.
- Age- and sex-specific RIs were established, showing distinct patterns related to development and puberty.
Conclusions:
- Preliminary age- and sex-specific serum hs-cTnI reference intervals were successfully established for healthy children in Wuhan.
- These RIs, derived using the Mindray CL-6000i system, provide a critical resource for pediatric clinical practice.
- The findings highlight the importance of age and sex considerations in interpreting hs-cTnI levels in children.
Background:
Troponin (Tn) is of an important biomarker for the diagnosis and prognosis of myocardial injury and for evaluating the severity of cardiac involvement due to other systemic diseases in children. Unfortunately, high-sensitivity cardiac troponin I (hs-cTnI) specific reference intervals (RIs) are extremely limited. This study aimed to establish a preliminary pediatric hs-cTnI RI for newborns, children, and adolescents in Wuhan, China.
Methods:
A total of 1,355 healthy participants (1 day to 19 years) were recruited from a cross-sectional study implemented in Wuhan Children's Hospital from September 2022 to August 2023. Serum hs-cTnI levels were detected via the Mindray automated chemiluminescence immunoassay analyzer (CL-6000i). Specific serum hs-cTnI RIs were established according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The RIs were defined by the nonparametric median (P50), and 2.5th, 97.5th [P50 (P2.5-P97.5)] intervals.
Results:
Of the 1,355 pediatric participants, serum hs-cTnI concentrations of 1,332 children were measured. The serum overall P50 and 95% interval range (P2.5-P97.5) of serum hs-cTnI was 0.41 (0.00, 44.31) ng/L. This was higher in males of 0.47 (0.00, 44.90) ng/L than in females of 0.36 (0.00, 44.17) ng/L (P<0.01). Age- and sex-specific differences in hs-cTnI levels were observed. The levels were highly variable in children under 1 year of age (especially in newborns), deriving a P50 (P2.5-P97.5) of 22.06 (1.04, 154.22) ng/L, and gradually narrowed and decreased with increasing age, with a markedly lower established P50 (P2.5-P97.5) of 0.36 (0.00, 2.16) ng/L. However, the levels began to increase slightly at the age of 9-12 years and reached a small peak at the age range of 15 to 18 years in males with 0.71 (0.03, 3.29) ng/L, while females were less affected by puberty. Sex- and age-specific RIs for hs-cTnI were established: 5 age-specific RIs in males, 1 day-1 month: 30.16 (8.67, 171.81) ng/L; >1-12 months: 13.20 (0.63, 61.91) ng/L; >1-15 years: 0.36 (0.00, 1.86) ng/L; >15-18 years: 0.71 (0.03, 3.29) ng/L; >18-19 years: 0.52 (0.00, 1.92) ng/L; and 4 age-specific RIs in females, 1 day-1 month: 43.93 (18.82, 146.38) ng/L; >1-12 months: 5.22 (0.92, 42.54) ng/L; >1-6 years: 0.54 (0.00, 2.74) ng/L; >6-19 years: 0.23 (0.00, 1.56) ng/L.
Conclusions:
This study preliminarily established age- and sex-specific serum hs-cTnI RIs using the Mindray CL-6000i system in healthy children in Wuhan, China.
More Related Videos
09:23Using Extraordinary Optical Transmission to Quantify Cardiac Biomarkers in Human Serum
Published on: December 13, 2017
10:12A Sensitive and Specific Quantitation Method for Determination of Serum Cardiac Myosin Binding Protein-C by Electrochemiluminescence Immunoassay
Published on: August 8, 2013
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...