High-Sensitivity Cardiac Troponin T in Healthy Sport-Participating Youth Aged 8-16 Years: Reference Values From the...

High-sensitivity cardiac troponin T (hs-cTnT) is widely used in adult cardiology, yet pediatric reference values remain scarce. This study aimed to establish reference values for hs-cTnT in healthy sport-participating youth aged 8-16 years from Spain; to examine differences by age, sex, and pubertal stage; and to explore associations with anthropometry and physical activity.

This cross-sectional study used baseline data from the Cor-School cohort, including 733 organized sport participants aged 8-16 years from northeastern Spain. Anthropometry, pubertal status, biological maturity, and PHV timing were assessed alongside hs-cTnT and habitual physical activity. Percentiles were calculated from detectable hs-cTnT concentrations below the 99.75th percentile. Group comparisons, correlations, and regression models examined developmental patterns.

Among 733 youth, 39% had detectable hs-cTnT and 4.7% exceeded 14 ng/L. The 97.5th and 99th percentiles were 15.2 ng/L (90% CI: 12.4-16.9) and 19.1 ng/L (90% CI: 15.2-21.3), peaking in early adolescence (11-13 years) and around PHV. Tanner Stage 4 showed the highest 99th percentile (20.4 ng/L), while Tanner 5 had lower values. Boys presented greater detectability (42% vs. 33%) and higher percentiles (99th: 19.1 vs. 15.6 ng/L). hs-cTnT correlated weakly with maturity offset (ρ = 0.183, p = 0.002) and inversely with body fat (ρ = -0.170, p = 0.040), but no independent predictors remained in multivariable models (R² adj = 0.033).

hs-cTnT increases physiologically during adolescence, reflecting biological maturation. Pediatric-specific reference values by age and developmental stage are recommended to avoid misclassification. As all participants were regularly engaged in organized sport, the reference values obtained likely represent the upper end of physiological hs-cTnT concentrations in physically active youth.