Population-specific reference intervals for 22 biochemical analytes: three indirect methods application in a...

Area of Science:

• Clinical Biochemistry
• Population Health
• Medical Diagnostics

Background:

• Reference intervals (RIs) are crucial for interpreting laboratory test results.
• Fixed RIs are often used in multi-ethnic regions despite demographic variations.
• Population-specific RIs are needed for accurate health assessments.

Purpose of the Study:

• To establish population-adapted reference intervals (RIs) for routine biochemical analytes.
• To investigate the influence of sex, age, and ethnicity on biochemical analytes in Uyghur and Han adults.
• To compare indirect algorithms for deriving RIs.

Main Methods:

• Retrospective analysis of 1,825,257 laboratory test results.
• Variance components analysis to assess demographic contributions (sex, age, ethnicity).
• Indirect algorithms (kosmic, refineR, Hoffmann) and GAMLSS for RI derivation and age-dependent modeling.

Main Results:

• Sex was the primary determinant of variability for most analytes.
• Ethnicity significantly affected apolipoprotein A-I (ApoA-I) levels, with lower limits in Uyghurs.
• Continuous age-dependent RIs revealed specific changes in older adults (≥60 years).

Conclusions:

• Sex and age are key factors influencing biochemical variability.
• Ethnicity has a selective but clinically relevant impact, particularly on ApoA-I.
• Data-driven, indirect RIs are practical for diverse populations, improving diagnostic accuracy.