A-029 Establishment of Age- and Sex-Specific Reference Intervals with High-Sensitivity Cardiac Troponin I in Healthy Pediatric Populations
Year: 2025
Type: conference-abstract
Abstract: Background Troponin (Tn) is an important biomarker for diagnosing and prognosing myocardial injury and assessing the severity of cardiac involvement due to other systemic diseases, including pediatric populations. While hs-cTnI is widely used in adults, its clinical application in children is limited due to a lack of established reference intervals (RIs). This gap is especially problematic as children’s physiological and developmental differences, such as age, sex, and puberty, which can influence troponin levels. This study aimed to address this gap by establishing a hs-cTnI RIs for pediatric population, thereby contributing to more precise cardiac risk assessment and management. Methods A total of 1355 healthy participants (0–19 years) were recruited from Wuhan Children’s Hospital from September 2022 to August 2023. Serum hs-cTnI levels were measured using the Mindray CL-6000i automated chemiluminescence immunoassay analyzer. 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 in different age and sex groups for various pediatric subgroups, and differences in hs-cTnI levels across these groups were statistically analyzed. Results Of the 1355 pediatric participants, serum hs-cTnI concentrations of 1332 participants were measured. The overall P50 and 95% interval range (P2.5–P97.5) for serum hs-cTnI in the entire cohort were 0.41 [0.00, 44.31] ng/L. Males had significantly s higher levels (0.47 [0.00, 44.9] ng/L) compared to females (0.36 [0.00, 44.17] ng/L, P < 0.01). Significant age- and sex-specific differences were observed in hs-cTnI levels. Serum hs-cTnI levels were highly variable under 1 year of age (especially in newborns), deriving a P50 [P2.5–P97.5] of 22.06 [1.04, 154.22] ng/L. As children aged hs-cTnI levels gradually decreased and the interval narrowed, with a significantly lower median value. However, slight increase was observed in the 9–12 years age group, and reached a small peak in males aged 15 to 18 years. In contrast, females showed less affected RIs by puberty. The sex- and age-specific RIs for hs-cTnI were established as follows: for males, 0–1 months: 30.16 [8.67, 171.81]; 1–12 months: 13.20 [0.63, 61.91]; 1–15 years: 0.36 [0.00, 1.86]; 15–18 years: 0.71 [0.03, 3.29]; and 18–19 years: 0.52 [0.00, 1.92]. For females, the RIs were 0–1 months: 43.93 [18.82, 146.38]; 1–12 months: 5.22 [0.92, 42.54]; 1–6 years: 0.54 [0.00, 2.74]; and 6–19 years: 0.23 [0.00, 1.56]. Conclusion This study preliminarily established the age- and sex-specific RIs for serum hs-cTnI levels using the Mindray CL-6000i system in healthy children in pediatric populations, providing a valuable tool for assessing myocardial injury in pediatric patients to enhance the clinical utility of hs-cTnI.
Source: Clinical Chemistry
Author: Yi Zhang
Institution: Mindray (China)
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4414741003
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