Key result
Age and sex significantly influenced myocardial enzyme reference intervals, with AST and LDH decreasing with age, CK remaining stable, and CKMB showing sex differences starting at 6 years of age.
Why the study?
This study aimed to establish concise, effective, sex- and age-specific reference intervals for myocardial enzyme activity in a population aged 1 to <18 years old in Changchun, China.
Cross-Sectional (n=6,322)
This study establishes age- and sex-specific reference intervals for myocardial enzymes in a pediatric population using Fisher's optimal segmentation method.
May enhance pediatric diagnostic accuracy; leaves open prospective validation before practice change.
BACKGROUND: Reference interval (RI) research is to make it a concise, effective, and practical diagnostic tool. This study aimed to establish sex- and age-specific RI for myocardial enzyme activity in population aged 1-<18 years old in Changchun, China. METHODS: = 6,322, 1-<18 years old) were recruited from communities and schools. Aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and creatine kinase isoenzyme (CKMB) were measured using an automatic biochemical analyzer. Fisher's optimal segmentation method was used to partition by including percentiles as impact factors, aiming at minimizing the sum of the squares of the total dispersion into groups as splitting sequence of ordered data. RESULTS: AST decreased gradually and was partitioned as 1, 2∼<10 and 10∼<18 years old. LDH presented disparate descending rate among 1∼<4, 4∼<12, and 12∼<18 years old. CK stood quite stable with the same RI in all ages. CKMB began to differ at 6 years of age sexually and then remained stable during 6∼<14 years old for male while it continued to decline in female. Cardiac development was partitioned as 1∼<6, 6∼<13, and 13∼<18 years old using multiple percentiles from massive data that reflect characteristics of totality as impact factors. CONCLUSIONS: Fisher's optimal segmentation method excelled for multidimensionality, continuity, and loop calculating as dealing with RIs for myocardial enzymes activity and cardiac development process despite limitations. In future, impact of partition on the overall interval should be delved into.
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Guo et al. (2020) conducted a cross-sectional in Healthy children and adolescents (n=6,322). Age and sex was evaluated on Age- and sex-specific reference intervals for myocardial enzyme activity (AST, LDH, CK, CKMB). Age and sex significantly influenced myocardial enzyme reference intervals, with AST and LDH decreasing with age, CK remaining stable, and CKMB showing sex differences starting at 6 years of age.
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