Establishment of the reference interval for high-sensitivity cardiac troponin T in healthy children of Chongqing Nan’an district

Abstract

Objective

To detect the concentration of high-sensitivity cardiac troponin T (hs-cTnT) in healthy children aged 0–14 years by electrochemiluminescence immunoassay (ECLIA), so as to explore the differences in different ages and genders. The aim of this study is to establish the reference interval for hs-cTnT in healthy children aged 0–14 years.

Methods

After screening, 3463 healthy children, including 1924 boys and 1539 girls, were selected from 4617 children aged 0–14 years. They were divided into nine groups: one day (umbilical cord blood; ‘UCB’), one day (venous blood; ‘VB’), 2–28 days, 29 days–<3 months, 3–<6 months, 6 months–<1 year old, 1–< 3 years old, 3–< 6 years old and 6–14 years old. A nonparametric test was used to detect the hs-cTnT concentration. The upper limit of the reference interval is the mean of the 99th percentile after bootstrap sampling.

Results

Hs-cTnT levels conformed to a non-Gaussian distribution. There was no significant difference in the concentration of hs-cTnT between boys and girls in the general data, but there were differences between boys and girls in the 3–<6 years old and 6–14 years old age groups. Except for UCB and 2–28 days, the concentration of hs-cTnT was significantly different in other age groups. The level of hs-cTnT in neonatal serum (2–28 days) was the highest. In other groups, it decreased gradually with age and dropped to the reference range of adults (0–14ng/L) at one-year old. The upper limit of reference interval of hs-cTnT concentration in each group was, respectively, 60.8, 78.8, 96.6, 58.6, 34.2, 16.2, 11.4, 8.0 (7.8 female), and 7.9 (7.3 female) ng/L.

Conclusions

Referring to WS/T 402-2012 establishment of reference intervals for clinical laboratory testing projects and CLSI (Clinical and Laboratory Standards Institute) C28-A3 documents and the joint expert consensus of ESC (European Society of Cardiology) and ACC (American College of Cardiology) in 2007, we established the reference interval of hs-cTnT concentration in children aged 0–14 years in Chongqing Nan’an district of China which can provide certain reference value for clinical diagnosis and treatment of myocarditis and myocardial (micro) injury in children.

Keywords:

• Children
• hs-cTnT
• reference interval
• nonparametric test
• bootstrap

Disclosure statement

The authors have declared that no conflict of interest exist.

Additional information

Funding

This work was supported by Medical research project in Nan'an District of Chongqing [2018-05], Yan Zhou’s research was supported by the National Natural Science Foundation of China [Grant No. 12071305].