New reference intervals for endocrinological biomarkers in pediatric patients: What can we learn from the LIFE child study?

Objectives: We established reference intervals for serum concentrations of hormones from healthy pediatric subjects and investigated their associations with gender, body mass index (BMI), puberty and oral contraceptives (oC). Methods: We calculated reference intervals for the thyroid parameters thyr...

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Bibliographic Details
Main Authors: Kiess, W. (Author), Kratzsch, J. (Author), Poulain, T. (Author), Vogel, M. (Author)
Format: Article
Language:English
Published: Walter de Gruyter GmbH 2021
Subjects:
age
Online Access:View Fulltext in Publisher
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Summary:Objectives: We established reference intervals for serum concentrations of hormones from healthy pediatric subjects and investigated their associations with gender, body mass index (BMI), puberty and oral contraceptives (oC). Methods: We calculated reference intervals for the thyroid parameters thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and calcitonin (Ct); the bone markers osteocalcin, procolagen type 1 N-propeptide, and carboxy-terminal cross-linking telopeptide of type 1 collagen; the calciotropic hormones 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone and the steroids cortisol, progesterone, 17-hydroxyprogesterone, androstenedione, testosterone, estradiol, dehydroepiandrosterone sulfate and aldosterone. Up to 10,002 blood serum samples from 3,229 healthy children and adolescents (age interval: 3 months to 20 years) were measured. To investigate the associations between the hormone levels with age, sex, weight status and the role of puberty-based changes, the measurement and BMI values were transformed into standard deviation scores. Results: Most of the hormones depended on age- and gender. Puberty was linked to a, in part, temporary decrease in TSH, FT3 (for females), FT4, Ct, cortisol (for girls) and aldosterone (for boys) and peak in the bone marker and calciotropic hormones (excluding 25(OH)D) and nearly all remaining steroids. BMI had effects on the thyroid, bone, and calciotropic parameters, whereas oC led to increased cortisol, suppressed progesterone and estradiol values. Conclusions: Age- and gender-specific reference intervals are essential for the interpretation of pediatric patients' hormone measurements. Influencing factors as puberty, BMI, or oC should be taken into consideration for diagnosis and treatment monitoring. © 2021 Juergen Kratzsch et al., published by De Gruyter, Berlin/Boston.
ISBN:25679430 (ISSN)
DOI:10.1515/labmed-2021-0145