Reference intervals for deconjugated urine metanephrines by Bhattacharya analysis.

IF 2.1 4区医学 Q3 MEDICAL LABORATORY TECHNOLOGY

Annals of Clinical Biochemistry Pub Date : 2024-05-01 Epub Date: 2023-11-02 DOI:10.1177/00045632231204505

Bobby Li, Richard King, Christiaan Sies, Simon Thompson, Chris Florkowski

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Abstract

Background: Urine metanephrines are used to screen for phaeochromocytoma or paraganglioma (PPGL). Current reference intervals (RI) derived in healthy individuals are not age or sex-stratified, and lower than in hypertensive patients, leading to high false positive rates. This study aims to determine age and sex-stratified RI from a contingent screening population.

Methods: Patients with 24-h deconjugated urine metanephrines from 3/6/2010 to 27/8/2022 were included (2936 males, 5285 females), initially by liquid chromatography-electrochemical detection (LC-ECD) then liquid chromatography-tandem mass spectrometry (LC-MS/MS). Bhattacharya analysis was used after log transformation to determine age and sex-stratified RI for metanephrine excretion, normetanephrine excretion, metanephrine/creatinine and normetanephrine/creatinine ratios.

Results: Normetanephrine excretion increases with age (RI: males: 18-<30 years: <3.4 µmol/24 h, 30-<40 years: <3.7 µmol/24 h, 40+ years: <5.3 µmol/24 h; females: 18-<30 years: <2.7 µmol/24 h, 30-<40 years: <3.1 µmol/24 h, 40+ years: <3.7 µmol/24 h), while metanephrine excretion was consistent across adulthood (RI: males: 18+ years: <1.8 µmol/24 h; females: 18+ years: <1.2 µmol/24 h). However, normetanephrine/creatinine and metanephrine/creatinine increase steadily with age after early adulthood, likely due to a decrease in muscle mass, with females having higher normetanephrine/creatinine and metanephrine/creatinine ratios.

Conclusions: Age and sex-stratified RI were derived for metanephrine excretion, normetanephrine excretion, metanephrine/creatinine and normetanephrine/creatinine ratios. This is expected to reduce false positives while flagging most PPGL.

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Bhattacharya分析的去结合尿后肾的参考间隔。

背景：尿液中的后肾用于筛查嗜铬细胞瘤或副神经节瘤（PPGL）。健康个体的当前参考区间（RI）没有年龄或性别分层，并且低于高血压患者，导致高假阳性率。本研究旨在确定一个偶然筛查人群的年龄和性别分层RI。方法：纳入2010年3月6日至2022年8月27日期间24小时去偶联尿中后肾的患者（2936名男性，5285名女性），首先通过液相色谱-电化学检测（LC-ECD），然后通过液相层析-串联质谱（LC-MS/MS）。对数转换后使用Bhattacharya分析来确定年龄和性别分层RI的后肾排泄量、去甲肾上腺素排泄量、后肾/肌酸酐和去甲肾上腺素/肌酸酐比率。结果：去甲肾上腺素排泄量随年龄增加而增加（RI：男性：18结论：年龄和性别分层RI是根据去甲肾上腺素的排泄量、去甲肾上腺素/肌酐和去甲肾上腺素-肌酐比值得出的。这有望减少假阳性，同时标记大多数PPGL。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Clinical Biochemistry Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry

CiteScore

5.20

自引率

4.50%

发文量

期刊介绍： Annals of Clinical Biochemistry is the fully peer reviewed international journal of the Association for Clinical Biochemistry and Laboratory Medicine. Annals of Clinical Biochemistry accepts papers that contribute to knowledge in all fields of laboratory medicine, especially those pertaining to the understanding, diagnosis and treatment of human disease. It publishes papers on clinical biochemistry, clinical audit, metabolic medicine, immunology, genetics, biotechnology, haematology, microbiology, computing and management where they have both biochemical and clinical relevance. Papers describing evaluation or implementation of commercial reagent kits or the performance of new analysers require substantial original information. Unless of exceptional interest and novelty, studies dealing with the redox status in various diseases are not generally considered within the journal''s scope. Studies documenting the association of single nucleotide polymorphisms (SNPs) with particular phenotypes will not normally be considered, given the greater strength of genome wide association studies (GWAS). Research undertaken in non-human animals will not be considered for publication in the Annals. Annals of Clinical Biochemistry is also the official journal of NVKC (de Nederlandse Vereniging voor Klinische Chemie) and JSCC (Japan Society of Clinical Chemistry).