Use of Data Mining in the Establishment of Reference Intervals for Albumin-Adjusted Calcium

IF 2.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Clinical Endocrinology Pub Date : 2025-06-04 DOI:10.1111/cen.15289

Esra Paydaş Hataysal, Ferruh Kemal İşman

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引用次数: 0

Abstract

Background

Calcium homeostasis is critical for numerous physiological functions, and while total calcium is commonly measured in clinical practice, albumin-adjusted calcium is widely used to account for protein binding, despite concerns about its accuracy and lack of standardized reference intervals. This study aims to establish a reliable reference range for albumin-adjusted calcium using real-world data from a high-volume tertiary care laboratory.

Methods

This study analyzed data from 33,159 individuals aged 18–80 years, selected from an initial population of 106,920 patients based on specific biochemical and clinical exclusion criteria. Statistical analysis involved outlier detection, partitioning, and calculation of age-specific reference intervals using the 2.5th and 97.5th percentiles.

Results

The study established age-stratified reference intervals for albumin-adjusted calcium (18–49 years: 2.17–2.55 mmol/L; 50–79 years: 2.20–2.61 mmol/L) and total calcium (18–49 years: 2.17–2.56 mmol/L; 50–79 years: 2.17–2.62 mmol/L).

Conclusions

Our study reveals that albumin-adjusted calcium reference intervals are age-dependent, with slightly higher upper limits (≈0.05 mmol/L) than traditionally used total calcium ranges, potentially reducing overdiagnosis of hypercalcemia. Further studies are needed to validate these reference intervals across different automated analyzers and diverse patient populations to ensure broader clinical applicability.

Abstract Image

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数据挖掘在建立白蛋白调整钙参考区间中的应用。

背景：钙稳态对许多生理功能至关重要，尽管在临床实践中通常测量总钙，但白蛋白调节钙被广泛用于解释蛋白质结合，尽管存在其准确性和缺乏标准化参考区间的问题。本研究旨在利用来自高容量三级护理实验室的真实数据建立可靠的白蛋白调整钙参考范围。方法：根据特定的生化和临床排除标准，本研究分析了从106920例患者的初始人群中选出的33159例18-80岁患者的数据。统计分析包括异常值检测、划分和使用2.5和97.5百分位计算年龄特定参考区间。结果：研究建立了白蛋白调节钙的年龄分层参考区间(18-49岁：2.17-2.55 mmol/L；50 ~ 79岁：2.20 ~ 2.61 mmol/L)、总钙(18 ~ 49岁：2.17 ~ 2.56 mmol/L；50 ~ 79岁：2.17 ~ 2.62 mmol/L)。结论：我们的研究表明，白蛋白调整钙参考区间与年龄相关，其上限（≈0.05 mmol/L）略高于传统使用的总钙范围，可能减少高钙血症的过度诊断。进一步的研究需要在不同的自动化分析仪和不同的患者群体中验证这些参考区间，以确保更广泛的临床适用性。

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

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.