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Research Article| Volume 92, P97-101, October 2016

Reference values for 34 frequently used laboratory tests in 80-year-old men and women

      Highlights

      • Reference values are reported for 34 frequently used laboratory tests in 80-year-old men and women.
      • Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance.
      • Several of the reference interval limits were outside the 90% confidence interval of the reference intervals of Nordic Reference Interval Project (NORIP).

      Abstract

      Objectives

      Reference values are usually based on blood samples from healthy individuals in the age range 20–50 years. Most patients seeking health care are older than this reference population. Many reference intervals are age dependent and there is thus a need to have appropriate reference intervals also for elderly individuals.

      Methods

      We analyzed a group of frequently used laboratory tests in an 80-year-old population (n = 531, 266 females and 265 males). The 2.5th and 97.5th percentiles for these markers were calculated according to the International Federation of Clinical Chemistry guidelines on the statistical treatment of reference values.

      Results

      Reference values are reported for serum alanine transaminase (ALT), albumin, alkaline phosphatase, pancreatic amylase, apolipoprotein A1, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio, aspartate aminotransferase (AST), AST/ALT ratio, bilirubin, calcium, calprotectin, cholesterol, HDL-cholesterol, creatinine kinase (CK), creatinine, creatinine estimated GFR, C-reactive protein, cystatin C, cystatin C estimated GFR, gamma-glutamyltransferase (GGT), iron, iron saturation, lactate dehydrogenase (LDH), magnesium, phosphate, transferrin, triglycerides, urate, urea, zinc, hemoglobin, platelet count and white blood cell count. The upper reference limit for creatinine and urea was significantly increased while the lower limit for iron and albumin was decreased in this elderly population in comparison with the population in the Nordic Reference Interval Project (NORIP).

      Conclusions

      Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance. Several of the reference interval limits were outside the 90% confidence interval of NORIP.

      Keywords

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      References

        • Oeppen J.
        • Vaupel J.W.
        Broken limits to life expectancy.
        Science. 2002; 296: 1029-1031
        • Carlsson L.
        • Lind L.
        • Larsson A.
        Reference values for 27 clinical chemistry tests in 70-year- old males and females.
        Gerontology. 2010; 56: 259-265
        • Rustad P.
        • Felding P.
        • Lahti A.
        • Hyltoft P.P.
        Descriptive analytical data and consequences for calculation of common reference intervals in the Nordic Reference Interval Project 2000.
        Scand. J. Clin. Lab. Invest. 2004; 64: 343-370
        • Lind L.
        • Fors N.
        • Hall J.
        • Marttala K.
        • Stenborg A.
        A comparison of three different methods to evaluate endothelium-dependent vasodilation in the elderly: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.
        Arterioscler. Thromb. Vasc. Biol. 2005; 25: 2368-2375
        • Levey A.S.
        • Stevens L.A.
        • Schmid C.H.
        • Zhang Y.L.
        • Castro A.F.
        • Feldman H.I.
        • et al.
        A new equation to estimate glomerular filtration rate.
        Ann. Int. Med. 2009; 150: 604-612
        • Grubb A.
        • Horio M.
        • Hansson L.-O.
        • Björk J.
        • Nyman U.
        • Flodin M.
        • et al.
        Generation of a new cystatin C-based estimating equation for glomerular filtration rate by use of 7 assays standardized to the international calibrator.
        Clin. Chem. 2014; 60: 974-986
        • Solberg H.E.
        RefVal: a program implementing the recommendations of the International Federation of Clinical Chemistry on the statistical treatment of reference values.
        Comput. Methods Programs Biomed. 1995; 48: 247-256
        • Solberg H.E.
        The IFCC recommendation on estimation of reference intervals. The RefVal program.
        Clin. Chem. Lab. Med. 2004; 42: 710-714
        • CLSI Clinical Laboratory Standards Institute
        3rd ed. Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Guideline. vol. 28. Wayne, PA, USA2008 (C28–A3)
        • Lahti A.
        • Hyltoft Petersen P.
        • Boyd J.C.
        • Fraser C.G.
        • Jørgensen N.
        Objective criteria for partitioning Gaussian-distributed reference values into subgroups.
        Clin. Chem. 2002; 48: 338-352
        • Nordin G.
        • Mårtensson A.
        • Swolin B.
        • Sandberg S.
        • Christensen N.J.
        • Thorsteinsson V.
        • et al.
        A multicentre study of reference intervals for haemoglobin: basic blood cell counts and erythrocyte indices in the adult population of the Nordic countries.
        Scand. J. Clin. Lab. Invest. 2004; 64: 385-398
        • Rustad P.
        • Felding P.
        • Franzson L.
        • Kairisto V.
        • Lahti A.
        • Mårtensson A.
        • et al.
        The Nordic Reference Interval Project 2000: recommended reference intervals for 25 common biochemical properties.
        Scand. J. Clin. Lab. Invest. 2004; 64: 271-284
        • Ryden I.
        • Lind L.
        • Larsson A.
        Reference values of thirty-one frequently used laboratory markers for 75-year-old males and females.
        Ups. J. Med. Sci. 2012; 117: 264-272
        • Coresh J.
        • Turin T.C.
        • Matsushita K.
        • Sang Y.
        • Ballew S.H.
        • Appel L.J.
        • et al.
        CKD Prognosis Consortium. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality.
        JAMA. 2014; 311: 2518-2531
        • Forouzanfar M.H.
        • Alexander L.
        • Anderson H.R.
        • Bachman V.F.
        • Biryukov S.
        • Brauer M.
        • et al.
        Global regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013.
        Lancet. 2015; 386: 2287-2323
        • Helmersson-Karlqvist J.
        • Flodin M.
        • Hansson L.O.
        • Larsson A.
        The age related association is more pronounced for cystatin C estimated GFR than for creatinine estimated GFR in primary care patients.
        Clin. Biochem. 2013; 46: 1761-1763