Plasma Concentrations of N-Terminal Brain Natriuretic Peptide in Healthy Children, Adolescents, and Young Adults: Effect of Age and Gender

Abstract

Children with congenital heart disease need adequate diagnostic classification regarding their cardiovascular status (CVS). N-terminal brain natriuretic peptide (N-BNP) plasma concentration indicates dysfunction of the cardiovascular system and guides decisions concerning treatment and prognosis. Reference values are established for adults, with age-dependent increasing values and higher values in women. To avoid misclassification concerning the CVS, a large group of healthy children and adolescents can be used show the relationship between gender, age, and N-BNP and these can serve as reference values. N-BNP was measured in 434 healthy subjects (240 female and 194 male) with ages ranging from 0 to 32 years without any cardiovascular disease or renal or hepatic impairment. Measurements were performed with an electrochemiluminescence immunoassay from Roche Diagnostics. Mean N-BNP decreased from 12.6 fmol/ml (0-9 years; n = 79) to 9.41 fmol/ml (10-14 years; n = 154) and in adolescents from 6.1 (15-19 years; n = 99) to 4.8 fmol/ml (> 19 years; n = 102) in adults (p < 0.05). Mean N-BNP concerning gender did not differ in any age group younger than 19 years. In contrast, the adult female group had 78% higher N-BNP compared to the male group (p < 0.05). There was a significant peak in N-BNP at the age of 12-14 years. This study shows that reference values for N-BNP differed profoundly in children compared to adults and were up to 260% higher in children without any gender difference. Therefore, these reference values will help to avoid CVS misclassification in children for the biomarker N-BNP.

Linkage disequilibrium analyses of natriuretic peptide precursor B locus reveal risk haplotype conferring high plasma BNP levels

“…CHF. Plasma BNP concentrations are higher in women than in men (23). In the present study, we showed that the NPPB gene is a key source of inter-individual variation in plasma BNP levels.…”

CLSI-based transference of CALIPER pediatric reference intervals to Beckman Coulter AU biochemical assays

“…This is particularly important for the pediatric population, 50 where the high rates of growth and development can alter the other-51 wise predicted levels of many analytes [1][2][3][4][5]. The use of adult reference 52 intervals for the interpretation of pediatric test results, a common prac-53 tice in many healthcare centers worldwide, is inappropriate, and 54 represents a major source of post-analytical error that can lead to 55 patient misdiagnoses and inappropriate treatment decisions [6][7][8][9]. 56 The lack of pediatric-specific reference intervals has remained a 57 major problem in the pediatric setting due to the difficulty in collecting 58 samples from healthy community children, particularly from young 59 children and infants, where only a small blood volume can be obtained.…”

A clinical importance of natriuretic peptides in pediatric practice

“…В противоположность этому сре-ди детей старше 10 лет наблюдали достоверное превы-шение концентраций BNP в группе мальчиков по срав-нению с девочками (12,1 и 5,1 пг/мл соответственно). Кроме того, плазменная концентрация BNP у девочек в пубертатном возрасте достоверно выше, чем в препу-бертатном (14,4 и 7,1 пг/мл соответственно) [34], что не противоречит другим работам [31,[35][36][37][38][39]. По данным статьи Nir A.…”