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Age-specific reference values for cerebrospinal fluid protein concentrations in children in southern China.

ABSTRACT: Cerebrospinal fluid (CSF) protein values decline over the first few months of life as the infant's blood-CSF barrier matures. However, published studies have not reported CSF protein reference values of Chinese infants and differ in the reported rate, timing, and magnitude of this decline. The objective of this study was to determine reference intervals for CSF protein using available data of children in southern China. This retrospective study included infants who had a lumbar puncture (LP) performed in the Department of Pediatrics of Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan of an urban tertiary care children's hospital between January 1, 2008 and May 31, 2018. Infants with conditions suspected or known to cause elevated CSF protein concentrations were excluded. Of 3712 infants undergoing LP, 1043 (28.1%) met inclusion criteria. Results showed that there is an age-related decline in CSF protein concentration. The median CSF protein value was 62?mg/dL [interquartile range (IQR): 47-81?mg/dL] in infants aged 0 to 56 days (group 1). The 95th percentile values were 116?mg/dL for infants 0 to 28 days and 80?mg/dL for infants 29 to 56 days. The 95th percentile values by age category were as follows: ages 0 to 14 days, 117?mg/dL; ages 15 to 28 days, 107?mg/dL; ages 29 to 42 days, 96?mg/dL; and ages 43 to 56 days, 74?mg/dL. The median CSF protein value was 21?mg/dL (IQR: 16-31?mg/dL) in infants aged 2 months to <3 years (group 2). The 95th percentile values were 57?mg/dL for infants 2 to <6 months and 34?mg/dL for infants 6 to ?24 months. The 95th percentile values by age category were as follows: ages 2 to <3 months, 66?mg/dL; ages 3 to <4 months, 52?mg/dL; ages 4 to <5 months, 53?mg/dL; and ages 5 to <6 months, 42?mg/dL. We quantify the age-related decline in CSF protein concentrations among infants 2 years of age and younger and provide age-specific reference values. The values reported here can be used to interpret the results of LP in infants ?2 years of age.

SUBMITTER: Liu Z

PROVIDER: S-EPMC6799853 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Age-specific reference values for cerebrospinal fluid protein concentrations in children in southern China.

Liu Zhigang Z Jia Deqin D Dai Jieming J Zhou Xing X Qin Zhoulian Z Chen Liang L Zhang Jieyan J Chen Guohua G He Xiaocheng X Wan Ruipin R Ye Xingguang X

Medicine 20191001 41

Cerebrospinal fluid (CSF) protein values decline over the first few months of life as the infant's blood-CSF barrier matures. However, published studies have not reported CSF protein reference values of Chinese infants and differ in the reported rate, timing, and magnitude of this decline. The objective of this study was to determine reference intervals for CSF protein using available data of children in southern China. This retrospective study included infants who had a lumbar puncture (LP) per ...[more]

PMID: 31593118

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Project description:ObjectivesWristband activity trackers (accelerometers) could serve as a convenient monitoring tool to continuously quantify physical activity throughout the day. We aim to provide reference values for the use of these devices in healthy children.MethodsChildren were recruited at a local school and provided with activity trackers (Fitbit Charge 2). Pupils were instructed to wear devices during all normal daytime activities over a period of 11-15 days. Demographic data, total number of daily steps and heart rate were recorded. In addition, all children/parents were asked to complete a questionnaire providing information about daily physical routine (mode of transport to school, sporting activities as well as sport club memberships).ResultsThree hundred two children (54.6% boys; median age 8.7 years) participated in this prospective study. Median wearing time of the device was 12.1 h/day. Overall, the median daily total step count was 12,095. Median step counts/day were significantly higher in boys compared to girls (13,015 vs. 11,305 steps/day; p < 0.0001). In addition, step counts were significantly higher during the week, compared to weekend days. The effect of age on daily step count was found to be non-linear: the total daily step count increased from 6 to 8.5 years of age, while older children (aged >8.5 years) had lower step counts compared to the younger children. Significant predictors of the daily step count were male gender (+1,324.9 steps, p = 0.0008), mode of transportation to school (walking, bicycle, scooter: +865.5 steps p = 0.049), active membership in a sports club (+1,324.9 steps/day, p = 0.0008), and number of structured units of physical exercise performed (+336.5/per 45 min, p < 0.0001). Severe obesity was associated with a significant reduction in total daily step count (-3037.7 steps/day, p = 0.015).ConclusionOur prospective cohort study of healthy school children provides reference values for wristband accelerometers in normal individuals. In addition, it clarifies the effect of age, body weight and lifestyle on normal daily step counts in school children. This data should be helpful to judge the degree of physical limitation of patients compared to healthy peers.

Project description:BackgroundDyslipidemia is reported in 27 - 43% of children and adolescents with overweight/obesity and tracks into adulthood, increasing the risk of cardiovascular morbidity. Cut-off values for fasting plasma lipid concentrations are typically set at fixed levels throughout childhood. The objective of this cross-sectional study was to generate fasting plasma lipid references for a Danish/North-European White population-based cohort of children and adolescents, and investigate the prevalence of dyslipidemia in this cohort as well as in a cohort with overweight/obesity.MethodsA population-based cohort of 2141 (1275 girls) children and adolescents aged 6 - 19 (median 11.5) years was recruited from 11 municipalities in Denmark. Additionally, a cohort of children and adolescents of 1421 (774 girls) with overweight/obesity aged 6 - 19 years (median 11.8) was recruited for the study. Height, weight, and fasting plasma lipid concentrations were measured on all participants. Smoothed reference curves and percentiles were generated using the Generalized Additive Models for Location Scale and Shape package in the statistical software R.ResultsIn the population-based cohort, plasma concentrations of total cholesterol (TC) (P < 0.05), low-density lipoprotein cholesterol (LDL) (P < 0.005), and high-density lipoprotein cholesterol (HDL) (P < 0.005) were higher in the youngest compared to the oldest tertile. Fasting plasma levels of triglycerides (TG) (P < 0.005) increased with age in both sexes. In boys, non-HDL was lower in the oldest compared to the youngest tertile (P < 0.0005). Concentrations of TC, LDL, non-HDL, and TG were higher (P < 0.05), and HDL lower (P < 0.05) in the cohort with overweight/obesity in both sexes and for all ages except for TC in the youngest girls. The overall prevalence of dyslipidemia was 6.4% in the population-based cohort and 28.0% in the cohort with overweight/obesity. The odds ratio for exhibiting dyslipidemia in the cohort with overweight/obesity compared with the population-based cohort was 6.2 (95% CI: 4.9 - 8.1, P < 2*10-16).ConclusionFasting plasma lipid concentrations change during childhood and adolescence and differ with sex and age. Children and adolescents with obesity have increased concentrations of circulating lipids and exhibit an increased prevalence of dyslipidemia.Trial registrationThe study is part of The Danish Childhood Obesity Biobank; ClinicalTrials.gov ID-no.: NCT00928473 retrospectively registered on June 25th 2009.

Dataset Information

Age-specific reference values for cerebrospinal fluid protein concentrations in children in southern China.

Publications

Age-specific reference values for cerebrospinal fluid protein concentrations in children in southern China.

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