Establishment of a paediatric age-related reference interval for the measurement of urinary total fractionated metanephrines

Ann Clin Biochem. 2011 Jan;48(Pt 1):41-4. doi: 10.1258/acb.2010.010062. Epub 2010 Dec 1.

Abstract

Introduction: Normetanephrine and metanephrine are intermediate metabolites of noradrenaline and adrenaline metabolism. To assess whether normetanephrine and metanephrine analysis may aid in the diagnosis of Neuroblastoma, a reference interval for these metabolites must first be established.

Aim: The overall aim of this study was to establish a paediatric age-related reference interval for the measurement of total fractionated metanephrines.

Methods: A total of 267 urine samples were analysed following acid hydrolysis. This releases the metanephrines from their sulphate-bound metabolites. The samples were analysed using reverse phase high-performance liquid chromatography with electro-chemical detection on a Gilson automated sequential trace enrichment of dialysate sample system.

Results: Data were analysed using Minitab Release version 14. Outliers were removed using the Dixon/Reed one-third rule. Partitioning of the age groups was achieved using Harris and Boyd's standard normal deviate test. Non-parametric analysis of the data was performed, followed by the establishment of the 2.5th and the 97.5th reference limits.

Conclusions: The established reference intervals are described in Table 2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Child
  • Child, Preschool
  • Chromatography, Reverse-Phase
  • Epinephrine / metabolism
  • Female
  • Humans
  • Infant
  • Male
  • Metanephrine / urine*
  • Neuroblastoma / diagnosis*
  • Neuroblastoma / urine
  • Norepinephrine / metabolism
  • Normetanephrine / urine*
  • ROC Curve
  • Reference Values
  • Statistics, Nonparametric

Substances

  • Normetanephrine
  • Metanephrine
  • Norepinephrine
  • Epinephrine