Abstract
Objectives
Glial fibrillary acidic protein (GFAP) in blood is an emerging biomarker of brain injury and neurological disease. Its clinical use in children is limited by the lack of a reference interval (RI). Thus, the aim of the present study was to establish an age-dependent continuous RI for serum GFAP in children.
Methods
Excess serum from routine allergy testing of 391 children, 0.4–17.9 years of age, was measured by a single-molecule array (Simoa) assay. A continuous RI was modelled using non-parametric quantile regression and presented both graphically and tabulated as discrete one-year RIs based on point estimates from the model.
Results
Serum GFAP showed a strong age-dependency with declining levels and variability from infants to adolescents. The estimated median level decreased 66 % from four months to five years of age and another 65 % from five years to 17.9 years of age. No gender difference was observed.
Conclusions
The study establishes an age-dependent RI for serum GFAP in children showing high levels and variability in the first years of life.
Funding source: Department of Clinical Biochemistry, Aarhus University Hospital
Acknowledgments
The authors sincerely thank Christian Gundesen for setting up the algorithm used to identify the relevant blood samples, and Charlotte Noerby Pedersen, Katrine Bremer and Arnaq Hammeken for organizing the analysis of blood samples and for excellent technical assistance.
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Research funding: The study was funded by the Department of Clinical Biochemistry, Aarhus University Hospital.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: According to Danish legislation, no approval from an Ethical Committee was required for the present study using anonymized biological material only.
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