Critical Reviews in Clinical Laboratory Sciences

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The Canadian laboratory initiative on pediatric

reference intervals: A CALIPER white paper

Khosrow Adeli, Victoria Higgins, Karin Trajcevski & Nicole White-Al Habeeb

To cite this article: Khosrow Adeli, Victoria Higgins, Karin Trajcevski & Nicole White-Al
Habeeb (2017) The Canadian laboratory initiative on pediatric reference intervals: A
CALIPER white paper, Critical Reviews in Clinical Laboratory Sciences, 54:6, 358-413, DOI:
10.1080/10408363.2017.1379945

To link to this article: https://doi.org/10.1080/10408363.2017.1379945

© 2017 The Author(s). Published by Informa

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Published online: 11 Oct 2017.

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CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES, 2017
VOL. 54, NO. 6, 358–413
https://doi.org/10.1080/10408363.2017.1379945

REVIEW ARTICLE

The Canadian laboratory initiative on pediatric reference intervals:

A CALIPER white paper
Khosrow Adelia,b, Victoria Higginsa,b, Karin Trajcevskia and Nicole White-Al Habeebb
a
The CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada; bDepartment of Laboratory
Medicine & Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Canada

ABSTRACT ARTICLE HISTORY

Laboratory investigations provide physicians with objective data to aid in disease diagnosis, clin- Received 26 July 2017
ical decision making, and patient follow up. Clinical interpretation of laboratory test results relies Revised 6 September 2017
heavily on the availability of appropriate population-based reference intervals (i.e. normative val- Accepted 12 September 2017
ues) or decision limits developed through clinical outcome studies. Although reference intervals
KEYWORDS
are fundamental to accurate laboratory test interpretation, and thus critically important to health- CALIPER; pediatric;
care, the need for sound evidence-based reference intervals has been largely overlooked, particu- reference intervals
larly in the pediatric population. In the field of pediatric laboratory medicine, accurate age- and
sex-specific reference intervals established using samples from healthy children and adolescents
have not been readily available, forcing many clinical laboratories to report adult reference inter-
vals with pediatric test results. When pediatric reference intervals are available, they have often
been established with a small sample size, inpatient or outpatient samples, outdated methodolo-
gies, and/or inappropriate statistical procedures. To address these unacceptable limitations, sev-
eral national and global initiatives have begun to close the critical evidence gaps in pediatric
reference intervals. Notably, the Canadian Laboratory Initiative on Pediatric Reference Intervals
(CALIPER) has made significant strides towards improving pediatric healthcare in Canada and glo-
bally. The present report is a white paper summarizing CALIPER, and provides a comprehensive
compendium of the data generated through this project over the past decade as a single
resource for clinical laboratory specialists, clinicians, and other healthcare workers. CALIPER
launched an outreach campaign in 2008 to recruit healthy community children and adolescents,
and developed a robust statistical algorithm, in accordance with the Clinical and Laboratory
Standards Institute (CLSI) guidelines, to develop accurate age- and sex-specific pediatric reference
intervals. The first CALIPER direct reference interval study was published in 2012, with age- and
sex-specific reference intervals reported for 40 common biochemical markers. To date, CALIPER
has collected health information and blood samples from over 9700 community children and
adolescents, and has established a comprehensive database of age- and sex-specific reference
intervals for over 100 biomarkers of pediatric disease. CALIPER has also performed a series of
transference and verification studies to expand the applicability of the CALIPER database to five
major analytical platforms, including Abbott, Beckman, Ortho, Roche, and Siemens. Through novel
knowledge translation initiatives, the CALIPER Reference Interval Database has been made freely
available online (www.caliperproject.ca) as well as on a mobile application (CALIPER Reference
App), and it is used by clinical laboratories across Canada, the United States, and globally. In add-
ition to establishing this comprehensive pediatric reference interval database, CALIPER has also
performed a series of sub-studies, including examining how reference intervals are affected by
pre-analytical factors (i.e. sample stability at specific storage conditions, fasting status and time of
sample collection), biological variation (i.e. intraindividual and interindividual biological variation,
reference change values), and ethnicity and pubertal development stage. In this white paper,
extensive tables of pediatric reference intervals are provided for easy reference for clinical labora-
tories worldwide. All data reported have been published in over 20 peer reviewed publications
and are also available through the CALIPER Reference Interval Database as well as the CALIPER
Reference App for mobile devices.

CONTACT Khosrow Adeli khosrow.adeli@sickkids.ca Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children, 555
University Avenue, Toronto, ON M5G 1X8 Canada
Referees Dr. Dennis Dietzen, Professor, Pathology & Immunology, Washington University School of Medicine, and Medical Director, Core Laboratory and
Metabolic Genetics Laboratory, St. Louis Children’s Hospital, St. Louis, MO, USA; Dr. Edgard Delvin, CHU Ste-Justine Research Centre, Gastroenterology,
Hepatology & Nutrition Division, Montreal, QC, Canada; Dr. Patricia Jones, Clinical Director, Chemistry and Metabolic Disease Labs, Children’s Medical
Center, and Professor of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
This article was originally published with errors, which have now been corrected in the online version. Please see Correction (http://dx.doi.org/10.1080/
10408363.2019.1704475)
ß 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-
nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed,
or built upon in any way.
 CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 359

Abbreviations: AFP: a-fetoprotein; ALT: alanine aminotransferase; ALP: alkaline phosphatase; anti-
CCP: anti-cyclic citrullinated peptide; anti-TPO: anti-thyroperoxidase; apoB-48: apolipoprotein B-48;
BAT: bioavailable testosterone; CA125: cancer antigen 125; CA15-3: cancer antigen 15-3; CALIPER:
Canadian Laboratory Initiative on Pediatric Reference Intervals; CHMS: Canadian Health Measures
Survey; CLSI: Clinical and Laboratory Standards Institute; CSCC: Canadian Society of Clinical
Chemists; EQA: external quality assurance; FAI: free androgen index; FSH: follicle-stimulating hor-
mone; FT: free testosterone; FT4: free thyroxine; GLP: glucagon-like peptide; HPLC: high-perform-
ance liquid chromatography; hs-cTnI: high sensitivity cardiac troponin I; IgG: immunoglobulin G;
IgM: immunoglobulin M; KT: knowledge translation; LC-MS/MS: liquid chromatography tandem
mass spectrometry; LH: luteinizing hormone; PTH: parathyroid hormone; PSA: prostate-specific
antigen; Q–Q: quantile–quantile; SHBG: sex-hormone binding globulin; TnI: troponin I; TSH: thy-
roid stimulating hormone; UPLC: ultra-performance liquid chromatography

Table of contents
1. Pediatric reference intervals ... ... ... ... ... ... ... ... ... ... 359
1.1. Reference intervals as health-associated
benchmarks ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 359
2. An overview of the CALIPER project ... ... ... ... ... ... 360
2.1. Pilot studies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 360
2.2. Direct reference interval studies ... ... ... ... ... ... ... 361
2.2.1. Common biochemical markers ... ... ... ... ...361
2.2.2. Biochemical and endocrine markers measured
by immunoassay ... ... ... ... ... ... ... ... ... ... ... ... ...362
2.2.3. Fertility hormones ... ... ... ... ... ... ... ... ... ... ...362
2.2.4. Steroid hormones ... ... ... ... ... ... ... ... ... ... ...363
2.2.5. Cancer markers ... ... ... ... ... ... ... ... ... ... ... ...363
2.2.6. Vitamins ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...363
2.2.7. Metabolic disease biomarkers ... ... ... ... ... ...363
2.2.8. Testosterone indices ... ... ... ... ... ... ... ... ... ...363
2.2.9. Other biochemical markers ... ... ... ... ... ... ...364
2.3. Knowledge translation strategies ... ... ... ... ... ... 364
3. CALIPER methodology for determination of direct
population-based reference intervals ... ... ... ... ... ... 364
3.1. Participant recruitment and defining a reference
population ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 364
3.2. Sample acquisition ... ... ... ... ... ... ... ... ... ... ...365
3.3. Selecting a reference sample group ... ... ... ... ... 365
3.4. Sample analysis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 365
3.5. Statistical analysis ... ... ... ... ... ... ... ... ... ... ... ... ... 365
4. CALIPER reference interval transference across ana-
lytical assays ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 366
5. CALIPER sub-studies ... ... ... ... ... ... ... ... ... ... ... ... ... ... 367
5.1. Preanalytical factors ... ... ... ... ... ... ... ... ... ... ... ... 367
5.2. Biological variation ... ... ... ... ... ... ... ... ... ... ... ... 367
5.3. Indirect versus direct approach to establishing ref-
erence intervals ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 368
5.4. Decision limits ... ... ... ... ... ... ... ... ... ... ... ... ... ... 368
5.5. Ethnicity and Tanner stage as additional
covariates ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 368
5.6. Canadian Health Measures Survey (CHMS)
collaboration ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 368
6. Current and future directions of CALIPER ... ... ... ... 369
6.1. Ethnic-specific reference intervals ... ... ... ... ... ... 369
6.2. Neonatal and infantile reference intervals ... ... 369
6.3. Fasting versus postprandial blood sampling ... 370
6.4. External quality assurance program ... ... ... ... ... 411
6.5. National and global knowledge translation ... 411
7. Pediatric reference interval tables – the CALIPER
database ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 411
Table 1. Pediatric reference intervals for the Abbott
ARCHITECT
Table 2. Pediatric reference intervals for the
Beckman AU
Table 3. Pediatric reference intervals for the
Beckman DxC
Table 4. Pediatric reference intervals for the
Beckman DxI
Table 5. Pediatric reference intervals for the Ortho
VITROS 5600
Table 6. Pediatric reference intervals for the Roche
cobas 6000
Table 7. Pediatric reference intervals for the Roche
Modular P
Table 8. Pediatric reference intervals for the Siemens
Vista
Table 9. Pediatric reference intervals for HPLC, UPLC,
and LC-MS/MS
Acknowledgements ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 411
Disclosure statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 411
References ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 411
1. Pediatric reference intervals
1.1. Reference intervals as health-associated
benchmarks
Reference intervals, sometimes referred to as
“normative” or “expected” values, refer to the set of val-
ues observed in a reference sample group defined by a
specific percentage, most commonly the central 95%
(Figure 1(A)) [1]. Reference intervals are fundamental
tools used by healthcare and laboratory professionals to
interpret patient laboratory test results, ideally enabling
differentiation of healthy and unhealthy individuals [2].
360 K. ADELI ET AL.
However, it is important to note that because popula-
tion-based reference intervals reflect the range of values
expected in a typical community population, laboratory
results that fall outside a reference interval do not neces-
sarily indicate a disease, but rather that additional med-
ical follow-up and/or treatment may be warranted. In
contrast, decision limits or cutoffs, rather than reference
intervals, associated with risk of specific adverse out-
comes are used for some laboratory tests, including lipid
parameters and bilirubin, to determine diagnosis or
treatment. Nevertheless, reference intervals are used
extensively in clinical practice to flag results outside the
defined normal range and inform physicians if a patient’s
result is normal or flagged as abnormal, potentially
requiring follow-up testing. Given the critical importance
to healthcare, it would be expected that accurate and
comprehensive reference intervals are readily available
to clinical laboratories and clinicians, but this is not
always the case. In fact, the necessity of sound evidence-
based reference intervals for accurate interpretation of
laboratory test results has been largely overlooked [3].
Instead, much of the effort in improving laboratory qual-
ity systems has focused on analytical assay performance.
Unfortunately, the tremendous efforts to improve assay
performance are wasted when inappropriate reference
intervals are used to interpret laboratory test results. This
problem is particularly apparent in the field of pediatric
laboratory medicine where age-specific reference inter-
vals based on healthy children and adolescents have not
been readily available. This has forced many clinical labo-
ratories to use adult reference intervals to interpret pedi-
atric test results, a practice that can lead to erroneous
and inaccurate test result interpretation. When pediatric
reference intervals are available for clinical use, they are
often severely limited, having been established using a
small sample size, outpatient or hospitalized patient
samples, outdated methodologies, or inappropriate stat-
istical procedures. These limitations are mainly due to
(A)
Reference Population Distribution
Number of Individuals Tested
Central 95%
Reference Interval
2.5th Percentile
Analyte Concentration
Figure 1. (A) Reference interval, defined as the central 95% of laboratory test results from a healthy, reference population. A rep-
resentative normal distribution for analyte concentration is shown. (B) Schematic of establishing reference intervals using the dir-
ect method. Adopted from CLSI EP28-A3c guideline [1].
challenges in obtaining a sufficient number of healthy
pediatric blood samples per partition (120 individuals as
per the Clinical and Laboratory Standards Institute (CLSI)
guidelines) necessary to establish robust reference inter-
vals for all partitions. The number of partitions required
for age- and sex-stratified reference intervals can be
quite numerous in the rapidly growing and changing
neonatal and pediatric population.
To close the critical evidence gaps in pediatric
laboratory medicine, several national and global initia-
tives over the past decade have begun to establish
pediatric reference intervals. Notably, the Canadian
Laboratory Initiative on Pediatric Reference Intervals
(CALIPER) was started by investigators at The Hospital
for Sick Children and University of Toronto as part of
the Canadian Society of Clinical Chemists (CSCC)
Pediatric Focus Group. This collaborative project among
seven pediatric hospitals across Canada (in St. John’s,
Montreal, Toronto, Ottawa, Hamilton, Saskatoon, and
Vancouver) has made significant strides towards
improving pediatric healthcare in Canada and globally.
2. An overview of the CALIPER project
2.1. Pilot studies
To both establish preliminary reference intervals for
select laboratory tests and help the CALIPER research
team gain practical experience with sample collection,
testing and statistical analysis, CALIPER performed sev-
eral pilot studies. Initially, 15 immunoassays and 24
chemistries were analyzed using the Abbott ARCHITECT
ci8200 platform (Abbott Instruments – Abbott
Diagnostics, Abbott Park, IL), with results published in
2009 [4]. Pediatric reference intervals were established
for five age partitions: birth–12 months, 1–5 years,
6–10 years, 11–14 years, and 15–18 years [4]. However,
these age partitions were chosen arbitrarily rather than
by using a statistical test, samples were collected from
(B) REFERENCE INDIVIDUALS
comprise a
REFERENCE POPULATION
from which is selected a
REFERENCE SAMPLE GROUP
on which are determined
REFERENCE VALUES
on which is observed a
REFERENCE DISTRIBUTION
from which are calculated
REFERENCE LIMITS
that may define
REFERENCE INTERVALS
97.5th Percentile

hospital outpatients rather than healthy community
children and adolescents, and the recommended num-
ber of 120 subjects per group was not always achieved,
particularly in the birth–12 month age partition [4].
Subsequently, four additional pilot studies were per-
formed. One study established reference intervals for 25
common analytes on the Ortho VITROS 5600 Integrated
System (Ortho Instruments – Ortho Clinical Diagnostics,
Rochester, NY) [5] and another established reference
intervals for 11 chemistries and 17 immunoassays using
Roche cobas 6000 assays (Roche Instruments – Roche
Diagnostics, Laval, QC, Canada) [6]. For both these stud-
ies, reference intervals were stratified by sex and five arbi-
trarily-chosen age groups. Due to sample size limitations,
the minimum CLSI requirement of 40 reference values
per partition was often not met, necessitating the merg-
ing of some age partitions. Additionally, these studies
were based on serum samples from pediatric outpatient
cohorts. CALIPER then determined reference intervals for
free thyroxine (FT4) and thyroid stimulating hormone
(TSH) for two predetermined age groups: 1–6 years and
7–17 years. However, these reference intervals were not
stratified by sex [7]. The final CALIPER pilot study estab-
lished age- and sex-specific reference intervals for five
bone markers [8]. The effects of body mass index, 25-
hydroxyvitamin D, and parathyroid hormone (PTH) on
the levels of these analytes were also investigated [8].
These initial pilot studies were imperative for assess-
ing the feasibility of the CALIPER project. Based on the
success of the pilot studies, the next step for CALIPER
was to initiate a major recruitment campaign to collect
health information and blood samples from healthy
children and adolescents. Directly sampling healthy
subjects from the community is essential to determine
accurate reference values from which robust reference
intervals can be established.
2.2. Direct reference interval studies
Population-based reference intervals can be established
using either an indirect or a direct sampling approach.
While indirect sampling uses laboratory values obtained
from a patient population to estimate reference intervals,
direct sampling involves the selection of healthy individ-
uals using defined inclusion and exclusion criteria [1].
Indirect sampling is more commonly used primarily
because it is more feasible and less costly. However, the
CLSI does not recommend the use of indirect sampling
due to the risk of including values from diseased individu-
als, which can lead to skewed, broader, and thus less sen-
sitive reference intervals [1]. Therefore, following its
initial pilot phase, CALIPER began to establish a compre-
hensive, robust pediatric reference interval database
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 361
using the direct sampling approach. CALIPER has been
extremely successful in overcoming the challenge of
obtaining a sufficient number of pediatric blood samples
by focusing on recruitment campaigns and blood collec-
tion clinics held in the community. To date, CALIPER has
created a biobank of healthy pediatric samples from over
9700 community children and adolescents. Using this
biobank, CALIPER has now established age- and sex-
specific reference intervals for over 100 biomarkers
including: common biochemical markers, proteins, lipids,
and enzymes [9], endocrine and other chemistry markers
[10,11], fertility hormones [12], steroid hormones [13],
cancer biomarkers [14], vitamins [15], metabolic disease
biomarkers [16], testosterone indices [17], and other bio-
chemical markers [17]. A summary of the findings from
each of these studies will be discussed here. The specific
methodology used by CALIPER to directly establish pedi-
atric reference intervals is explained in Section 3.
2.2.1. Common biochemical markers
The first comprehensive direct reference interval study
by CALIPER was published in 2012 and established age-
and sex-specific reference intervals for 40 biochemical
markers including common chemistry markers, enzymes,
lipids and lipoproteins, and proteins [9]. Serum samples
from a total of 1072 males and 1116 females (aged 0 to
<19 years) were analyzed using Abbott ARCHITECT
c8000 assays. This study highlighted the unique age-
and sex-related trends observed for each analyte
throughout childhood and adolescence. Overall, age-
related changes were found to be more common than
sex-associated differences, and only one analyte, lipase,
required no age or sex partitions. For creatinine, both
the Jaffe and enzymatic methods were used, with the
Jaffe method yielding higher results, as expected,
because the Jaffe assay is known to be more susceptible
to interfering substances. Albumin was also measured
using two methods (bromcresol green and bromcresol
purple); the values obtained using the bromcresol green
method were found to be slightly higher than bromcre-
sol purple. Additional interesting findings included ele-
vated values of several biochemical markers in the
neonatal period that rapidly declined after 2 weeks of
life. However, some markers were found to have the
opposite trend (i.e. low values in the neonatal period
that subsequently increased), while others were found
to have a wider reference interval during the neonatal
period. Overall, these findings highlight the profound
importance of establishing accurate reference intervals
specific to the neonatal period. Furthermore, as the
CALIPER cohort is composed of a multiethnic popula-
tion, a preliminary investigation into differences in
362 K. ADELI ET AL.
biochemical markers of major Canadian ethnic groups
was performed. Ethnic differences were demonstrated in
only seven of the 40 analytes including alanine amino-
transferase, amylase, immunoglobulin G, immunoglobu-
lin M, magnesium, total protein, and transferrin. Overall,
this foundational study established age- and sex-specific
reference intervals based on a large number of healthy
pediatric subjects of various ethnic backgrounds.
2.2.2. Biochemical and endocrine markers measured
by immunoassay
In 2013, CALIPER published reference intervals for an
additional 14 analytes, including endocrine and bio-
chemical markers measured by immunoassay [10].
Serum samples from 736 males and 746 females aged
0–<19 years were analyzed using Abbott ARCHITECT
i2000 assays. All 14 analytes required age and/or sex
partitioning, with several analytes, including a-fetopro-
tein (AFP), cortisol, ferritin, FT4, troponin I (TnI), and 25-
hydroxyvitamin D, requiring additional age partitioning
within the first year of life. Of these, AFP, TnI, and fer-
ritin had high concentrations in the neonatal period,
decreasing shortly after birth. Several other analytes,
including thyroid hormones, had high variance at birth
that was reduced by 1 year of age. The majority of ana-
lytes had wider reference intervals both during the neo-
natal period and adolescence, reflecting the influence
of growth and development on analyte concentrations.
Although transference studies can be performed to
make CALIPER reference intervals applicable to other
commonly used analytical platforms (discussed further in
Section 4), transference is contingent on a high correl-
ation of assay results between the two analytical systems
in question. As there is substantial platform-specific vari-
ation for immunoassays, CALIPER is continuing to per-
form direct reference interval studies for immunoassays
on all major analytical platforms. CALIPER established
age- and sex-specific reference intervals for 29 endocrine
and biochemical markers using the Beckman Coulter DxI
800 Immunoassay System and the Access 2 Immunoassay
System (Beckman Coulter instruments – Beckman Coulter
Canada Inc, Mississauga, ON, Canada), which were pub-
lished in 2016 [11]. Overall, similar dynamic patterns in
concentration observed using Abbott assays were
observed with Beckman assays. One notable difference
between the studies was the reduced number of age par-
titions in the Beckman study, likely due to fewer total par-
ticipant samples being used [(n ¼ 711 (11) versus
n ¼ 1234–1482 [10,12]] although exact sample sizes for
each assay vary for a number of reasons, including the
number of partitions required and the volume of the sam-
ple being used. Additionally, although concentration
patterns were largely comparable between Beckman and
Abbott assays, differences were observed in concentra-
tion ranges for a subset of analytes. This was particularly
evident for progesterone, follicle-stimulating hormone
(FSH), luteinizing hormone (LH) and PTH. More recently,
CALIPER established age- and sex-specific reference inter-
vals for 29 immunoassays using Ortho VITROS 5600 assays
[18]. Although the age and sex trends in analyte concen-
tration were similar to those observed using Abbott and
Beckman assays, some analyte concentrations were
higher or lower overall. This was particularly evident in
the neonatal population, with higher concentrations of
estradiol, progesterone, testosterone, and TSH obtained
when measured on Ortho compared with Abbott and
Beckman assays. These observations further highlight the
importance of establishing assay-specific reference inter-
vals for immunoassays.
2.2.3. Fertility hormones
In 2013, CALIPER established age-, sex-, and Tanner
stage-specific reference intervals for seven fertility hor-
mones [12]. In this study, serum samples from 1234
healthy children and adolescents aged 0–<19 years
were analyzed using Abbott ARCHITECT i2000 assays. All
fertility hormones demonstrated a complex pattern of
change in analyte concentration with age and between
sexes, requiring some degree of age and sex partition-
ing, except for prolactin, which required no sex parti-
tioning. Higher concentrations of estradiol,
progesterone, FSH, LH, testosterone, and prolactin were
observed in the neonatal and infantile period, requiring
age-specific references intervals within the first year of
life. Most of the hormones remained stable throughout
childhood, but marked increases observed in both sexes
during adolescence necessitated multiple age partitions.
Estradiol, FSH, LH, and progesterone increased to a
greater extent in female adolescents, while testosterone
increased to a greater extent in male adolescents. Sex-
hormone binding globulin (SHBG), on the other hand,
decreased after puberty. Tanner stage-specific reference
intervals were also established for these hormones. Each
Tanner stage was comprised of a wide range of ages for
both males and females. All seven hormones demon-
strated similar Tanner stage reference intervals to those
determined by sex and age partitioning. Estradiol, FSH,
LH, and progesterone markedly increased between
Tanner stages I and V in females, but to a lesser extent
in males. The opposite was observed for testosterone,
with markedly increased concentrations across Tanner
stages in males, but to a lesser extent in females.
Overall, this study highlighted the complex changes in
fertility hormones, particularly throughout adolescence,

and underscores the importance of reference intervals
specific for the pediatric population.
2.2.4. Steroid hormones
Using a total of 337 serum samples from healthy chil-
dren and adolescents, CALIPER established age- and
sex-specific reference intervals for a panel of eight ster-
oid hormones [13] measured using liquid chromatog-
raphy tandem mass spectrometry (LC-MS/MS). The
effect of diurnal variation on cortisol concentration was
examined further; cortisol levels were the highest
between 7 and 10 am, then declined to minimal levels
and spiked again between 12 and 3 pm, although this
peak did not reach the maximum levels seen in the early
morning. All subjects aged 0–<19 years were included
in the diurnal variation analysis of cortisol; however, its
concentration was elevated and more variable in the
newborn period, necessitating further studies of diurnal
variation for this specific age group. All steroid hor-
mones exhibited dynamic age- and sex-related trends.
Elevated and variable levels were noted for all steroid
hormones except progesterone. Furthermore, most ster-
oid hormones increased at the onset of puberty, with
androstenedione, testosterone, and progesterone exhib-
iting sex differences. Androstenedione and testosterone
were higher in males, while progesterone was higher in
females. Overall, this study reported pediatric reference
intervals for a newly developed LC-MS/MS method that
allows simultaneous measurement of eight steroid hor-
mones using a small volume of serum.
2.2.5. Cancer markers
CALIPER established age- and sex-specific reference
intervals for 11 cancer biomarkers using 400-700 serum
samples (depending on the analyte in question) from
healthy children in 2014 [14]. These samples were meas-
ured using Abbott ARCHITECT ci4100 assays. Significant
age-related trends were noted for all biomarkers, with
the exception of anti-thyroglobulin antibodies. Most
cancer markers were elevated in the first week of life,
followed by a rapid decrease in concentration that
remained relatively stable throughout childhood and
adolescence. The exceptions to this age-related trend
were the cancer antigens (CA125 and CA15–3) that
showed slightly lower concentrations in the first week
of life and relatively stable concentrations thereafter.
Lastly, both free and total prostate-specific antigen con-
centrations were very low and stable throughout the
pediatric age range, with elevated levels in males dur-
ing adolescence. Overall, this study highlighted the pro-
found differences observed between pediatric and
adult reference intervals for cancer biomarkers.
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 363
Pediatric cancer biomarker reference intervals are useful
not only in clinical practice but also in related research.
2.2.6. Vitamins
CALIPER established age- and sex-specific reference
intervals for vitamins A and E, as well as ratios of vita-
min E to cholesterol (E:C ratio) and triglycerides (E:T
ratio) in 2014 [15]. Serum samples from 307 and 330
healthy children and adolescents were collected for
vitamin A and vitamin E, respectively, and were meas-
ured using high performance liquid chromatography
(HPLC) with a C18 reverse-phase column. No sex parti-
tioning was required for either analyte. Vitamin A had
lower concentrations during the first year of life, then
gradually increased with age. Vitamin E required a wide
reference interval at birth, which subsequently nar-
rowed and remained stable throughout childhood and
adolescence. Both E:C and E:T ratios required no age or
sex partitioning, with one reference interval spanning
the 1–<19 year age range. Overall, these reference
intervals will be useful to monitor nutritional status in
the pediatric population and highlight the importance
of age-specific reference intervals.
2.2.7. Metabolic disease biomarkers
In 2016, 500 CALIPER samples were used to establish
age- and sex-specific reference intervals for 37 amino
acids using ultra-performance liquid chromatography
(UPLC), 32 acylcarnitines, as well as free and total carni-
tine using tandem mass spectrometry, and b-hydroxy-
butyrate and free fatty acids using Ortho VITROS 5.1
chemistry analyzer assays [16]. Over 50% of amino acids
and over 70% of acylcarnitines required partitioning of
reference intervals during the neonatal period.
Additionally, 21% of all analytes required partitioning
throughout adolescence, and half of these also required
sex partitioning. This publication was the first report of
sex-specific reference intervals for branched-chain
amino acids (valine, leucine, and isoleucine) as well as
free and total carnitine for the adolescent population.
All three of the branched-chain amino acids required
sex-specific reference intervals, with higher levels in
males than females in all cases. In addition, free and
total carnitine required sex-specific reference intervals
in adolescence, with higher levels in females compared
to males. Overall, this report will contribute to improved
detection and monitoring of several metabolic diseases
in the pediatric population.
2.2.8. Testosterone indices
CALIPER established reference intervals for calculated
testosterone indices including free testosterone (FT),
364 K. ADELI ET AL.
bioavailable testosterone (BAT), and the free androgen
index (FAI) based on a cohort of 471 healthy commu-
nity children and adolescents in 2015 [17]. Serum sam-
ples were measured for total testosterone, SHBG, and
albumin using Abbott ARCHITECT ci4100 assays. These
parameters were then used to calculate the testoster-
one indices. FT and BAT were calculated using the
Vermeulen equation [19], and FAI was calculated as the
percent ratio of total testosterone to SHBG. All calcu-
lated testosterone indices exhibited the same age- and
sex-related trends throughout the pediatric age range.
Levels were initially elevated in males after birth but
then declined, with males and females both having low
values throughout childhood. At the onset of puberty,
all testosterone indices increased to a significantly
greater extent in males compared to females.
2.2.9. Other biochemical markers
A total of 1917 healthy CALIPER samples were used to
measure serum concentrations of an additional 14 bio-
chemical markers using Abbott ARCHITECT ci4100
assays in 2015 [20]. Again, age- and sex-specific pedi-
atric reference intervals were subsequently established.
The majority of analytes exhibited dynamic changes in
concentration throughout the pediatric age range
and required at least three age partitions. Exceptions
to this included cholinesterase, cholinesterase-dibu-
caine number, and immunoglobulin E which required
only two age partitions, and a-1-antitrypsin which
required only one age partition. Additionally, eight of
the 14 markers, including C-peptide, ceruloplasmin,
and insulin, required age partitions within the first
year of life. Furthermore, levels of anti-cyclic citrulli-
nated peptide (anti-CCP) and anti-thyroperoxidase
(anti-TPO) were below the detection limit of the assay
for the entire pediatric age range. These findings fur-
ther emphasize the need for accurate pediatric refer-
ence intervals.
2.3. Knowledge translation strategies
The rigorous process undertaken to directly sample
pediatric subjects, perform accurate laboratory analysis,
and statistically analyze data to establish age- and sex-
specific reference intervals has resulted in a CALIPER
database of unprecedented richness, underscoring the
importance of research on circulating biomarkers. To
ensure that this database of invaluable information is
disseminated to healthcare and laboratory professio-
nals, CALIPER has begun several knowledge translation
(KT) initiatives. First, all reference intervals established
using the CALIPER cohort have been reported in peer--
reviewed publications, and have been presented at
regional and international conferences and workshops.
CALIPER has additionally used innovative KT tools
including the CALIPER web database (www.caliperpro-
ject.ca) and a novel mobile application of the database.
These technological tools allow physicians and labora-
tory personnel, as well as patients and parents, the
ability to view pediatric reference intervals and interpret
a child’s laboratory test results based on the CALIPER
database. Following the implementation of CALIPER KT
strategies, there has been widespread adoption and
implementation of CALIPER reference intervals by
hospitals across Canada, the United States, and globally.
CALIPER has been providing direct support to clinical
laboratories interested in implementing CALIPER refer-
ence intervals by providing healthy pediatric samples to
validate the CALIPER ranges on each local laboratory
system and by offering advice and support on data
analysis and implementation. A series of transference
studies to transfer CALIPER reference intervals from
Abbott assays (the instrument used initially to establish
CALIPER reference intervals) to assays on Beckman
Coulter, Ortho, Roche, and Siemens instruments
(Siemens Instruments – Siemens Healthcare Diagnostics
Inc, Newark, NJ) have also increased the wide-spread
applicability of the CALIPER database to laboratories
using any one of these major analytical platforms.
3. CALIPER methodology for determination of
direct population-based reference intervals
CALIPER has employed consistent procedures for
recruiting pediatric participants, collecting blood sam-
ples and health information, analyzing samples, and
statistical analysis to determine covariate-specific refer-
ence intervals. In this section, the methodology used by
CALIPER to establish direct population-based reference
intervals will be discussed.
3.1. Participant recruitment and defining a
reference population
A schematic of the relationship between a fit-for-pur-
pose laboratory reference interval and the population it
serves, as proposed by CLSI, is shown in Figure 1(B).
Importantly, it highlights that the first step of selecting
appropriate reference individuals largely determines the
quality of the resulting reference interval [21]. Reference
sample groups should be established by direct sampling
of reference individuals from the age group(s) of interest
using defined inclusion and exclusion criteria. Direct
sampling of an appropriately selected reference popula-
tion is the approach recommended by CLSI, and assess-
ment and subsequent exclusion of any unhealthy

individuals increases the validity and appropriateness of
the reference interval [1]. Reference individuals should
be as similar as possible to the target patient in all
aspects other than the disease or condition under
investigation.
3.2. Sample acquisition
CALIPER recruits healthy children and adolescents from
birth up to (but excluding) 19 years of age from the
greater Toronto and Hamilton areas. CALIPER commu-
nity clinics are held at schools, daycares, community
centers, and camps to collect blood samples from
healthy children and adolescents. In addition, CALIPER
occasionally recruits participants through information
booths at the Hospital for Sick Children and the
CALIPER website (www.caliperproject.ca). Interested
participants and their parents provide informed con-
sent by completing written consent forms, which are
verified by CALIPER staff and volunteers. Once con-
sented, participants complete a health questionnaire
about personal and family health history and demo-
graphic information. Anthropometric measurements,
including height, weight, and waist circumference, are
taken. Participants may also be asked to complete an
optional self-report on Tanner stage, a measure of sex-
ual maturity. Tanner staging, created by Marshall and
Tanner, is the 5-stage standard clinical system used to
describe normal pubertal development [22,23]. Blood
collection amount is determined by age, with partici-
pants aged 0–<1 year donating 3.5 ml of blood, partic-
ipants aged 1–<11 years donating 7 ml of blood and
participants aged 11–<19 years donating 10.5 ml of
blood. Blood samples are collected in serum separator
tubes, and are centrifuged, separated, and aliquoted
within 4 h of collection. Serum aliquots are kept frozen
in the CALIPER biobank at 80  C until testing.
CALIPER clinics are held throughout the year on morn-
ings, afternoons, or evenings. Therefore, while date
and time of blood collection are recorded, they do
vary across samples. Furthermore, fasting is not
required, although the time since the last meal is
recorded. As remuneration, participants are provided a
small cash gift, two volunteer hours (a minimum num-
ber of volunteer hours are mandatory for completion
of high school in Ontario), and a choice of a CALIPER
t-shirt, teddy bear, or storybook.
3.3. Selecting a reference sample group
Upon successful recruitment, a reference sample group
is selected to obtain reference values. CALIPER applies
several exclusion criteria to subjects when selecting
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 365
serum samples to analyze. Exclusion criteria include
pregnancy, history of chronic illness or metabolic dis-
ease, acute illness within the week preceding donation,
and use of prescription medication within the 2 weeks
preceding donation. Following the application of exclu-
sion criteria, the study population is randomly selected
from the remaining healthy participants while ensuring
a balanced age and sex distribution. Additionally, efforts
are made to ensure that the multiethnic composition of
the reference sample reflects that of the province of
Ontario as reported by the 2006 Ontario census
(Statistics Canada) [24].
3.4. Sample analysis
Batch analysis of samples to obtain reference values
is performed after selecting the reference sample
group’s frozen aliquots and thawing at 5  C.
Analytical methods are verified according to the
manufacturer’s instructions through preventive main-
tenance, function checks, calibration, and quality con-
trol. Calibration is performed after initial assay set-up
on the analyzer and each time a reagent kit with a
new lot number is used, as per manufacturer's
instructions. Quality control procedures are performed
for each assay prior to testing, for each day that
sample testing is conducted. Quality control results
are examined to ensure that the values are within
the recommended range for each control level. All
samples undergo automated interference analysis for
hemolysis, icterus, and turbidity. The majority of dir-
ect reference interval studies used assays performed
on Abbott ARCHITECT instrumentation, using the
c8000 [9], the i2000 [10,12], or the ci4100 [14,17,20]
model. Additional direct reference interval studies
used LC-MS/MS [13,16], HPLC [15], UPLC [16], or
Ortho VITROS 5.1 [16], Ortho VITROS 5600 [18] or
Beckman Coulter DxI or Access 2 assays [11].
3.5. Statistical analysis
CALIPER has published several reference interval stud-
ies (discussed in the preceding section) [9–17,20]. All
direct reference interval studies used a robust statis-
tical method based on CLSI guideline C28-A3 [1]
(Figure 2). Once the reference values of the analyte of
interest are determined through analysis of the refer-
ence sample group’s serum samples, scatterplots and
boxplots are created to visually inspect the data.
Extreme outliers are identified by visual inspection and
subsequently removed. Visual inspection of scatter-
plots of age against analyte concentration is used to
identify potential age and sex partitions. To determine
366 K. ADELI ET AL.
Visually Inspect data using scaerplots and boxplots and remove extreme outliers
Suspected age and sex parons idenfied through visual
inspecon stascally determined using the Harris & Boyd method
Data transformed using Box-Cox
transformaon for skewed parons
Remove outliers using Tukey method Remove outliers using adjusted Tukey
twice if normally distributed aer method twice if data sll skewed
Box-Cox transformaon aer Box-Cox transformaon
Calculate 2.5th and 97.5th percenles as lower
and upper reference limits, respecvely
Parons ≥ 120 sample size: Parons > 40 and < 120 sample size:
Calculate reference interval using Calculate reference interval using
nonparametric rank method Horn and Pesce robust method
Calculate 90% confidence intervals Calculate 90% confidence intervals
around the upper and lower limits around the upper and lower limits
using ranked observaons using percenle bootstrap esmates.
Figure 2. Robust statistical algorithm used by CALIPER to
establish pediatric reference intervals using the direct method
in accordance with CLSI EP28-A3c guideline [1].
if these partitions are statistically significant, the Harris
and Boyd method is used. This method suggests parti-
tioning if the ratio of the subgroup standard devia-
tions is 1.5 [25] and examines not only the
differences in means, but also the differences in stand-
ard deviation between two subgroups. Statistically sig-
nificant age and sex partitions are then reviewed with
clinical experts and partitions may be collapsed if
appropriate. Following confirmation or rejection of sus-
pected partitions, data in each individual partition are
transformed using the Box–Cox transformation method
to obtain a Gaussian distribution. Following transform-
ation, the normality of each partition is assessed using
quantile–quantile (Q–Q) plots and the Shapiro–Wilk
test. If data are normally distributed following trans-
formation, outliers are removed using the Tukey test
twice [26]. However, if data remain skewed following
transformation, outliers are removed using the
adjusted Tukey test twice, which accounts for skew-
ness of the data [27]. Following outlier removal, refer-
ence intervals are calculated for partitions with a
sample size 120 using the non-parametric rank
method [1], and corresponding 90% confidence inter-
vals around the upper and lower limits are calculated
using ranked observations. For partitions with a sam-
ple size >40 and <120, the robust method of Horn
and Pesce is used for reference interval calculation
[28], and 90% confidence intervals of the limits are cal-
culated using percentile bootstrap estimates.
Create scaerplot of method comparison data
Remove isolated extreme high and low data points
R2 < 0.70 0.70 < R2 < 0.95 R2 ≥ 0.95
Do not transfer
Determine the Determine equaon of
equaon of the line the line of best fit by
of best fit using linear regression using
Deming Regression the least squares
approach
Assess appropriateness of linear model with normally distributed data points
(Review Bland-Altman, standardized residual and Q-Q plots)
Linear model not appropriate Linear model appropriate and
and/or assumpons not met assumpons met
Do not transfer Use equaon to transfer original
reference interval to other assays
Determine 95% confidence intervals around upper and lower limits using the
root of mean square error
Verify the transferred reference intervals by calculang the percentage of healthy
sample results that fall within the transferred reference interval
Figure 3. Statistical algorithm used by CALIPER to transfer
and verify pediatric reference intervals in accordance with CLSI
EP28-A3c and EP9-A2 guidelines [1,33].
4. CALIPER reference interval transference
across analytical assays
When reference intervals are developed, they are spe-
cific to the method, instrument and population from
which they were established. Rather than creating direct
reference intervals for each laboratory, which would be
extremely costly and labor-intensive, reference intervals
can be transferred from one laboratory (or instrument)
to another. The majority of CALIPER reference intervals
originally established on Abbott assays have since been
transferred to assays from other manufacturers includ-
ing Beckman Coulter, Ortho, Roche, and Siemens
[29–32].
To transfer reference intervals, CALIPER uses an
approach in accordance with CLSI guidelines C28-A3c
and EP9-A2 [1,33] (Figure 3). First, 200 patient samples
are analyzed on the assay that was used to establish
the original reference interval (donor) and the assay
that the reference interval is being transferred to
(receiver). Samples are selected to ensure that a broad
age, sex, and concentration/activity range is covered for
each analyte under study.
Statistical analysis of the analyte concentrations
obtained from the donor and receiver assays are plotted
against each other. Similar to the method used for refer-
ence interval establishment, gross outliers are identified
and removed by visual inspection. The line of best fit is

determined differently according to the R2 value.
Simple linear regression using the least squares
approach is used if the R2  0.95, and Deming regres-
sion is used if 0.70 < R2 < 0.95. An R2 < 0.70 indicates
that the correlation between the instruments is inad-
equate and the reference interval cannot be transferred.
The appropriateness of the linear model is assessed
by examining Q–Q plots, standardized residual plots,
and Bland–Altman plots. The Q–Q plots are used to
assess the normality of the residuals, with points close
to the line y ¼ x representing a normal distribution. The
standardized residual plot was used to assess the ran-
dom distribution of residuals. If trends, patterns or clus-
ters were observed, the reference interval was
considered non-transferable. Then the Bland–Altman
plot was visually inspected, with a random distribution
of points, and absence of patterns, clustering or trends
suggestive of no bias in the relationship between the
methods. If all three graphical analyses demonstrate
acceptable method transference, the reference interval
is transferred using the line of best fit. Otherwise, trans-
ference is deemed inappropriate and a full reference
interval study must be performed. The 95% confidence
intervals around each reference limit are also deter-
mined. Lastly, the transferred reference intervals are
verified using approximately 100 healthy CALIPER refer-
ence samples. The percentage of reference sample val-
ues that fall within the transferred reference intervals
and confidence intervals are determined. The reference
interval is considered fully verified, according to CLSI
guidelines [33], if at least 90% of reference sample val-
ues fall within the transferred reference interval.
Individual clinical laboratories should verify CALIPER ref-
erence intervals on their local platform and population
prior to implementing them in clinical practice, as rec-
ommended by CLSI [1].
5. CALIPER sub-studies
In addition to establishing direct reference intervals and
transferring these to assays on other instruments,
CALIPER has performed several sub-studies, including
pre-analytical factors, biological variation, and the influ-
ence of ethnicity and sexual development on reference
values, to further examine areas of interest in pediatric
laboratory medicine. Each CALIPER sub-study is sum-
marized here and references to the detailed published
studies are provided as resources.
5.1. Preanalytical factors
Preanalytical factors examined by CALIPER include sam-
ple stability at specific storage conditions, fasting status
and time of sample collection. To examine the effect of
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 367
storage time on analyte concentration, CALIPER deter-
mined the stability of 57 chemistry, protein, and hor-
mone analytes stored at 80  C on assays for three
analytical instruments (Ortho VITROS Chemistry System,
Roche cobas Integra 400 Plus, and Siemens Immulite
2500) [34]. Samples from children and adolescents
(aged 0–18 years) were analyzed at monthly intervals
over 10–13 months and each aliquot was subjected to
one freeze-thaw cycle prior to analysis. The majority of
analytes examined in this study, with the exception of
PTH, were stable when stored at 80  C [34], suggest-
ing that with appropriate storage, most pediatric sam-
ples do not require immediate testing for reference
interval determination.
Given the challenging nature of obtaining fasting
samples from the pediatric population, particularly from
neonates, CALIPER analyzed the change in concentration
of 38 routine clinical chemistry analytes measured at
fasting, postprandial, and random time points through-
out the day [35]. This study was performed on 27
healthy children and adolescents (aged 4–<19 years) by
obtaining blood samples after an overnight fast, immedi-
ately after a mid-morning breakfast, 2 h after lunch, and
in the late afternoon [35]. Data analysis revealed signifi-
cant differences in concentration for a number of analy-
tes depending on fasting state and time of blood
sample collection [35]. These observations confirmed
some (e.g. triglycerides), but not all (e.g. glucose), analy-
tes known to vary between the fasting and postprandial
state, but also identified some chemistry markers not
previously known to significantly change with food
intake (e.g. immunoglobulins). It is important for pedia-
tricians to be aware of these physiological variations in
concentration for specific analytes to ensure informed
decisions are made when ordering fasting, random, post-
prandial, or serial sample testing for pediatric patients.
5.2. Biological variation
Understanding biological variation is important for both
patient monitoring and establishing quality specifica-
tions. CALIPER examined short-term biological variation
to further understand the physiological changes that
occur within and between pediatric subjects for 38
chemistry, lipid, enzyme, and protein analytes [36]. Four
blood samples were obtained from 29 healthy children
and adolescents (aged 4–<19 years) at different time
points throughout an 8-h day [36]. Within- and
between-person biological variation, reference change
values, and index of individuality were established for
these 38 analytes [36]. This study was the first to pro-
vide insight into physiological changes that occur
within and between pediatric individuals, which quality
368 K. ADELI ET AL.
specifications are suitable for a given test, and how and
when to use reference intervals appropriately.
5.3. Indirect versus direct approach to establishing
reference intervals
Reference intervals can be established indirectly using
historical patient data or directly by testing specimens
obtained from healthy subjects. CALIPER compared
these two approaches to validate the utility of the indir-
ect approach for use in the pediatric population [37].
CALIPER reference intervals established via direct ana-
lysis of healthy child and adolescent specimens were
compared with reference intervals established indirectly
from hospital-based data using the Hoffman approach.
The Hoffman approach aims to identify statistically the
portion of a large dataset that represents healthy indi-
viduals and to extrapolate these data to determine the
2.5th and 97.5th percentiles [38]. Indirect reference
intervals were generally wider than those calculated
using the CALIPER direct approach described in detail
above [37]. In fact, no reference intervals from the indir-
ect approach fell within the 90% confidence intervals
calculated with the direct approach [37]. Thus, although
the indirect approach removes the challenge of recruit-
ing healthy individuals, reference intervals robustly
established using the direct approach are more accurate
and applicable to clinical practice.
5.4. Decision limits
Some biochemical markers require the use of decision
limits rather than reference intervals. Decision limits are
determined from clinical outcome studies or consensus
statements based on expert opinion. When a test value
exceeds the decision limit, a diagnostic decision can be
made. This contrasts with a reference interval that sim-
ply defines the range encompassing 95% of values in a
healthy reference population. CALIPER has determined
and reported decision limits for two analytes: high sensi-
tivity cardiac troponin I (hs-cTnI) and direct bilirubin
[39,40]. The 99th percentile limit of hs-cTnI established
from a healthy reference population is used for diagnos-
ing acute myocardial infarction [41]. CALIPER explored
the potential sex and age effects on hs-cTnI concentra-
tions in a group of healthy children and adolescents
from the CALIPER cohort, as well as the effect of outlier
removal on deriving the 97.5th and 99th percentiles as
decision limits [39]. This study showed no apparent age
or sex difference in hs-cTnI concentration, but con-
cluded that a larger sample size than that recom-
mended by the IFCC (i.e. 300 healthy individuals to
establish a 99th percentile) is necessary to prevent
inappropriate removal of data as outliers [39]. Total and
direct bilirubin are routinely measured for the differen-
tial diagnosis of hyperbilirubinemias; however, clinical
decision limits for the interpretation of direct bilirubin in
pediatrics has been lacking [40]. Total and direct biliru-
bin were measured in serum samples from 795 healthy
children and adolescents; it was concluded that a direct
bilirubin concentration of 10 mmol/L or >10% of total
bilirubin should be used as a decision limit to consider
the presence of conjugated hyperbilirubinemia if total
bilirubin is also above the reference interval [40].
5.5. Ethnicity and Tanner stage as additional
covariates
Several covariates can influence the physiological con-
centrations of common laboratory markers. CALIPER has
thus far partitioned reference intervals by age and sex;
however, ethnicity and sexual development may also
substantially influence partitioning. Identifying analytes
which are significantly affected by these covariates is
essential to ensure appropriate reference intervals are
established and implemented across populations.
CALIPER has performed preliminary analysis on the
effect of ethnicity among major ethnic groups including
Caucasians, South Asians, East Asians, and others
[9,10,12]. Preliminary analysis of the influence of ethni-
city was performed in three direct CALIPER reference
interval studies that looked at biochemical markers [9],
fertility hormones [12], and other chemistry/endocrine
markers [10]. Across all three studies, approximately
26% of analytes were found to be significantly different
between at least two ethnic groups; however the clin-
ical significance was not assessed. CALIPER is currently
performing a more robust and comprehensive analysis
of the effect of ethnicity, which will be discussed in
“Current and future directions”. The effect of sexual
development on reference intervals was examined in
Konforte et al. to specifically determine how fertility
hormones differ depending on the stage of sexual
development [12]. Tanner stages were determined via
self-assessment of consenting CALIPER participants.
Tanner stage-specific reference intervals were estab-
lished for fertility hormones.
5.6. Canadian Health Measures Survey (CHMS)
collaboration
The CHMS, a program of Statistics Canada, is a nation-
wide initiative aimed at addressing limitations within
Canada’s health information system [42]. From March
2007 through February 2009, Cycle 1 of the CHMS col-
lected comprehensive health information and blood

samples from participants aged 6–<80 years. From
August 2009 through November 2011, Cycle 2 of the
CHMS collected data from participants aged
3–<80 years. Their sampling was representative of
approximately 96% of the Canadian population, and
excluded only full-time members of the Canadian
Forces, people living on reserves or in other aboriginal
settlements, residents of institutions, and people living
in certain remote regions. The survey consisted of an
initial in-home interview to collect general health infor-
mation (i.e. nutrition, smoking habits, and medical his-
tory), followed by a visit to a mobile examination center
to obtain biological samples and direct physical body
measures (i.e. height, weight, and blood pressure).
Additional details on design and sampling procedures
of the CHMS are available at www.statcan.gc.ca/chms.
Through collaboration with Statistics Canada,
CALIPER accessed data from the CHMS Cycles 1 and 2,
including approximately 12,000 Canadians aged
3–<80 years, to establish age- and sex-specific refer-
ence intervals. This collaboration has allowed CALIPER
to expand its reference interval database beyond the
pediatric population, to include adult and geriatric pop-
ulations and to determine how representative the
CALIPER cohort is of the greater Canadian population.
Additionally, as analysis of hematologic parameters
requires immediate analysis of whole blood samples,
which can be ogistically challenging and costly, this col-
laboration allowed CALIPER to establish reference inter-
vals for hematology markers for the first time. Overall,
CALIPER examined age- and sex-specific changes in bio-
chemical markers [43], endocrine and other chemistry
markers [44], and hematology markers [45], and subse-
quently established a comprehensive database of refer-
ence intervals for pediatric, adult, and geriatric
Canadian populations.
As the CALIPER cohort has primarily been recruited
from the greater Toronto and Hamilton regions and
the CHMS participants were recruited at 16 sites across
Canada, this provided a valuable opportunity to deter-
mine if the CALIPER cohort is similar to that of CHMS
and if it is representative of the Canadian population.
Extensive similarities were noted between CALIPER
and CHMS data, which confirms that the CALIPER
cohort is sufficiently representative of the Canadian
population. Figures 4 and 5 show scatterplots of over-
lapping CALIPER and CHMS data for alkaline phosphat-
ase (ALP) and creatinine, respectively. The majority of
analytes measured in both the CALIPER and CHMS
studies also showed great similarities in both concen-
tration and age- and sex-related trends. Additionally,
significant differences were noted between the pediat-
ric and adult population for several analytes, further
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 369
highlighting the importance of establishing reference
intervals specific for the pediatric population. Most
notable were the significant age-related trends
observed for creatinine and uric acid, in which concen-
trations were much lower in the pediatric compared
to adult population [43]. Similarly, ALP and phosphate
were also profoundly different across the age range,
with significantly higher values in the pediatric com-
pared to adult population [43]. These examples under-
score the potential risk to patient safety of using
inappropriate reference intervals, as patients can be
misclassified due to incorrect interpretation of labora-
tory test results.
6. Current and future directions of CALIPER
Despite CALIPER’s enormous contributions, significant
evidence gaps remain in the development of a truly
comprehensive national pediatric reference interval
database. CALIPER plans to continue its initiative to
close the remaining gaps and expand the current data-
base of pediatric reference intervals.
6.1. Ethnic-specific reference intervals
Numerous studies have demonstrated that the lack of
consideration for ethnicity-related differences in bio-
marker levels can pose serious risks to patient safety
[46–50]. Therefore, Canada’s multi-ethnic population
compels a careful examination of the influence of ethni-
city on pediatric reference intervals to minimize diag-
nostic error. To expand on the preliminary analysis of
the changes in biomarker concentration with ethnicity,
CALIPER is currently performing a more comprehensive
and robust analysis comparing serum concentrations of
laboratory biomarkers in four of the major Canadian
ethnic groups (i.e. Caucasians, East Asians, South Asians,
and Afro-Caribbeans). Ethnicity-specific reference inter-
vals may need to be calculated for a select group of
analytes that show statistically and clinically significant
differences among ethnic groups examined.
6.2. Neonatal and infantile reference intervals
The CALIPER pediatric reference interval database is
extremely robust from 1 to <19 years of age. However,
the data available for neonates and infants (0–<1 year)
are limited by the fact that these samples were col-
lected primarily from outpatient clinics. CALIPER is ini-
tiating a new project to address this limitation by
establishing comprehensive neonatal and infant refer-
ence intervals through recruitment of expectant
370 K. ADELI ET AL.

Figure 4. Scatterplots comparing alkaline phosphatase concentration obtained by the CALIPER [9] and CHMS [43] studies for
(A) the entire age range covered by both studies (0–<80 years), and (B) the overlapping age range (3–<19 years).

mothers to allow monitoring of circulating biomarkers 6.3. Fasting versus postprandial blood sampling
at birth and throughout the first year of life. This will
Collecting a blood sample in the fasting versus post-
provide, for the first time, complete reference interval
prandial (i.e. after a meal) state is an important pre-ana-
data for neonates and infants, which is currently
lytical consideration that can introduce test result
very limited due to difficulties in recruitment and blood
variability for a subset of analytes. While most analytes
collection in this age group. As CALIPER will be
are not altered following consumption of a meal, and,
recruiting pregnant women, trimester-specific reference
therefore, can be measured in a random sample (i.e.
intervals, which are also severely lacking, will be estab-
anytime, irrespective of hours fasted), some analytes are
lished. These planned studies will lead to improved
significantly altered in the postprandial state. Most not-
healthcare for neonates and infants in complex, tertiary
ably, laboratory tests used to diagnose metabolic
care pediatric centers, and pregnant women across
abnormalities, including type 2 diabetes and lipid
Canada.
 CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 371

Figure 5. Scatterplots comparing creatinine concentration obtained by the CALIPER [9] and CHMS [43] studies for (A) the entire
age range covered by both studies (0–<80 years), and (B) the overlapping age range (3–<19 years).

disorders (i.e. glucose and triglycerides, respectively)
vary considerably between the fasting and postprandial
states and, therefore, have traditionally required
patients to fast 10–12 h prior to blood sample collec-
tion. However, postprandial rather than fasting meas-
urements may be more informative of the metabolic
status of an individual and subsequently may be a more
valuable measure of metabolic abnormalities in insulin
resistant states and a better predictor of future cardio-
vascular disease risk. In fact, a prospective study of over
26,000 US women showed that non-fasting triglyceride
levels were independently associated with incident car-
diovascular events, while fasting levels showed little
independent relationship [51]. As several analytes
involved in lipid metabolism are secreted following a
meal and thus play physiological roles in the postpran-
dial state, it is not surprising that the postprandial pro-
file may be a valuable, or even superior, measure of
abnormal lipid metabolism. CALIPER plans to study the
postprandial profile of analytes involved in postprandial
lipid metabolism in adolescents by collecting blood
samples at fasting and specified time points following
ingestion of a high-fat drink. Analytes implicated in
postprandial lipid metabolism include intestinal apoli-
poprotein B-48 (apoB-48)-containing triglyceride-rich
lipoproteins (i.e. chylomicrons), which carry dietary
Table 1. Pediatric reference intervals for the Abbott ARCHITECT – age and sex specific.
372

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Alanine aminotransferase (ALT)a 0–<1 yr 348 5 U/L 33 U/L 5 U/L 33 U/L 348 5 U/L 33 U/L 5 U/L 33 U/L
1–<13 yrs 542 9 U/L 25 U/L 9 U/L 25 U/L 542 9 U/L 25 U/L 9 U/L 25 U/L
13–<19 yrs 180 8 U/L 22 U/L 8 U/L 22 U/L 162 9 U/L 24 U/L 9 U/L 24 U/L
K. ADELI ET AL.

ALT with pyridoxal phosphate (ALT ACT)a 0–<1 yr 177 5 U/L 51 U/L 5 U/L 51 U/L 177 5 U/L 51 U/L 5 U/L 51 U/L
1–<13 yrs 503 11 U/L 30 U/L 11 U/L 30 U/L 503 11 U/L 30 U/L 11 U/L 30 U/L
13–<19 yrs 171 8 U/L 24 U/L 8 U/L 24 U/L 173 10 U/L 33 U/L 10 U/L 33 U/L
Albumin G (bromcresol green)a 0–<15 d 191 33 g/L 45 g/L 3.3 g/dL 4.5 g/dL 191 33 g/L 45 g/L 3.3 g/dL 4.5 g/dL
15 d–<1 yr 156 28 g/L 47 g/L 2.8 g/dL 4.7 g/dL 156 28 g/L 47 g/L 2.8 g/dL 4.7 g/dL
1–<8 yrs 298 38 g/L 47 g/L 3.8 g/dL 4.7 g/dL 298 38 g/L 47 g/L 3.8 g/dL 4.7 g/dL
8–<15 yrs 388 41 g/L 48 g/L 4.1 g/dL 4.8 g/dL 388 41 g/L 48 g/L 4.1 g/dL 4.8 g/dL
15–<19 yrs 119 40 g/L 49 g/L 4.0 g/dL 4.9 g/dL 123 41 g/L 51 g/L 4.1 g/dL 5.1 g/dL
Albumin P (bromcresol purple)a 0–<15 d 182 28 g/L 41 g/L 2.8 g/dL 4.1 g/dL 182 28 g/L 41 g/L 2.8 g/dL 4.1 g/dL
15 d–<1 yr 153 25 g/L 46 g/L 2.5 g/dL 4.6 g/dL 153 25 g/L 46 g/L 2.5 g/dL 4.6 g/dL
1–<8 yrs 298 35 g/L 45 g/L 3.5 g/dL 4.5 g/dL 298 35 g/L 45 g/L 3.5 g/dL 4.5 g/dL
8–<15 yrs 390 37 g/L 47 g/L 3.7 g/dL 4.7 g/dL 390 37 g/L 47 g/L 3.7 g/dL 4.7 g/dL
15–<19 yrs 119 35 g/L 49 g/L 3.5 g/dL 4.9 g/dL 123 38 g/L 50 g/L 3.8 g/dL 5.0 g/dL
Alkaline phosphatase (ALP)a 0–<15 d 155 90 U/L 273 U/L 90 U/L 273 U/L 155 90 U/L 273 U/L 90 U/L 273 U/L
15 d–<1 yr 147 134 U/L 518 U/L 134 U/L 518 U/L 147 134 U/L 518 U/L 134 U/L 518 U/L
1–<10 yrs 391 156 U/L 369 U/L 156 U/L 369 U/L 391 156 U/L 369 U/L 156 U/L 369 U/L
10–<13 yrs 154 141 U/L 460 U/L 141 U/L 460 U/L 154 141 U/L 460 U/L 141 U/L 460 U/L
13–<15 yrs 68 62 U/L 280 U/L 62 U/L 280 U/L 66 127 U/L 517 U/L 127 U/L 517 U/L
15–<17 yrs 74 54 U/L 128 U/L 54 U/L 128 U/L 64 89 U/L 365 U/L 89 U/L 365 U/L
17–<19 yrs 40 48 U/L 95 U/L 48 U/L 95 U/L 54 59 U/L 164 U/L 59 U/L 164 U/L
Alpha-1-antitrypsin (A1AT)b 0–<19 yrs 675 1.10 g/L 1.81 g/L 110 mg/dL 181 mg/dL 675 1.10 g/L 1.81 g/L 110 mg/dL 181 mg/dL
Alpha-1-glycoprotein (AGP)b 0–<6 m 77 0.21 g/L 0.85 g/L 21 mg/dL 85 mg/dL 77 0.21 g/L 0.85 g/L 21 mg/dL 85 mg/dL
6 m–<5 yrs 259 0.48 g/L 2.01 g/L 48 mg/dL 201 mg/dL 259 0.48 g/L 2.01 g/L 48 mg/dL 201 mg/dL
5–<19 yrs 450 0.48 g/L 1.14 g/L 48 mg/dL 114 mg/dL 450 0.48 g/L 1.14 g/L 48 mg/dL 114 mg/dL
Alpha fetoprotein (AFP)c 0–<1 m 113 NA >2000 mg/L NA >2000 ng/mL 113 NA >2000 mg/L NA >2000 ng/mL
1–<6 m 44 10 mg/L 1359 mg/L 10 ng/mL 1359 ng/mL 44 10 mg/L 1359 mg/L 10 ng/mL 1359 ng/mL
6 m–<1 yr 57 0 mg/L 103 mg/L 0 ng/mL 103 ng/mL 57 0 mg/L 103 mg/L 0 ng/mL 103 ng/mL
1–<19 yrs 252 1 mg/L 35 mg/L 1 ng/mL 35 ng/mL 252 1 mg/L 35 mg/L 1 ng/mL 35 ng/mL
Amylasea 0–<15 d 129 3 U/L 10 U/L 3 U/L 10 U/L 129 3 U/L 10 U/L 3 U/L 10 U/L
15 d–<13 wks 62 2 U/L 22 U/L 2 U/L 22 U/L 62 2 U/L 22 U/L 2 U/L 22 U/L
13 wks–<1 yr 235 3 U/L 50 U/L 3 U/L 50 U/L 235 3 U/L 50 U/L 3 U/L 50 U/L
1–<19 yrs 938 25 U/L 101 U/L 25 U/L 101 U/L 938 25 U/L 101 U/L 25 U/L 101 U/L
Amylase, pancreatic (AmyP)b 0–<6 m 67 0.0 U/L 11.5 U/L 0.0 U/L 11.5 U/L 67 0.0 U/L 11.5 U/L 0.0 U/L 11.5 U/L
6 m–<1 yr 59 0.6 U/L 23.2 U/L 0.6 U/L 23.2 U/L 59 0.6 U/L 23.2 U/L 0.6 U/L 23.2 U/L
1–<2 yrs 59 2.6 U/L 27.8 U/L 2.6 U/L 27.8 U/L 62 0.7 U/L 22.5 U/L 0.7 U/L 22.5 U/L
2–<19 yrs 517 4.1 U/L 31.3 U/L 4.1 U/L 31.3 U/L 517 4.1 U/L 31.3 U/L 4.1 U/L 31.3 U/L
Androgen Index, Free (FAI)d 0–<1 yr 103 0.0 % 1.3 % 0.0 % 1.3 % 43 0.0 % 32.7 % 0.0 % 32.7 %
1–<9 yrs 103 0.0 % 1.3 % 0.0 % 1.3 % 68 0.0 % 0.6 % 0.0 % 0.6 %
9–<14 yrs 66 0.1 % 2.6 % 0.1 % 2.6 % 53 0.2 % 34.7 % 0.2 % 34.7 %
14–<19 yrs 65 0.6 % 6.5 % 0.6 % 6.5 % 60 3.6 % 83.3 % 3.6 % 83.3 %
Antistreptolysin-O (ASO)a 0–<6 m 63 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 63 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL
6 m–<1 yr 58 0 IU/mL 30 IU/mL 0 IU/mL 30 IU/mL 58 0 IU/mL 30 IU/mL 0 IU/mL 30 IU/mL
1–<6 yrs 127 0 IU/mL 104 IU/mL 0 IU/mL 104 IU/mL 127 0 IU/mL 104 IU/mL 0 IU/mL 104 IU/mL
6–<19 yrs 603 0 IU/mL 331 IU/mL 0 IU/mL 331 IU/mL 603 0 IU/mL 331 IU/mL 0 IU/mL 331 IU/mL
(continued)
Table 1. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Anti-cyclic citrullated protein (Anti-CCP)b 0–<19 yrs 147 <0.5 U/mL NA <0.5 U/mL NA 151 <0.5 U/mL NA <0.5 U/mL NA
Anti-thyroid peroxidase antibodies (anti-TPO)b 0–<19 yrs 147 <1.0 IU/mL NA <1.0 IU/mL NA 151 <1.0 IU/mL NA <1.0 IU/mL NA
Anti-thyroglobulin antibodies (Anti-Tg)c 0–<19 yrs 387 0.4 kIU/L 17.7 kIU/L 0.4 IU/mL 17.7 IU/mL 387 0.4 kIU/L 17.7 kIU/L 0.4 IU/mL 17.7 IU/mL
Apolipoprotein AI (Apo AI)a 0–<15 d 11 0.71 g/L 0.97 g/L 71 mg/dL 97 mg/dL 13 0.62 g/L 0.91 g/L 62 mg/dL 91 mg/dL
15 d–<1 yr 124 0.53 g/L 1.75 g/L 53 mg/dL 175 mg/dL 124 0.53 g/L 1.75 g/L 53 mg/dL 175 mg/dL
1–<14 yrs 574 0.80 g/L 1.64 g/L 80 mg/dL 164 mg/dL 574 0.80 g/L 1.64 g/L 80 mg/dL 164 mg/dL
14–<19 yrs 302 0.72 g/L 1.54 g/L 72 mg/dL 154 mg/dL 302 0.72 g/L 1.54 g/L 72 mg/dL 154 mg/dL
Apolipoprotein B (Apo B)a 0–<15 d 135 0.09 g/L 0.67 g/L 9 mg/dL 67 mg/dL 135 0.09 g/L 0.67 g/L 9 mg/dL 67 mg/dL
15 d–<1 yr 150 0.19 g/L 1.23 g/L 19 mg/dL 123 mg/dL 150 0.19 g/L 1.23 g/L 19 mg/dL 123 mg/dL
1–<6 yrs 196 0.41 g/L 0.93 g/L 41 mg/dL 93 mg/dL 196 0.41 g/L 0.93 g/L 41 mg/dL 93 mg/dL
6–<19 yrs 697 0.31 g/L 0.84 g/L 31 mg/dL 84 mg/dL 697 0.31 g/L 0.84 g/L 31 mg/dL 84 mg/dL
Aspartate aminotransferase (AST)a 0–<15 d 210 32 U/L 162 U/L 32 U/L 162 U/L 210 32 U/L 162 U/L 32 U/L 162 U/L
15 d–<1 yr 140 20 U/L 67 U/L 20 U/L 67 U/L 140 20 U/L 67 U/L 20 U/L 67 U/L
1–<7 yrs 262 21 U/L 44 U/L 21 U/L 44 U/L 262 21 U/L 44 U/L 21 U/L 44 U/L
7–<12 yrs 236 18 U/L 36 U/L 18 U/L 36 U/L 236 18 U/L 36 U/L 18 U/L 36 U/L
12–<19 yrs 208 13 U/L 26 U/L 13 U/L 26 U/L 197 14 U/L 35 U/L 14 U/L 35 U/L
Aspartate aminotransferase with pyridoxal 0–<15 d 145 23 U/L 186 U/L 23 U/L 186 U/L 145 23 U/L 186 U/L 23 U/L 186 U/L
phosphate (AST ACT)a 15 d–<1 yr 141 23 U/L 83 U/L 23 U/L 83 U/L 141 23 U/L 83 U/L 23 U/L 83 U/L
1–<7 yrs 225 26 U/L 55 U/L 26 U/L 55 U/L 225 26 U/L 55 U/L 26 U/L 55 U/L
7–<12 yrs 229 22 U/L 41 U/L 22 U/L 41 U/L 229 22 U/L 41 U/L 22 U/L 41 U/L
12–<19 yrs 209 17 U/L 33 U/L 17 U/L 33 U/L 194 18 U/L 40 U/L 18 U/L 40 U/L
Beta-2-microglobulin (B2M)b 0–<3 m 60 1.89 mg/L 5.81 mg/L 0.19 mg/dL 0.58 mg/dL 60 1.91 mg/L 4.70 mg/L 0.19 mg/dL 0.47 mg/dL
3 m–<2 yrs 174 1.31 mg/L 4.54 mg/L 0.13 mg/dL 0.45 mg/dL 174 1.31 mg/L 4.54 mg/L 0.13 mg/dL 0.45 mg/dL
2–<19 yrs 240 1.19 mg/L 2.25 mg/L 0.12 mg/dL 0.23 mg/dL 240 1.19 mg/L 2.25 mg/L 0.12 mg/dL 0.23 mg/dL
Bilirubin, directa 0–<15 d 171 5.7 mmol/L 12.1 mmol/L 0.33 mg/dL 0.71 mg/dL 171 5.7 mmol/L 12.1 mmol/L 0.33 mg/dL 0.71 mg/dL
15 d–<1 yr 108 0.8 mmol/L 5.2 mmol/L 0.05 mg/dL 0.30 mg/dL 108 0.8 mmol/L 5.2 mmol/L 0.05 mg/dL 0.30 mg/dL
1–<9 yrs 281 0.8 mmol/L 3.4 mmol/L 0.05 mg/dL 0.20 mg/dL 281 0.8 mmol/L 3.4 mmol/L 0.05 mg/dL 0.20 mg/dL
9–<13 yrs 181 0.8 mmol/L 5.0 mmol/L 0.05 mg/dL 0.29 mg/dL 181 0.8 mmol/L 5.0 mmol/L 0.05 mg/dL 0.29 mg/dL
13–<19 yrs 177 1.7 mmol/L 6.7 mmol/L 0.10 mg/dL 0.39 mg/dL 170 1.9 mmol/L 7.1 mmol/L 0.11 mg/dL 0.42 mg/dL
Bilirubin, totala 0–<15 d 166 3.3 mmol/L 283.8 mmol/L 0.19 mg/dL 16.60 mg/dL 166 3.3 mmol/L 283.8 mmol/L 0.19 mg/dL 16.60 mg/dL
15 d–<1 yr 245 0.8 mmol/L 11.7 mmol/L 0.05 mg/dL 0.68 mg/dL 245 0.8 mmol/L 11.7 mmol/L 0.05 mg/dL 0.68 mg/dL
1–<9 yrs 270 0.8 mmol/L 6.8 mmol/L 0.05 mg/dL 0.40 mg/dL 270 0.8 mmol/L 6.8 mmol/L 0.05 mg/dL 0.40 mg/dL
9–<12 yrs 135 0.8 mmol/L 9.4 mmol/L 0.05 mg/dL 0.55 mg/dL 135 0.8 mmol/L 9.4 mmol/L 0.05 mg/dL 0.55 mg/dL
12–<15 yrs 161 1.7 mmol/L 11.9 mmol/L 0.10 mg/dL 0.70 mg/dL 161 1.7 mmol/L 11.9 mmol/L 0.10 mg/dL 0.70 mg/dL
15–<19 yrs 219 1.7 mmol/L 14.4 mmol/L 0.10 mg/dL 0.84 mg/dL 219 1.7 mmol/L 14.4 mmol/L 0.10 mg/dL 0.84 mg/dL
Calciuma 0–<1 yr 259 2.13 mmol/L 2.74 mmol/L 8.5 mg/dL 11.0 mg/dL 259 2.13 mmol/L 2.74 mmol/L 8.5 mg/dL 11.0 mg/dL
1–<19 yrs 897 2.29 mmol/L 2.63 mmol/L 9.2 mg/dL 10.5 mg/dL 897 2.29 mmol/L 2.63 mmol/L 9.2 mg/dL 10.5 mg/dL
Cancer antigen 15-3 (CA15-3)c 0–<1 wk 49 3 kU/L 24 kU/L 3 U/mL 24 U/mL 49 3 kU/L 24 kU/L 3 U/mL 24 U/mL
1 wk–<1 yr 100 5 kU/L 33 kU/L 5 U/mL 33 U/mL 100 5 kU/L 33 kU/L 5 U/mL 33 U/mL
1–<19 yrs 252 4 kU/L 21 kU/L 4 U/mL 21 U/mL 252 4 kU/L 21 kU/L 4 U/mL 21 U/mL
Cancer antigen 19-9 (CA19-9)c 0–<1 yr 122 <2 kU/L 64 kU/L <2 U/mL 64 U/mL 122 <2 kU/L 64 kU/L <2 U/mL 64 U/mL
1–<19 yrs 251 <2 kU/L 41 kU/L <2 U/mL 41 U/mL 251 <2 kU/L 41 kU/L <2 U/mL 41 U/mL
Cancer antigen 125 (CA125)c 0–<4 m 55 2 kU/L 22 kU/L 2 U/mL 22 U/mL 55 2 kU/L 22 kU/L 2 U/mL 22 U/mL
4 m–<5 yrs 190 8 kU/L 33 kU/L 8 U/mL 33 U/mL 190 8 kU/L 33 kU/L 8 U/mL 33 U/mL
5–<11 yrs 178 5 kU/L 30 kU/L 5 U/mL 30 U/mL 178 5 kU/L 30 kU/L 5 U/mL 30 U/mL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

11–<19 yrs 127 6 kU/L 39 kU/L 6 U/mL 39 U/mL 123 5 kU/L 28 kU/L 5 U/mL 28 U/mL
(continued)
373
Table 1. Continued
374

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Carbon dioxidea 0–<15 d 178 5 mmol/L 20 mmol/L 5 mmol/L 20 mmol/L 178 5 mmol/L 20 mmol/L 5 mmol/L 20 mmol/L
15 d–<1 yr 147 10 mmol/L 24 mmol/L 10 mmol/L 24 mmol/L 147 10 mmol/L 24 mmol/L 10 mmol/L 24 mmol/L
1–<5 yrs 146 14 mmol/L 24 mmol/L 14 mmol/L 24 mmol/L 146 14 mmol/L 24 mmol/L 14 mmol/L 24 mmol/L
K. ADELI ET AL.

5–<15 yrs 488 17 mmol/L 26 mmol/L 17 mmol/L 26 mmol/L 488 17 mmol/L 26 mmol/L 17 mmol/L 26 mmol/L
15–<19 yrs 122 17 mmol/L 26 mmol/L 17 mmol/L 26 mmol/L 121 18 mmol/L 28 mmol/L 18 mmol/L 28 mmol/L
Carcinoembryonic antigen (CEA)c 0–<1 wk 44 8.1 mg/L 62.0 mg/L 8.1 ng/mL 62.0 ng/mL 44 8.1 mg/L 62.0 mg/L 8.1 ng/mL 62.0 ng/mL
1 wk–<2 yrs 136 <0.5 mg/L 4.7 mg/L <0.5 ng/mL 4.7 ng/mL 136 <0.5 mg/L 4.7 mg/L <0.5 ng/mL 4.7 ng/mL
2–<19 yrs 516 <0.5 mg/L 2.6 mg/L <0.5 ng/mL 2.6 ng/mL 516 <0.5 mg/L 2.6 mg/L <0.5 ng/mL 2.6 ng/mL
Ceruloplasmin (Cerul)b 0–<2 m 49 74 mg/L 237 mg/L 7 mg/dL 24 mg/dL 49 74 mg/L 237 mg/L 7 mg/dL 24 mg/dL
2–<6 m 63 135 mg/L 329 mg/L 14 mg/dL 33 mg/dL 63 135 mg/L 329 mg/L 14 mg/dL 33 mg/dL
6 m–<1 yr 71 137 mg/L 389 mg/L 14 mg/dL 39 mg/dL 71 137 mg/L 389 mg/L 14 mg/dL 39 mg/dL
1–<8 yrs 229 217 mg/L 433 mg/L 22 mg/dL 43 mg/dL 229 217 mg/L 433 mg/L 22 mg/dL 43 mg/dL
8–<14 yrs 196 205 mg/L 402 mg/L 21 mg/dL 40 mg/dL 196 205 mg/L 402 mg/L 21 mg/dL 40 mg/dL
14–<19 yrs 79 208 mg/L 432 mg/L 21 mg/dL 43 mg/dL 82 170 mg/L 348 mg/L 17 mg/dL 35 mg/dL
Cholesterola 0–<15 d 101 1.20 mmol/L 3.23 mmol/L 46 mg/dL 125 mg/dL 47 1.10 mmol/L 2.82 mmol/L 42 mg/dL 109 mg/dL
15 d–<1 yr 152 1.66 mmol/L 6.13 mmol/L 64 mg/dL 237 mg/dL 152 1.66 mmol/L 6.13 mmol/L 64 mg/dL 237 mg/dL
1–<19 yrs 931 2.90 mmol/L 5.40 mmol/L 112 mg/dL 208 mg/dL 931 2.90 mmol/L 5.40 mmol/L 112 mg/dL 208 mg/dL
Cholinesterasea 0–<15 d 48 4421 U/L 9722 U/L 4421 U/L 99722 U/L 48 4421 U/L 9722 U/L 4421 U/L 99722 U/L
15 d–<1 yr 119 5182 U/L 16027 U/L 5182 U/L 16027 U/L 119 5182 U/L 16027 U/L 5182 U/L 16027 U/L
1–<17 yrs 751 7769 U/L 15206 U/L 7769 U/L 15206 U/L 751 7769 U/L 15206 U/L 7769 U/L 15206 U/L
17–<19 yrs 37 7511 U/L 10904 U/L 7511 U/L 10904 U/L 42 8186 U/L 12639 U/L 8186 U/L 12639 U/L
Cholinesterase dibucaine number (ChEDi)b 0–<1 m 100 797 U/L 2478 U/L 1 kU/L 2 kU/L 100 797 U/L 2478 U/L 1 kU/L 2 kU/L
1 m –<19 yrs 611 1523 U/L 3280 U/L 2 kU/L 3 kU/L 611 1523 U/L 3280 U/L 2 kU/L 3 kU/L
Cobalamine 5 d–<1 yr 257 191 pmol/L 1163 pmol/L 259 pg/mL 1576 pg/mL 257 191 pmol/L 1163 pmol/L 259 pg/mL 1576 pg/mL
1–<9 yrs 267 209 pmol/L 1190 pmol/L 283 pg/mL 1613 pg/mL 267 209 pmol/L 1190 pmol/L 283 pg/mL 1613 pg/mL
9–<14 yrs 374 186 pmol/L 830 pmol/L 252 pg/mL 1125 pg/mL 374 186 pmol/L 830 pmol/L 252 pg/mL 1125 pg/mL
14–<17 yrs 217 180 pmol/L 655 pmol/L 244 pg/mL 888 pg/mL 217 180 pmol/L 655 pmol/L 244 pg/mL 888 pg/mL
17–<19 yrs 127 150 pmol/L 599 pmol/L 203 pg/mL 811 pg/mL 127 150 pmol/L 599 pmol/L 203 pg/mL 811 pg/mL
Complement component 3 (C3)a 0–<15 d 155 0.50 g/L 1.21 g/L 50 mg/dL 121 mg/dL 155 0.50 g/L 1.21 g/L 50 mg/dL 121 mg/dL
15 d–<1 yr 151 0.51 g/L 1.60 g/L 51 mg/dL 160 mg/dL 151 0.51 g/L 1.60 g/L 51 mg/dL 160 mg/dL
1–<19 yrs 877 0.83 g/L 1.52 g/L 83 mg/dL 152 mg/dL 877 0.83 g/L 1.52 g/L 83 mg/dL 152 mg/dL
Complement component 4 (C4)a 0–<1 yr 353 0.07 g/L 0.30 g/L 7 mg/dL 30 mg/dL 353 0.07 g/L 0.30 g/L 7 mg/dL 30 mg/dL
1–<19 yrs 864 0.13 g/L 0.37 g/L 13 mg/dL 37 mg/dL 864 0.13 g/L 0.37 g/L 13 mg/dL 37 mg/dL
Cortisole 2–<15 d 120 13 nmol/L 340 nmol/L 0.5 mg/dL 12.3 mg/dL 120 13 nmol/L 340 nmol/L 0.5 mg/dL 12.3 mg/dL
15 d–<1 yr 292 14 nmol/L 458 nmol/L 0.5 mg/dL 16.6 mg/dL 292 14 nmol/L 458 nmol/L 0.5 mg/dL 16.6 mg/dL
1–<9 yrs 284 48 nmol/L 297 nmol/L 1.7 mg/dL 10.8 mg/dL 284 48 nmol/L 297 nmol/L 1.7 mg/dL 10.8 mg/dL
9–<14 yrs 359 61 nmol/L 349 nmol/L 2.2 mg/dL 12.7 mg/dL 359 61 nmol/L 349 nmol/L 2.2 mg/dL 12.7 mg/dL
14–<17 yrs 201 77 nmol/L 453 nmol/L 2.8 mg/dL 16.4 mg/dL 201 77 nmol/L 453 nmol/L 2.8 mg/dL 16.4 mg/dL
17–<19 yrs 125 97 nmol/L 506 nmol/L 3.5 mg/dL 18.3 mg/dL 125 97 nmol/L 506 nmol/L 3.5 mg/dL 18.3 mg/dL
C-Peptideb 0–<1 yr 214 70 pmol/L 1448 pmol/L 0.2 ng/mL 4.4 ng/mL 214 70 pmol/L 1448 pmol/L 0.2 ng/mL 4.4 ng/mL
1–<6 yrs 160 116 pmol/L 1477 pmol/L 0.4 ng/mL 4.5 ng/mL 160 116 pmol/L 1477 pmol/L 0.4 ng/mL 4.5 ng/mL
6–<19 yrs 407 257 pmol/L 2241 pmol/L 0.8 ng/mL 6.8 ng/mL 407 257 pmol/L 2241 pmol/L 0.8 ng/mL 6.8 ng/mL
C-reactive protein – high sensitivity (CRP)a 0–<15 d 139 0.3 mg/L 6.1 mg/L 0.3 mg/L 6.1 mg/L 139 0.3 mg/L 6.1 mg/L 0.3 mg/L 6.1 mg/L
15 d–<15 yrs 653 0.1 mg/L 1.0 mg/L 0.1 mg/L 1.0 mg/L 653 0.1 mg/L 1.0 mg/L 0.1 mg/L 1.0 mg/L
15–<19 yrs 196 0.1 mg/L 1.7 mg/L 0.1 mg/L 1.7 mg/L 196 0.1 mg/L 1.7 mg/L 0.1 mg/L 1.7 mg/L
(continued)
Table 1. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Creatinine, enzymatica 0–<15 d 147 29 mmol/L 82 mmol/L 0.32 mg/dL 0.92 mg/dL 147 29 mmol/L 82 mmol/L 0.32 mg/dL 0.92 mg/dL
15 d–<2 yrs 168 9 mmol/L 32 mmol/L 0.10 mg/dL 0.36 mg/dL 168 9 mmol/L 32 mmol/L 0.10 mg/dL 0.36 mg/dL
2–<5 yrs 155 18 mmol/L 38 mmol/L 0.20 mg/dL 0.43 mg/dL 155 18 mmol/L 38 mmol/L 0.20 mg/dL 0.43 mg/dL
5–<12 yrs 321 27 mmol/L 54 mmol/L 0.31 mg/dL 0.61 mg/dL 321 27 mmol/L 54 mmol/L 0.31 mg/dL 0.61 mg/dL
12–<15 yrs 183 40 mmol/L 72 mmol/L 0.45 mg/dL 0.81 mg/dL 183 40 mmol/L 72 mmol/L 0.45 mg/dL 0.81 mg/dL
15–<19 yrs 161 43 mmol/L 74 mmol/L 0.49 mg/dL 0.84 mg/dL 151 55 mmol/L 96 mmol/L 0.62 mg/dL 1.08 mg/dL
Creatinine, Jaffea 0–<15 d 158 37 mmol/L 93 mmol/L 0.42 mg/dL 1.05 mg/dL 158 37 mmol/L 93 mmol/L 0.42 mg/dL 1.05 mg/dL
15 d–<1 yr 130 28 mmol/L 47 mmol/L 0.31 mg/dL 0.53 mg/dL 130 28 mmol/L 47 mmol/L 0.31 mg/dL 0.53 mg/dL
1–<4 yrs 121 34 mmol/L 48 mmol/L 0.39 mg/dL 0.55 mg/dL 121 34 mmol/L 48 mmol/L 0.39 mg/dL 0.55 mg/dL
4–<7 yrs 146 39 mmol/L 57 mmol/L 0.44 mg/dL 0.65 mg/dL 146 39 mmol/L 57 mmol/L 0.44 mg/dL 0.65 mg/dL
7–<12 yrs 234 46 mmol/L 61 mmol/L 0.52 mg/dL 0.69 mg/dL 234 46 mmol/L 61 mmol/L 0.52 mg/dL 0.69 mg/dL
12–<15 yrs 184 50 mmol/L 71 mmol/L 0.57 mg/dL 0.80 mg/dL 184 50 mmol/L 71 mmol/L 0.57 mg/dL 0.80 mg/dL
15–<17 yrs 77 52 mmol/L 76 mmol/L 0.59 mg/dL 0.86 mg/dL 68 58 mmol/L 92 mmol/L 0.65 mg/dL 1.04 mg/dL
17–<19 yrs 88 53 mmol/L 78 mmol/L 0.60 mg/dL 0.88 mg/dL 86 61 mmol/L 97 mmol/L 0.69 mg/dL 1.10 mg/dL
Cystatin C (CYSC)b 0–<1 m 100 1.49 mg/L 2.85 mg/L 1.49 mg/L 2.85 mg/L 100 1.49 mg/L 2.85 mg/L 1.49 mg/L 2.85 mg/L
1–<5 m 46 1.01 mg/L 1.92 mg/L 1.01 mg/L 1.92 mg/L 46 1.01 mg/L 1.92 mg/L 1.01 mg/L 1.92 mg/L
5 m–<1 yr 98 0.75 mg/L 1.53 mg/L 0.75 mg/L 1.53 mg/L 98 0.75 mg/L 1.53 mg/L 0.75 mg/L 1.53 mg/L
1–<2 yrs 56 0.60 mg/L 1.20 mg/L 0.60 mg/L 1.20 mg/L 53 0.77 mg/L 1.85 mg/L 0.77 mg/L 1.85 mg/L
2–<19 yrs 529 0.62 mg/L 1.11 mg/L 0.62 mg/L 1.11 mg/L 529 0.62 mg/L 1.11 mg/L 0.62 mg/L 1.11 mg/L
Dehydroepiandrosterone sulfate (DHEA-S)b 0–<2 m 115 28.9 mmol/L >40.7 mmol/L 11.1 mg/mL >15.7 mg/mL 115 28.9 mmol/L >40.7 mmol/L 11.1 mg/mL >15.7 mg/mL
2–<6 m 69 0.7 mmol/L 15.6 mmol/L 0.3 mg/mL 6.0 mg/mL 69 0.7 mmol/L 15.6 mmol/L 0.3 mg/mL 6.0 mg/mL
6 m–<1 yr 77 0.2 mmol/L 4.8 mmol/L 0.1 mg/mL 1.8 mg/mL 77 0.2 mmol/L 4.8 mmol/L 0.1 mg/mL 1.8 mg/mL
1–<6 yrs 78 0.1 mmol/L 3.0 mmol/L 0.0 mg/mL 1.2 mg/mL 78 0.1 mmol/L 3.0 mmol/L 0.0 mg/mL 1.2 mg/mL
6–<9 yrs 108 0.1 mmol/L 4.1 mmol/L 0.1 mg/mL 1.6 mg/mL 108 0.1 mmol/L 4.1 mmol/L 0.1 mg/mL 1.6 mg/mL
9–<13 yrs 133 0.9 mmol/L 7.3 mmol/L 0.3 mg/mL 2.8 mg/mL 133 0.9 mmol/L 7.3 mmol/L 0.3 mg/mL 2.8 mg/mL
13–<16 yrs 98 1.5 mmol/L 12.5 mmol/L 0.6 mg/mL 4.8 mg/mL 98 1.5 mmol/L 12.5 mmol/L 0.6 mg/mL 4.8 mg/mL
16–<19 yrs 45 4.0 mmol/L 15.5 mmol/L 1.5 mg/mL 5.9 mg/mL 46 3.4 mmol/L 18.2 mmol/L 1.3 mg/mL 7.0 mg/mL
Estradiolf (age partitions) 15 d–<1 yr 197 NA 92 pmol/L NA 25 pg/mL 197 NA 92 pmol/L NA 25 pg/mL
1–<9 yrs 261 NA 37 pmol/L NA 10 pg/mL
9–<11 yrs 81 NA 176 pmol/L NA 48 pg/mL
11–<12 yrs 87 NA 345 pmol/L NA 94 pg/mL
12–<14 yrs 83 39 pmol/L 631 pmol/L 11 pg/mL 172 pg/mL
14–<19 yrs 175 NA 936 pmol/L NA 255 pg/mL
1–<11 yrs 331 NA 46 pmol/L NA 13 pg/mL
11–<13 yrs 81 NA 95 pmol/L NA 26 pg/mL
13–<15 yrs 80 NA 102 pmol/L NA 28 pg/mL
15–<19 yrs 137 NA 141 pmol/L NA 38 pg/mL
Estradiolf (Tanner stage partitions) I 22 NA 74 pmol/L NA 20 pg/mL 27 NA 68 pmol/L NA 19 pg/mL
II 23 NA 96 pmol/L NA 26 pg/mL 38 NA 67 pmol/L NA 18 pg/mL
III 26 NA 317 pmol/L NA 86 pg/mL 23 NA 76 pmol/L NA 21 pg/mL
IV 57 49 pmol/L 517 pmol/L 13 pg/mL 141 pg/mL 47 NA 128 pmol/L NA 35 pg/mL
V 30 69 pmol/L 762 pmol/L 19 pg/mL 208 pg/mL 16 64 pmol/L 126 pmol/L 17 pg/mL 34 pg/mL
Ferritine 4–<15 d 127 224 pmol/L 1611 pmol/L 100 ng/mL 717 ng/mL 127 224 pmol/L 1611 pmol/L 100 ng/mL 717 ng/mL
15 d–<6 m 172 31 pmol/L 1454 pmol/L 14 ng/mL 647 ng/mL 172 31 pmol/L 1454 pmol/L 14 ng/mL 647 ng/mL
6 m–<1 yr 140 19 pmol/L 409 pmol/L 8 ng/mL 182 ng/mL 140 19 pmol/L 409 pmol/L 8 ng/mL 182 ng/mL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

1–<5 yrs 126 12 pmol/L 224 pmol/L 5 ng/mL 100 ng/mL 126 12 pmol/L 224 pmol/L 5 ng/mL 100 ng/mL
5–<14 yrs 497 31 pmol/L 177 pmol/L 14 ng/mL 79 ng/mL 497 31 pmol/L 177 pmol/L 14 ng/mL 79 ng/mL
(continued)
375
Table 1. Continued
376

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
14–<19 yrs 151 12 pmol/L 152 pmol/L 6 ng/mL 67 ng/mL
14–<16 yrs 65 28 pmol/L 186 pmol/L 13 ng/mL 83 ng/mL
16–<19 yrs 88 25 pmol/L 386 pmol/L 11 ng/mL 172 ng/mL
K. ADELI ET AL.

e
Folate, serum 5 d–<1 yr 235 23.9 nmol/L NA 10.6 ng/mL NA 235 23.9 nmol/L NA 10.6 ng/mL NA
1–<3 yrs 50 8.7 nmol/L NA 3.9 ng/mL NA 50 8.7 nmol/L NA 3.9 ng/mL NA
3–<6 yrs 90 27.0 nmol/L NA 11.9 ng/mL NA 90 27.0 nmol/L NA 11.9 ng/mL NA
6–<8 yrs 70 29.7 nmol/L NA 13.1 ng/mL NA 70 29.7 nmol/L NA 13.1 ng/mL NA
8–<12 yrs 284 25.9 nmol/L NA 11.4 ng/mL NA 284 25.9 nmol/L NA 11.4 ng/mL NA
12–<14 yrs 144 27.0 nmol/L NA 11.9 ng/mL NA 144 27.0 nmol/L NA 11.9 ng/mL NA
14–<19 yrs 342 18.0 nmol/L NA 7.9 ng/mL NA 342 18.0 nmol/L NA 7.9 ng/mL NA
Folicle stimulating hormone (FSH)f (age 30 d–<1 yr 118 0.4 IU/L 10.4 IU/L 0.4 mIU/mL 10.4 mIU/mL 142 0.1 IU/L 2.4 IU/L 0.1 mIU/mL 2.4 mIU/mL
partitions) 1–<9 yrs 119 0.4 IU/L 5.5 IU/L 0.4 mIU/mL 5.5 mIU/mL
9–<11 yrs 74 0.4 IU/L 4.2 IU/L 0.4 mIU/mL 4.2 mIU/mL
11–<19 yrs 275 0.3 IU/L 7.8 IU/L 0.3 mIU/mL 7.8 mIU/mL
1–<5 yrs 67 NA 0.9 IU/L NA 0.9 mIU/mL
5–<10 yrs 118 NA 1.6 IU/L NA 1.6 mIU/mL
10–<13 yrs 110 0.4 IU/L 3.9 IU/L 0.4 mIU/mL 3.9 mIU/mL
13–<19 yrs 202 0.8 IU/L 5.1 IU/L 0.8 mIU/mL 5.1 mIU/mL
Folicle stimulating hormone (FSH)f (Tanner stage I 22 0.63 IU/L 4.05 IU/L 0.63 mIU/mL 4.05 mIU/mL 21 NA 1.52 IU/L NA 1.52 mIU/mL
partitions) II 26 0.27 IU/L 5.76 IU/L 0.27 mIU/mL 5.76 mIU/mL 34 NA 2.98 IU/L NA 2.98 mIU/mL
III 30 0.10 IU/L 7.19 IU/L 0.10 mIU/mL 7.19 mIU/mL 22 NA 6.24 IU/L NA 6.24 mIU/mL
IV 61 0.30 IU/L 6.95 IU/L 0.30 mIU/mL 6.95 mIU/mL 51 0.58 IU/L 5.05 IU/L 0.58 mIU/mL 5.05 mIU/mL
V 36 0.41 IU/L 8.59 IU/L 0.41 mIU/mL 8.59 mIU/mL 71 0.79 IU/L 7.19 IU/L 0.79 mIU/mL 7.19 mIU/mL
Gamma-glutamyl transferase (GGT)a 0–<15 d 171 23 U/L 219 U/L 23 U/L 219 U/L 171 23 U/L 219 U/L 23 U/L 219 U/L
15 d–<1 yr 141 8 U/L 127 U/L 8 U/L 127 U/L 141 8 U/L 127 U/L 8 U/L 127 U/L
1–<11 yrs 438 6 U/L 16 U/L 6 U/L 16 U/L 438 6 U/L 16 U/L 6 U/L 16 U/L
11–<19 yrs 444 7 U/L 21 U/L 7 U/L 21 U/L 444 7 U/L 21 U/L 7 U/L 21 U/L
Haptoglobina 0–<15 d 64 0.00 g/L 0.10 g/L 0 mg/dL 10 mg/dL 64 0.00 g/L 0.10 g/L 0 mg/dL 10 mg/dL
15 d–<1 yr 129 0.07 g/L 2.21 g/L 7 mg/dL 221 mg/dL 129 0.07 g/L 2.21 g/L 7 mg/dL 221 mg/dL
1–<12 yrs 444 0.07 g/L 1.63 g/L 7 mg/dL 163 mg/dL 444 0.07 g/L 1.63 g/L 7 mg/dL 163 mg/dL
12–<19 yrs 418 0.07 g/L 1.79 g/L 7 mg/dL 179 mg/dL 418 0.07 g/L 1.79 g/L 7 mg/dL 179 mg/dL
High-density lipoprotein cholesterol (HDL-C)a 0–<15 d 147 0.40 mmol/L 1.08 mmol/L 15 mg/dL 42 mg/dL 147 0.40 mmol/L 1.08 mmol/L 15 mg/dL 42 mg/dL
15 d–<1 yr 146 0.30 mmol/L 1.85 mmol/L 12 mg/dL 71 mg/dL 146 0.30 mmol/L 1.85 mmol/L 12 mg/dL 71 mg/dL
1–<4 yrs 97 0.84 mmol/L 1.63 mmol/L 32 mg/dL 63 mg/dL 97 0.84 mmol/L 1.63 mmol/L 32 mg/dL 63 mg/dL
4–<13 yrs 407 0.92 mmol/L 1.88 mmol/L 36 mg/dL 73 mg/dL 407 0.92 mmol/L 1.88 mmol/L 36 mg/dL 73 mg/dL
13–<19 yrs 203 0.83 mmol/L 1.86 mmol/L 32 mg/dL 72 mg/dL 197 0.82 mmol/L 1.77 mmol/L 32 mg/dL 68 mg/dL
Homocysteine, total (tHcy)e 5 d–<1 yr 266 2.9 mmol/L 10.0 mmol/L 0.39 mg/mL 1.35 mg/mL 266 2.9 mmol/L 10.0 mmol/L 0.39 mg/mL 1.35 mg/mL
1–<7 yrs 196 2.8 mmol/L 7.6 mmol/L 0.37 mg/mL 1.03 mg/mL 196 2.8 mmol/L 7.6 mmol/L 0.37 mg/mL 1.03 mg/mL
7–<12yrs 279 3.4 mmol/L 8.5 mmol/L 0.46 mg/mL 1.14 mg/mL 279 3.4 mmol/L 8.5 mmol/L 0.46 mg/mL 1.14 mg/mL
12–<15 yrs 104 4.1 mmol/L 10.4 mmol/L 0.55 mg/mL 1.40 mg/mL 95 4.7 mmol/L 10.4 mmol/L 0.64 mg/mL 1.41 mg/mL
15–<19 yrs 116 4.9 mmol/L 11.9 mmol/L 0.67 mg/mL 1.61 mg/mL 113 5.5 mmol/L 13.4 mmol/L 0.74 mg/mL 1.81 mg/mL
Human epididymis protein 4 (HE4)c 0–<1 wk 44 159 pmol/L 618 pmol/L 159 pmol/L 618 pmol/L 44 159 pmol/L 618 pmol/L 159 pmol/L 618 pmol/L
1 wk–<6 m 68 56 pmol/L 178 pmol/L 56 pmol/L 178 pmol/L 68 56 pmol/L 178 pmol/L 56 pmol/L 178 pmol/L
6 m–<2 yrs 92 31 pmol/L 99 pmol/L 31 pmol/L 99 pmol/L 92 31 pmol/L 99 pmol/L 31 pmol/L 99 pmol/L
2–<10 yrs 181 27 pmol/L 70 pmol/L 27 pmol/L 70 pmol/L 181 27 pmol/L 70 pmol/L 27 pmol/L 70 pmol/L
10–<19 yrs 233 23 pmol/L 62 pmol/L 23 pmol/L 62 pmol/L 233 23 pmol/L 62 pmol/L 23 pmol/L 62 pmol/L
(continued)
Table 1. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Immunoglobulin A (IgA)a 0–<1 yr 116 0.0 g/L 0.3 g/L 1 mg/dL 29 mg/dL 116 0.0 g/L 0.3 g/L 1 mg/dL 29 mg/dL
1–<3 yrs 48 0.0 g/L 0.9 g/L 4 mg/dL 90 mg/dL 48 0.0 g/L 0.9 g/L 4 mg/dL 90 mg/dL
3–<6 yrs 109 0.3 g/L 1.5 g/L 26 mg/dL 147 mg/dL 109 0.3 g/L 1.5 g/L 26 mg/dL 147 mg/dL
6–<14 yrs 372 0.5 g/L 2.2 g/L 47 mg/dL 221 mg/dL 372 0.5 g/L 2.2 g/L 47 mg/dL 221 mg/dL
14–<19 yrs 290 0.5 g/L 2.9 g/L 53 mg/dL 287 mg/dL 290 0.5 g/L 2.9 g/L 53 mg/dL 287 mg/dL
Immunoglobulin E (IgE)b 0–<7 yrs 334 <25 IU/mL 440 IU/mL <25 kIU/L 440 kIU/L 334 <25 IU/mL 440 IU/mL <25 kIU/L 440 kIU/L
7–<19 yrs 365 <25 IU/mL 450 IU/mL <25 kIU/L 450 kIU/L 365 <25 IU/mL 450 IU/mL <25 kIU/L 450 kIU/L
Immunoglobulin G (IgG)a 0–<15 d 203 3.2 g/L 14.0 g/L 320 mg/dL 1407 mg/dL 203 3.2 g/L 14.0 g/L 320 mg/dL 1407 mg/dL
15 d–<1 yr 131 1.1 g/L 7.0 g/L 108 mg/dL 702 mg/dL 131 1.1 g/L 7.0 g/L 108 mg/dL 702 mg/dL
1–<4 yrs 111 3.2 g/L 11.5 g/L 316 mg/dL 1148 mg/dL 111 3.2 g/L 11.5 g/L 316 mg/dL 1148 mg/dL
4–<10 yrs 262 5.4 g/L 13.6 g/L 542 mg/dL 1358 mg/dL 262 5.4 g/L 13.6 g/L 542 mg/dL 1358 mg/dL
10–<19 yrs 521 6.6 g/L 15.3 g/L 658 mg/dL 1534 mg/dL 521 6.6 g/L 15.3 g/L 658 mg/dL 1534 mg/dL
Immunoglobulin M (IgM)a 0–<15 d 148 0.1 g/L 0.4 g/L 5 mg/dL 35 mg/dL 148 0.1 g/L 0.4 g/L 5 mg/dL 35 mg/dL
15 d–<13 wk 136 0.1 g/L 0.7 g/L 12 mg/dL 71 mg/dL 136 0.1 g/L 0.7 g/L 12 mg/dL 71 mg/dL
13 wk–<1 yr 173 0.2 g/L 0.9 g/L 16 mg/dL 86 mg/dL 173 0.2 g/L 0.9 g/L 16 mg/dL 86 mg/dL
1–<19 yrs 420 0.5 g/L 1.9 g/L 48 mg/dL 186 mg/dL 382 0.4 g/L 1.5 g/L 39 mg/dL 151 mg/dL
Insulinb 0–<1 yr 96 7 pmol/L 163 pmol/L 1.0 lIU/mL 23.5 lIU/mL 96 7 pmol/L 163 pmol/L 1.0 lIU/mL 23.5 lIU/mL
1–<6 yrs 79 9 pmol/L 279 pmol/L 1.3 lIU/mL 40.2 lIU/mL 79 9 pmol/L 279 pmol/L 1.3 lIU/mL 40.2 lIU/mL
6–<11 yrs 72 11 pmol/L 257 pmol/L 1.6 lIU/mL 37.0 lIU/mL 72 11 pmol/L 257 pmol/L 1.6 lIU/mL 37.0 lIU/mL
11–<19 yrs 120 18 pmol/L 492 pmol/L 2.6 lIU/mL 71.4 lIU/mL 120 18 pmol/L 492 pmol/L 2.6 lIU/mL 71.4 lIU/mL
Irona 0–<14 yrs 588 2.8 mmol/L 22.9 mmol/L 16 mg/dL 128 mg/dL 588 2.8 mmol/L 22.9 mmol/L 16 mg/dL 128 mg/dL
14–<19 yrs 143 3.5 mmol/L 29.0 mmol/L 20 mg/dL 162 mg/dL 138 5.5 mmol/L 30.0 mmol/L 31 mg/dL 168 mg/dL
Lactate dehydrogenase (LDH)a 0–<15 d 197 309 U/L 1222 U/L 309 U/L 1222 U/L 197 309 U/L 1222 U/L 309 U/L 1222 U/L
15 d–<1 yr 145 163 U/L 452 U/L 163 U/L 452 U/L 145 163 U/L 452 U/L 163 U/L 452 U/L
1–<10 yrs 370 192 U/L 321 U/L 192 U/L 321 U/L 370 192 U/L 321 U/L 192 U/L 321 U/L
10–<15 yrs 141 157 U/L 272 U/L 157 U/L 272 U/L 125 170 U/L 283 U/L 170 U/L 283 U/L
15–<19 yrs 227 130 U/L 250 U/L 130 U/L 250 U/L 227 130 U/L 250 U/L 130 U/L 250 U/L
Lipasec 0–<19 yrs 946 4 U/L 39 U/L 4 U/L 39 U/L 946 4 U/L 39 U/L 4 U/L 39 U/L
Luteinizing hormone (LH)f (age partitions) 4 d–<3 m 48 NA 2.4 IU/L NA 2.4 mIU/mL 51 0.2 IU/L 3.8 IU/L 0.2 mIU/mL 3.8 mIU/mL
3 m–<1 yr 99 NA 1.2 IU/L NA 1.2 mIU/mL 125 NA 2.9 IU/L NA 2.9 mIU/mL
1–<10 yrs 336 NA 0.3 IU/L NA 0.3 mIU/mL 336 NA 0.3 IU/L NA 0.3 mIU/mL
10–<13 yrs 210 NA 4.3 IU/L NA 4.3 mIU/mL 210 NA 4.3 IU/L NA 4.3 mIU/mL
13–<15 yrs 60 0.4 IU/L 6.5 IU/L 0.4 mIU/mL 6.5 mIU/mL 73 NA 4.1 IU/L NA 4.1 mIU/mL
15–<17 yrs 63 NA 13.1 IU/L NA 13.1 mIU/mL 66 0.8 IU/L 4.8 IU/L 0.8 mIU/mL 4.8 mIU/mL
17–<19 yrs 51 NA 8.4 IU/L NA 8.4 mIU/mL 69 0.9 IU/L 7.1 IU/L 0.9 mIU/mL 7.1 mIU/mL
Luteinizing hormone (LH)f (Tanner stage I 23 NA 0.1 IU/L NA 0.1 mIU/mL 25 NA 1.2 IU/L NA 1.2 mIU/mL
partitions) II 24 NA 2.3 IU/L NA 2.3 mIU/mL 36 NA 1.2 IU/L NA 1.2 mIU/mL
III 29 NA 7.4 IU/L NA 7.4 mIU/mL 21 NA 2.3 IU/L NA 2.3 mIU/mL
IV 60 0.3 IU/L 6.7 IU/L 0.3 mIU/mL 6.7 mIU/mL 52 NA 4.9 IU/L NA 4.9 mIU/mL
V 34 0.4 IU/L 21.2 IU/L 0.4 mIU/mL 21.2 mIU/mL 17 0.6 IU/L 5.9 IU/L 0.6 mIU/mL 5.9 mIU/mL
Magnesiuma 0–<15 d 183 0.82 mmol/L 1.62 mmol/L 1.99 mg/dL 3.94 mg/dL 183 0.82 mmol/L 1.62 mmol/L 1.99 mg/dL 3.94 mg/dL
15 d–<1 yr 145 0.81 mmol/L 1.27 mmol/L 1.97 mg/dL 3.09 mg/dL 145 0.81 mmol/L 1.27 mmol/L 1.97 mg/dL 3.09 mg/dL
1–<19 yrs 897 0.86 mmol/L 1.17 mmol/L 2.09 mg/dL 2.84 mg/dL 897 0.86 mmol/L 1.17 mmol/L 2.09 mg/dL 2.84 mg/dL
Parathyroid hormone, intact (PTH)e 6 d–<1 yr 172 0.68 pmol/L 9.39 pmol/L 6.4 pg/mL 88.6 pg/mL 172 0.68 pmol/L 9.39 pmol/L 6.4 pg/mL 88.6 pg/mL
1–<9 yrs 221 1.72 pmol/L 6.68 pmol/L 16.2 pg/mL 63.0 pg/mL 221 1.72 pmol/L 6.68 pmol/L 16.2 pg/mL 63.0 pg/mL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

9–<17 yrs 534 2.32 pmol/L 9.28 pmol/L 21.9 pg/mL 87.6 pg/mL 534 2.32 pmol/L 9.28 pmol/L 21.9 pg/mL 87.6 pg/mL
17–<19 yrs 104 1.70 pmol/L 6.40 pmol/L 16.0 pg/mL 60.4 pg/mL 104 1.70 pmol/L 6.40 pmol/L 16.0 pg/mL 60.4 pg/mL
(continued)
377
Table 1. Continued
378

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Phosphatea 0–<15 d 204 1.80 mmol/L 3.40 mmol/L 5.6 mg/dL 10.5 mg/dL 204 1.80 mmol/L 3.40 mmol/L 5.6 mg/dL 10.5 mg/dL
15 d–<1 yr 144 1.54 mmol/L 2.72 mmol/L 4.8 mg/dL 8.4 mg/dL 144 1.54 mmol/L 2.72 mmol/L 4.8 mg/dL 8.4 mg/dL
1–<5 yrs 184 1.38 mmol/L 2.19 mmol/L 4.3 mg/dL 6.8 mg/dL 184 1.38 mmol/L 2.19 mmol/L 4.3 mg/dL 6.8 mg/dL
K. ADELI ET AL.

5–<13 yrs 352 1.33 mmol/L 1.92 mmol/L 4.1 mg/dL 5.9 mg/dL 352 1.33 mmol/L 1.92 mmol/L 4.1 mg/dL 5.9 mg/dL
13–<16 yrs 95 1.02 mmol/L 1.79 mmol/L 3.2 mg/dL 5.5 mg/dL 95 1.14 mmol/L 1.99 mmol/L 3.5 mg/dL 6.2 mg/dL
16–<19 yrs 187 0.95 mmol/L 1.62 mmol/L 2.9 mg/dL 5.0 mg/dL 187 0.95 mmol/L 1.62 mmol/L 2.9 mg/dL 5.0 mg/dL
Prealbumina 0–<15 d 127 0.02 g/L 0.12 g/L 2 mg/dL 12 mg/dL 127 0.02 g/L 0.12 g/L 2 mg/dL 12 mg/dL
15 d–<1 yr 137 0.05 g/L 0.24 g/L 5 mg/dL 24 mg/dL 137 0.05 g/L 0.24 g/L 5 mg/dL 24 mg/dL
1–<5 yrs 148 0.12 g/L 0.23 g/L 12 mg/dL 23 mg/dL 148 0.12 g/L 0.23 g/L 12 mg/dL 23 mg/dL
5–<13 yrs 359 0.14 g/L 0.26 g/L 14 mg/dL 26 mg/dL 359 0.14 g/L 0.26 g/L 14 mg/dL 26 mg/dL
13–<16 yrs 187 0.18 g/L 0.31 g/L 18 mg/dL 31 mg/dL 187 0.18 g/L 0.31 g/L 18 mg/dL 31 mg/dL
16–<19 yrs 96 0.17 g/L 0.33 g/L 17 mg/dL 33 mg/dL 95 0.20 g/L 0.35 g/L 20 mg/dL 35 mg/dL
Progastrin-releasing peptide (ProGRP)c 0–<1 wk 45 535 ng/L 1889 ng/L 535 pg/mL 1889 pg/mL 45 535 ng/L 1889 ng/L 535 pg/mL 1889 pg/mL
1 wk–<6 m 70 57 ng/L 817 ng/L 57 pg/mL 817 pg/mL 70 57 ng/L 817 ng/L 57 pg/mL 817 pg/mL
6 m–<1 yr 52 25 ng/L 198 ng/L 25 pg/mL 198 pg/mL 52 25 ng/L 198 ng/L 25 pg/mL 198 pg/mL
1–<12 yrs 257 22 ng/L 129 ng/L 22 pg/mL 129 pg/mL 257 22 ng/L 129 ng/L 22 pg/mL 129 pg/mL
12–<19 yrs 183 17 ng/L 83 ng/L 17 pg/mL 83 pg/mL 183 17 ng/L 83 ng/L 17 pg/mL 83 pg/mL
Progesteronef (age partitions) 4 d–<1 yr 269 NA 4 nmol/L NA 132 ng/dL 149 NA 2 nmol/L NA 66 ng/dL
1–<10 yrs 198 NA 1 nmol/L NA 35 ng/dL 343 NA 1 nmol/L NA 35 ng/dL
10–<15 yrs 373 0 nmol/L 3 nmol/L 13 ng/dL 85 ng/dL 373 0 nmol/L 3 nmol/L 13 ng/dL 85 ng/dL
15–<19 yrs 100 1 nmol/L 33 nmol/L 20 ng/dL 1026 ng/dL 131 1 nmol/L 2 nmol/L 16 ng/dL 57 ng/dL
Progesteronef (Tanner stage partitions) I 22 NA 1 nmol/L NA 28 ng/dL 25 NA 1 nmol/L NA 44 ng/dL
II 26 0 nmol/L 1 nmol/L 13 ng/dL 41 ng/dL 36 NA 1 nmol/L NA 44 ng/dL
III 26 1 nmol/L 2 nmol/L 16 ng/dL 47 ng/dL 22 NA 2 nmol/L NA 50 ng/dL
IV 45 1 nmol/L 2 nmol/L 19 ng/dL 72 ng/dL 50 NA 1 nmol/L NA 41 ng/dL
V 36 NA 34 nmol/L NA 1082 ng/dL 17 0 nmol/L 2 nmol/L 13 ng/dL 50 ng/dL
Prolactinf (age partitions) 4–<30 d 44 264 mIU/L 4468 mIU/L 13 ng/mL 213 ng/mL 44 264 mIU/L 4468 mIU/L 13 ng/mL 213 ng/mL
30 d–<1 yr 235 132 mIU/L 2388 mIU/L 6 ng/mL 114 ng/mL 235 132 mIU/L 2388 mIU/L 6 ng/mL 114 ng/mL
1–<19 yrs 979 88 mIU/L 484 mIU/L 4 ng/mL 23 ng/mL 979 88 mIU/L 484 mIU/L 4 ng/mL 23 ng/mL
Prolactinf (Tanner stage partitions) I 22 44 mIU/L 417 mIU/L 2 ng/mL 20 ng/mL 23 66 mIU/L 417 mIU/L 3 ng/mL 20 ng/mL
II 23 83 mIU/L 484 mIU/L 4 ng/mL 23 ng/mL 36 75 mIU/L 391 mIU/L 4 ng/mL 19 ng/mL
III 29 82 mIU/L 485 mIU/L 4 ng/mL 23 ng/mL 29 82 mIU/L 485 mIU/L 4 ng/mL 23 ng/mL
IV 60 123 mIU/L 487 mIU/L 6 ng/mL 23 ng/mL 50 126 mIU/L 419 mIU/L 6 ng/mL 20 ng/mL
V 33 114 mIU/L 486 mIU/L 5 ng/mL 23 ng/mL 17 136 mIU/L 671 mIU/L 6 ng/mL 32 ng/mL
Prostate-specific antigen, free (free PSA)c 0–<19 yrs 302 <0.008 mg/L 0.097 mg/L <0.008 ng/mL 0.097 ng/mL
0–<12 yrs 69 NA <0.008 mg/L NA <0.008 ng/mL
12–<19 yrs 122 <0.008 mg/L 0.239 mg/L <0.008 ng/mL 0.239 ng/mL
Prostate-specific antigen, total (total PSA)c 0–<1 wk 40 <0.008 mg/L 0.039 mg/L <0.008 ng/mL 0.039 ng/mL 50 <0.008 mg/L 0.047 mg/L <0.008 ng/mL 0.047 ng/mL
1 wk–<1 yr 53 <0.008 mg/L 0.010 mg/L <0.008 ng/mL 0.010 ng/mL
1–<19 yrs 183 <0.008 mg/L 0.015 mg/L <0.008 ng/mL 0.015 ng/mL
1 wk–<6 m 47 <0.008 mg/L 0.038 mg/L <0.008 ng/mL 0.038 ng/mL
6 m–<12 yrs 119 <0.008 mg/L 0.353 mg/L <0.008 ng/mL 0.353 ng/mL
12–<19 yrs 82 <0.008 mg/L 0.566 mg/L <0.008 ng/mL 0.566 ng/mL
Rheumatoid factora 0–<15 d 164 9.0 IU/mL 17.1 IU/mL 9.0 mg/dL 17.1 mg/dL 164 9.0 IU/mL 17.1 IU/mL 9.0 mg/dL 17.1 mg/dL
15 d–<19 yrs 1016 9.0 IU/mL 9.0 IU/mL 9.0 mg/dL 9.0 mg/dL 1016 9.0 IU/mL 9.0 IU/mL 9.0 mg/dL 9.0 mg/dL
Sex hormone-binding globulin 4 d–<1 m 113 14 nmol/L 120 nmol/L 14 nmol/L 120 nmol/L 113 14 nmol/L 120 nmol/L 14 nmol/L 120 nmol/L
(SHBG)f (age partitions) 1 m–<1 yr 239 36 nmol/L 229 nmol/L 36 nmol/L 229 nmol/L 239 36 nmol/L 229 nmol/L 36 nmol/L 229 nmol/L
(continued)
Table 1. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
1–<8 yrs 236 42 nmol/L 189 nmol/L 15 nmol/L 189 nmol/L 236 42 nmol/L 189 nmol/L 15 nmol/L 189 nmol/L
8–<11 yrs 184 26 nmol/L 162 nmol/L 26 nmol/L 162 nmol/L 184 26 nmol/L 162 nmol/L 26 nmol/L 162 nmol/L
11–<13 yrs 158 15 nmol/L 108 nmol/L 15 nmol/L 108 nmol/L 158 15 nmol/L 108 nmol/L 15 nmol/L 108 nmol/L
13–<15 yrs 160 11 nmol/L 98 nmol/L 11 nmol/L 98 nmol/L 160 11 nmol/L 98 nmol/L 11 nmol/L 98 nmol/L
15–<17 yrs 64 10 nmol/L 84 nmol/L 10 nmol/L 84 nmol/L
17–<19 yrs 52 11 nmol/L 155 nmol/L 11 nmol/L 155 nmol/L
15–<19 yrs 129 10 nmol/L 50 nmol/L 10 nmol/L 50 nmol/L
Sex hormone-binding globulin (SHBG)f (Tanner I 22 21 nmol/L 210 nmol/L 21 nmol/L 210 nmol/L 25 23 nmol/L 157 nmol/L 23 nmol/L 157 nmol/L
stage partitions) II 26 30 nmol/L 141 nmol/L 30 nmol/L 141 nmol/L 32 28 nmol/L 133 nmol/L 28 nmol/L 133 nmol/L
III 31 24 nmol/L 102 nmol/L 24 nmol/L 102 nmol/L 23 17 nmol/L 160 nmol/L 17 nmol/L 160 nmol/L
IV 62 12 nmol/L 126 nmol/L 12 nmol/L 126 nmol/L 51 12 nmol/L 79 nmol/L 12 nmol/L 79 nmol/L
V 33 15 nmol/L 93 nmol/L 15 nmol/L 93 nmol/L 17 8 nmol/L 49 nmol/L 8 nmol/L 49 nmol/L
Squamous cell carcinoma antigen (SCC)c 0–<1 wk 44 NA > 70.0 mg/L NA > 70.0 ng/mL 44 NA > 70.0 mg/L NA > 70.0 ng/mL
1 wk–<1 yr 130 0.6 mg/L 17.0 mg/L 0.6 ng/mL 17.0 ng/mL 130 0.6 mg/L 17.0 mg/L 0.6 ng/mL 17.0 ng/mL
1–<19 yrs 208 0.4 mg/L 1.6 mg/L 0.4 ng/mL 1.6 ng/mL 208 0.4 mg/L 1.6 mg/L 0.4 ng/mL 1.6 ng/mL
Thyroxine, free (FT4)e 5–<15 d 66 13.5 pmol/L 41.3 pmol/L 1.05 ng/dL 3.21 ng/dL 66 13.5 pmol/L 41.3 pmol/L 1.05 ng/dL 3.21 ng/dL
15–<30 d 55 8.7 pmol/L 32.5 pmol/L 0.68 ng/dL 2.53 ng/dL 55 8.7 pmol/L 32.5 pmol/L 0.68 ng/dL 2.53 ng/dL
30 d–<1 yr 270 11.4 pmol/L 21.9 pmol/L 0.89 ng/dL 1.70 ng/dL 270 11.4 pmol/L 21.9 pmol/L 0.89 ng/dL 1.70 ng/dL
1–<19 yrs 952 11.4 pmol/L 17.6 pmol/L 0.89 ng/dL 1.37 ng/dL 952 11.4 pmol/L 17.6 pmol/L 0.89 ng/dL 1.37 ng/dL
Thyroxine, total (TT4)e 7 d–<1 yr 301 76 nmol/L 176 nmol/L 5.9 mg/dL 13.7 mg/dL 301 76 nmol/L 176 nmol/L 5.9 mg/dL 13.7 mg/dL
1–<9 yrs 239 79 nmol/L 133 nmol/L 6.2 mg/dL 10.3 mg/dL 239 79 nmol/L 133 nmol/L 6.2 mg/dL 10.3 mg/dL
9–<12 yrs 177 71 nmol/L 120 nmol/L 5.5 mg/dL 9.3 mg/dL 177 71 nmol/L 120 nmol/L 5.5 mg/dL 9.3 mg/dL
12–<14 yrs 62 65 nmol/L 107 nmol/L 5.1 mg/dL 8.3 mg/dL 54 65 nmol/L 107 nmol/L 5.0 mg/dL 8.3 mg/dL
14–<19 yrs 131 70 nmol/L 167 nmol/L 5.5 mg/dL 13.0 mg/dL 145 60 nmol/L 111 nmol/L 4.7 mg/dL 8.6 mg/dL
Triiodothyronine, free (FT3)e 4 d–<1 yr 360 3.56 pmol/L 7.48 pmol/L 2.32 pg/mL 4.87 pg/mL 360 3.56 pmol/L 7.48 pmol/L 2.32 pg/mL 4.87 pg/mL
1–<12 yrs 528 4.29 pmol/L 6.79 pmol/L 2.79 pg/mL 4.42 pg/mL 528 4.29 pmol/L 6.79 pmol/L 2.79 pg/mL 4.42 pg/mL
12–<15 yrs 109 3.84 pmol/L 6.06 pmol/L 2.50 pg/mL 3.95 pg/mL 103 4.44 pmol/L 6.65 pmol/L 2.89 pg/mL 4.33 pg/mL
15–<19 yrs 124 3.55 pmol/L 5.70 pmol/L 2.31 pg/mL 3.71 pg/mL 133 3.46 pmol/L 5.92 pmol/L 2.25 pg/mL 3.85 pg/mL
Triiodothyronine, total (TT3)e 4 d–<1 yr 382 1.30 nmol/L 3.60 nmol/L 85 ng/dL 234 ng/dL 382 1.30 nmol/L 3.60 nmol/L 85 ng/dL 234 ng/dL
1–<12 yrs 513 1.74 nmol/L 2.91 nmol/L 113 ng/dL 189 ng/dL 513 1.74 nmol/L 2.91 nmol/L 113 ng/dL 189 ng/dL
12–<15 yrs 208 1.50 nmol/L 2.71 nmol/L 98 ng/dL 176 ng/dL 208 1.50 nmol/L 2.71 nmol/L 98 ng/dL 176 ng/dL
15–<17 yrs 59 1.42 nmol/L 2.18 nmol/L 92 ng/dL 142 ng/dL 64 1.44 nmol/L 2.40 nmol/L 94 ng/dL 156 ng/dL
17–<19 yrs 127 1.38 nmol/L 2.58 nmol/L 90 ng/dL 168 ng/dL 127 1.38 nmol/L 2.58 nmol/L 90 ng/dL 168 ng/dL
Testosterone, calculated bioavailable (cBAT)d 0–<1 yr 103 0.01 nmol/L 0.21 nmol/L 0 ng/dL 6 ng/dL 43 0.01 nmol/L 4.23 nmol/L 0 ng/dL 122 ng/dL
1–<9 yrs 103 0.01 nmol/L 0.21 nmol/L 0 ng/dL 6 ng/dL 67 0.01 nmol/L 0.10 nmol/L 0 ng/dL 3 ng/dL
9–<14 yrs 66 0.02 nmol/L 0.38 nmol/L 1 ng/dL 11 ng/dL 58 0.02 nmol/L 5.62 nmol/L 1 ng/dL 162 ng/dL
14–<19 yrs 64 0.13 nmol/L 0.80 nmol/L 4 ng/dL 23 ng/dL 62 0.42 nmol/L 12.03 nmol/L 12 ng/dL 347 ng/dL
Testosterone, calculated free (cFT)d 0–<1 yr 103 0.3 pmol/L 9.1 pmol/L 0.0 ng/dL 0.3 ng/dL 43 0.1 pmol/L 198.4 pmol/L 0.0 ng/dL 5.7 ng/dL
1–<9 yrs 103 0.3 pmol/L 9.1 pmol/L 0.0 ng/dL 0.3 ng/dL 67 0.3 pmol/L 4.0 pmol/L 0.0 ng/dL 0.1 ng/dL
9–<14 yrs 66 1.0 pmol/L 16.4 pmol/L 0.0 ng/dL 0.5 ng/dL 50 1.5 pmol/L 250.6 pmol/L 0.0 ng/dL 7.2 ng/dL
14–<19 yrs 65 4.9 pmol/L 34.3 pmol/L 0.1 ng/dL 1.0 ng/dL 62 17.4 pmol/L 494.0 pmol/L 0.5 ng/dL 14.2 ng/dL
Testosteronef (age partitions) 4 d –<9 yrs 125 0.04 nmol/L 2.15 nmol/L <1.2 ng/dL 62.0 ng/dL
9–<13 yrs 102 NA 0.98 nmol/L NA 28.2 ng/dL
13–<15 yrs 79 0.36 nmol/L 1.54 nmol/L 10.4 ng/dL 44.4 ng/dL
15–<19 yrs 110 0.49 nmol/L 1.70 nmol/L 14.1 ng/dL 49.0 ng/dL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

4 d –<6 m 72 0.3 nmol/L 10.4 nmol/L <9 ng/dL 299 ng/dL

6 m–<9 yrs 61 NA 1.2 nmol/L NA 36 ng/dL
(continued)
379
Table 1. Continued
380

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
9–<11 yrs 45 NA 0.8 nmol/L NA 23 ng/dL
11–<14 yrs 89 NA 15.4 nmol/L NA 444 ng/dL
14–<16 yrs 78 1.3 nmol/L 21.9 nmol/L 36 ng/dL 632 ng/dL
K. ADELI ET AL.

16–<19 yrs 94 5.1 nmol/L 27.6 nmol/L 148 ng/dL 794 ng/dL
Testosteronef (Tanner stage partitions) I 21 NA 1 nmol/L NA 17 ng/dL 20 NA 1 nmol/L NA 18 ng/dL
II 21 NA 1 nmol/L NA 20 ng/dL 32 NA 1 nmol/L NA 25 ng/dL
III 26 NA 1 nmol/L NA 42 ng/dL 22 NA 19 nmol/L NA 543 ng/dL
IV 62 0 nmol/L 1 nmol/L 9 ng/dL 42 ng/dL 52 0 nmol/L 22 nmol/L 9 ng/dL 636 ng/dL
V 34 0 nmol/L 2 nmol/L 4 ng/dL 50 ng/dL 17 3 nmol/L 26 nmol/L 100 ng/dL 760 ng/dL
Thyroid stimulating hormone (TSH)e 4 d–<6 m 139 0.73 mIU/L 4.77 mIU/L 0.73 mIU/L 4.77 mIU/L 139 0.73 mIU/L 4.77 mIU/L 0.73 mIU/L 4.77 mIU/L
6 m–<14 yrs 640 0.70 mIU/L 4.17 mIU/L 0.70 mIU/L 4.17 mIU/L 640 0.70 mIU/L 4.17 mIU/L 0.70 mIU/L 4.17 mIU/L
14–<19 yrs 259 0.47 mIU/L 3.41 mIU/L 0.47 mIU/L 3.41 mIU/L 259 0.47 mIU/L 3.41 mIU/L 0.47 mIU/L 3.41 mIU/L
Total proteina 0–<15 d 158 53 g/L 83 g/L 5.3 g/dL 8.3 g/dL 158 53 g/L 83 g/L 5.3 g/dL 8.3 g/dL
15 d–<1 yr 152 44 g/L 71 g/L 4.4 g/dL 7.1 g/dL 152 44 g/L 71 g/L 4.4 g/dL 7.1 g/dL
1–<6 yrs 209 61 g/L 75 g/L 6.1 g/dL 7.5 g/dL 209 61 g/L 75 g/L 6.1 g/dL 7.5 g/dL
6–<9 yrs 118 64 g/L 77 g/L 6.4 g/dL 7.7 g/dL 118 64 g/L 77 g/L 6.4 g/dL 7.7 g/dL
9–<19 yrs 558 65 g/L 81 g/L 6.5 g/dL 8.1 g/dL 558 65 g/L 81 g/L 6.5 g/dL 8.1 g/dL
Transferrina 0–<9 wk 188 1.04 g/L 2.24 g/L 104 mg/dL 224 mg/dL 188 1.04 g/L 2.24 g/L 104 mg/dL 224 mg/dL
9 wk–<1 yr 104 1.07 g/L 3.24 g/L 107 mg/dL 324 mg/dL 104 1.07 g/L 3.24 g/L 107 mg/dL 324 mg/dL
1–<19 yrs 878 2.20 g/L 3.37 g/L 220 mg/dL 337 mg/dL 878 2.20 g/L 3.37 g/L 220 mg/dL 337 mg/dL
Triglyceridesa 0–<15 d 138 0.93 mmol/L 2.93 mmol/L 82 mg/dL 259 mg/dL 138 0.93 mmol/L 2.93 mmol/L 82 mg/dL 259 mg/dL
15 d–<1 yr 141 0.60 mmol/L 2.92 mmol/L 53 mg/dL 258 mg/dL 141 0.60 mmol/L 2.92 mmol/L 53 mg/dL 258 mg/dL
1 yr–<19 yrs 863 0.50 mmol/L 2.23 mmol/L 44 mg/dL 197 mg/dL 863 0.50 mmol/L 2.23 mmol/L 44 mg/dL 197 mg/dL
Troponin I (TnI)e 5–<15 d 46 3 ng/L 936 ng/L 3 ng/L 936 ng/L 46 3 ng/L 936 ng/L 3 ng/L 936 ng/L
15 d–<3 m 35 NA NA NA NA 35 NA NA NA NA
3 m–<19 yrs 691 NA <9 ng/L NA <9 ng/L 691 NA <9 ng/L NA <9 ng/L
Ureaa 0–<15 d 312 1.0 nmol/L 8.2 nmol/L 2.8 mg/dL 23.0 mg/dL 312 1.0 nmol/L 8.2 nmol/L 2.8 mg/dL 23.0 mg/dL
15 d–<1 yr 138 1.2 nmol/L 6.0 nmol/L 3.4 mg/dL 16.8 mg/dL 138 1.2 nmol/L 6.0 nmol/L 3.4 mg/dL 16.8 mg/dL
1–<10 yrs 406 3.2 nmol/L 7.9 nmol/L 9.0 mg/dL 22.1 mg/dL 406 3.2 nmol/L 7.9 nmol/L 9.0 mg/dL 22.1 mg/dL
10–<19 yrs 273 2.6 nmol/L 6.8 nmol/L 7.3 mg/dL 19.0 mg/dL 262 2.6 nmol/L 7.5 nmol/L 7.3 mg/dL 21.0 mg/dL
Uric acida 0–<15 d 193 164 mmol/L 757 mmol/L 2.8 mg/dL 12.7 mg/dL 193 164 mmol/L 757 mmol/L 2.8 mg/dL 12.7 mg/dL
15 d–<1 yr 149 94 mmol/L 377 mmol/L 1.6 mg/dL 6.3 mg/dL 149 94 mmol/L 377 mmol/L 1.6 mg/dL 6.3 mg/dL
1–<12 yrs 506 106 mmol/L 289 mmol/L 1.8 mg/dL 4.9 mg/dL 506 106 mmol/L 289 mmol/L 1.8 mg/dL 4.9 mg/dL
12–<19 yrs 220 153 mmol/L 349 mmol/L 2.6 mg/dL 5.9 mg/dL 208 156 mmol/L 454 mmol/L 2.6 mg/dL 7.6 mg/dL
Vitamin D (25OH)e 5–<15 d 100 4 nmol/L 85 nmol/L 1.7 ng/mL 34.0 ng/mL 100 4 nmol/L 85 nmol/L 1.7 ng/mL 34.0 ng/mL
15 d–<3 m 52 15 nmol/L 101 nmol/L 6.2 ng/mL 40.5 ng/mL 52 15 nmol/L 101 nmol/L 6.2 ng/mL 40.5 ng/mL
3 m–<1 yr 111 17 nmol/L 118 nmol/L 6.9 ng/mL 47.3 ng/mL 111 17 nmol/L 118 nmol/L 6.9 ng/mL 47.3 ng/mL
1–<9 yrs 244 33 nmol/L 137 nmol/L 13.2 ng/mL 54.9 ng/mL 244 33 nmol/L 137 nmol/L 13.2 ng/mL 54.9 ng/mL
9–<14 yrs 281 32 nmol/L 116 nmol/L 12.7 ng/mL 46.5 ng/mL 281 32 nmol/L 116 nmol/L 12.7 ng/mL 46.5 ng/mL
14–<19 yrs 270 12 nmol/L 106 nmol/L 4.8 ng/mL 42.3 ng/mL 270 12 nmol/L 106 nmol/L 4.8 ng/mL 42.3 ng/mL
Reference interval value units are in Standard International units (SI units) and Conventional units (CON units). Colored partitions indicate sex-specific differences within the age partitions.
a
Refer to the original publication [9] for additional information.
b
Refer to the original publication [20] for additional information.
c
Refer to the original publication [14] for additional information.
d
Refer to the original publication [17] for additional information.
e
Refer to the original publication [10] for additional information.
f
Refer to the original publication [12] for additional information.
Table 2. Pediatric reference intervals for the Beckman AU – age and sex specific.
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Alanine aminotransferase– US (ALT) 0–<1 yr 6 U/L 30 U/L 6 U/L 30 U/L 6 U/L 30 U/L 6 U/L 30 U/L
1–<13 yrs 9 U/L 23 U/L 9 U/L 23 U/L 9 U/L 23 U/L 9 U/L 23 U/L
13–<19 yrs 8 U/L 21 U/L 8 U/L 21 U/L 9 U/L 22 U/L 9 U/L 22 U/L
Alanine aminotransferase-non US (ALTO) 0–<1 yr 6 U/L 33 U/L 6 U/L 33 U/L 6 U/L 33 U/L 6 U/L 33 U/L
1–<13 yrs 10 U/L 25 U/L 10 U/L 25 U/L 10 U/L 25 U/L 10 U/L 25 U/L
13–<19 yrs 9 U/L 22 U/L 9 U/L 22 U/L 10 U/L 24 U/L 10 U/L 24 U/L
Albumin-US (ALB) 0–<15 d 31 g/L 43 g/L 3.1 g/dL 4.3 g/dL 31 g/L 43 g/L 3.1 g/dL 4.3 g/dL
15 d–<1 yr 28 g/L 48 g/L 2.8 g/dL 4.8 g/dL 28 g/L 48 g/L 2.8 g/dL 4.8 g/dL
1–<8 yrs 38 g/L 47 g/L 3.8 g/dL 4.7 g/dL 38 g/L 47 g/L 3.8 g/dL 4.7 g/dL
8–<15 yrs 39 g/L 49 g/L 3.9 g/dL 4.9 g/dL 39 g/L 49 g/L 3.9 g/dL 4.9 g/dL
15–<19 yrs 38 g/L 51 g/L 3.8 g/dL 5.1 g/dL 40 g/L 52 g/L 4.0 g/dL 5.2 g/dL
Alkaline phosphatase-US (ALP) 0–<15 d 76 U/L 233 U/L 76 U/L 233 U/L 76 U/L 233 U/L 76 U/L 233 U/L
15 d–<1 yr 113 U/L 443 U/L 113 U/L 443 U/L 113 U/L 443 U/L 113 U/L 443 U/L
1–<10 yrs 132 U/L 315 U/L 132 U/L 315 U/L 132 U/L 315 U/L 132 U/L 315 U/L
10–<13 yrs 119 U/L 393 U/L 119 U/L 393 U/L 119 U/L 393 U/L 119 U/L 393 U/L
13–<15 yrs 52 U/L 239 U/L 52 U/L 239 U/L 107 U/L 442 U/L 107 U/L 442 U/L
15–<17 yrs 45 U/L 108 U/L 45 U/L 108 U/L 75 U/L 312 U/L 75 U/L 312 U/L
17–<19 yrs 40 U/L 80 U/L 40 U/L 80 U/L 49 U/L 139 U/L 49 U/L 139 U/L
Alkaline phosphatase-non-US (ALPO) 0–<15 d 91 U/L 281 U/L 91 U/L 281 U/L 91 U/L 281 U/L 91 U/L 281 U/L
15 d–<1 yr 137 U/L 535 U/L 137 U/L 535 U/L 137 U/L 535 U/L 137 U/L 535 U/L
1–<10 yrs 160 U/L 381 U/L 160 U/L 381 U/L 160 U/L 381 U/L 160 U/L 381 U/L
10–<13 yrs 144 U/L 475 U/L 144 U/L 475 U/L 144 U/L 475 U/L 144 U/L 475 U/L
13–<15 yrs 62 U/L 288 U/L 62 U/L 288 U/L 130 U/L 534 U/L 130 U/L 534 U/L
15–<17 yrs 54 U/L 131 U/L 54 U/L 131 U/L 90 U/L 377 U/L 90 U/L 377 U/L
17–<19 yrs 48 U/L 96 U/L 48 U/L 96 U/L 59 U/L 168 U/L 59 U/L 168 U/L
Amylase-US (AMY) 0–<15 d 1 U/L 7 U/L 1 U/L 7 U/L 1 U/L 7 U/L 1 U/L 7 U/L
15 d–<13 wks 1 U/L 16 U/L 1 U/L 16 U/L 1 U/L 16 U/L 1 U/L 16 U/L
13 wks–<1 yr 1 U/L 37 U/L 1 U/L 37 U/L 1 U/L 37 U/L 1 U/L 37 U/L
1–<19 yrs 18 U/L 76 U/L 18 U/L 76 U/L 18 U/L 76 U/L 18 U/L 76 U/L
Amylase-non-US-OSR6x06 (AMYA) 0–<15 d 0 U/L 6 U/L 0 U/L 6 U/L 0 U/L 6 U/L 0 U/L 6 U/L
15 d–<13 wks 0 U/L 17 U/L 0 U/L 17 U/L 0 U/L 17 U/L 0 U/L 17 U/L
13 wks–<1 yr 0 U/L 43 U/L 0 U/L 43 U/L 0 U/L 43 U/L 0 U/L 43 U/L
1–<19 yrs 20 U/L 90 U/L 20 U/L 90 U/L 20 U/L 90 U/L 20 U/L 90 U/L
Amylase-non-US-OSR6x82 (AMYB) 0–<15 d 2 U/L 10 U/L 2 U/L 10 U/L 2 U/L 10 U/L 2 U/L 10 U/L
15 d–<13 wks 1 U/L 24 U/L 1 U/L 24 U/L 1 U/L 24 U/L 1 U/L 24 U/L
13 wks–<1 yr 2 U/L 56 U/L 2 U/L 56 U/L 2 U/L 56 U/L 2 U/L 56 U/L
1–<19 yrs 27 U/L 115 U/L 27 U/L 115 U/L 27 U/L 115 U/L 27 U/L 115 U/L
Antistreptolysin-O (ASO) 0–<6 m 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL
6 m–<1 yr 0 IU/mL 19 IU/mL 0 IU/mL 19 IU/mL 0 IU/mL 19 IU/mL 0 IU/mL 19 IU/mL
1–<6 yrs 0 IU/mL 137 IU/mL 0 IU/mL 137 IU/mL 0 IU/mL 137 IU/mL 0 IU/mL 137 IU/mL
6–<19 yrs 0 IU/mL 500 IU/mL 0 IU/mL 500 IU/mL 0 IU/mL 500 IU/mL 0 IU/mL 500 IU/mL
Apolipoprotein B (APOB) 0–<15 d 0.08 g/L 0.67 g/L 8 mg/dL 67 mg/dL 0.08 g/L 0.67 g/L 8 mg/dL 67 mg/dL
15 d–<1 yr 0.18 g/L 1.23 g/L 18 mg/dL 123 mg/dL 0.18 g/L 1.23 g/L 18 mg/dL 123 mg/dL
1–<6 yrs 0.40 g/L 0.93 g/L 40 mg/dL 93 mg/dL 0.40 g/L 0.93 g/L 40 mg/dL 93 mg/dL
6–<19 yrs 0.30 g/L 0.84 g/L 30 mg/dL 84 mg/dL 0.30 g/L 0.84 g/L 30 mg/dL 84 mg/dL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

Aspartate aminotransferase-US (AST) 0–<15 d 30 U/L 146 U/L 30 U/L 146 U/L 30 U/L 146 U/L 30 U/L 146 U/L
15 d–<1 yr 19 U/L 61 U/L 19 U/L 61 U/L 19 U/L 61 U/L 19 U/L 61 U/L
(continued)
381
Table 2. Continued
382

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
1–<7 yrs 20 U/L 40 U/L 20 U/L 40 U/L 20 U/L 40 U/L 20 U/L 40 U/L
7–<12 yrs 17 U/L 33 U/L 17 U/L 33 U/L 17 U/L 33 U/L 17 U/L 33 U/L
12–<19 yrs 12 U/L 24 U/L 12 U/L 24 U/L 13 U/L 32 U/L 13 U/L 32 U/L
K. ADELI ET AL.

Aspartate aminotransferase-non-US (ASTA) 0–<15 d 34 U/L 166 U/L 34 U/L 166 U/L 34 U/L 166 U/L 34 U/L 166 U/L
15 d–<1 yr 22 U/L 70 U/L 22 U/L 70 U/L 22 U/L 70 U/L 22 U/L 70 U/L
1–<7 yrs 23 U/L 46 U/L 23 U/L 46 U/L 23 U/L 46 U/L 23 U/L 46 U/L
7–<12 yrs 20 U/L 38 U/L 20 U/L 38 U/L 20 U/L 38 U/L 20 U/L 38 U/L
12–<19 yrs 15 U/L 28 U/L 15 U/L 28 U/L 16 U/L 37 U/L 16 U/L 37 U/L
Bilirubin, direct-US (DBILC) 0–<15 d 3.3 mmol/L 7.6 mmol/L 0.2 mg/dL 0.4 mg/dL 3.3 mmol/L 7.6 mmol/L 0.2 mg/dL 0.4 mg/dL
15 d–<1 yr 0.1 mmol/L 3.0 mmol/L 0.0 mg/dL 0.2 mg/dL 0.1 mmol/L 3.0 mmol/L 0.0 mg/dL 0.2 mg/dL
1–<9 yrs 0.1 mmol/L 1.8 mmol/L 0.0 mg/dL 0.1 mg/dL 0.1 mmol/L 1.8 mmol/L 0.0 mg/dL 0.1 mg/dL
9–<13 yrs 0.1 mmol/L 2.8 mmol/L 0.0 mg/dL 0.2 mg/dL 0.1 mmol/L 2.8 mmol/L 0.0 mg/dL 0.2 mg/dL
13–<19 yrs 0.7 mmol/L 4.0 mmol/L 0.0 mg/dL 0.2 mg/dL 0.8 mmol/L 4.2 mmol/L 0.0 mg/dL 0.2 mg/dL
Bilirubin, direct-non-US (DBILCO) 0–<15 d 3.3 mmol/L 7.5 mmol/L 0.2 mg/dL 0.4 mg/dL 3.3 mmol/L 7.5 mmol/L 0.2 mg/dL 0.4 mg/dL
15 d–<1 yr 0.1 mmol/L 2.9 mmol/L 0.0 mg/dL 0.2 mg/dL 0.1 mmol/L 2.9 mmol/L 0.0 mg/dL 0.2 mg/dL
1–<9 yrs 0.1 mmol/L 1.8 mmol/L 0.0 mg/dL 0.1 mg/dL 0.1 mmol/L 1.8 mmol/L 0.0 mg/dL 0.1 mg/dL
9–<13 yrs 0.1 mmol/L 2.8 mmol/L 0.0 mg/dL 0.2 mg/dL 0.1 mmol/L 2.8 mmol/L 0.0 mg/dL 0.2 mg/dL
13–<19 yrs 0.6 mmol/L 3.9 mmol/L 0.0 mg/dL 0.2 mg/dL 0.8 mmol/L 4.2 mmol/L 0.1 mg/dL 0.3 mg/dL
Bilirubin, total-US (TBILC) 0–<15 d 4.4 mmol/L 252.6 mmol/L 0.3 mg/dL 14.8 mg/dL 4.4 mmol/L 252.6 mmol/L 0.3 mg/dL 14.8 mg/dL
15 d–<1 yr 2.2 mmol/L 11.8 mmol/L 0.1 mg/dL 0.7 mg/dL 2.2 mmol/L 11.8 mmol/L 0.1 mg/dL 0.7 mg/dL
1–<9 yrs 2.2 mmol/L 7.5 mmol/L 0.1 mg/dL 0.4 mg/dL 2.2 mmol/L 7.5 mmol/L 0.1 mg/dL 0.4 mg/dL
9–<12 yrs 2.2 mmol/L 9.8 mmol/L 0.1 mg/dL 0.6 mg/dL 2.2 mmol/L 9.8 mmol/L 0.1 mg/dL 0.6 mg/dL
12–<15 yrs 3.0 mmol/L 12.0 mmol/L 0.2 mg/dL 0.7 mg/dL 3.0 mmol/L 12.0 mmol/L 0.2 mg/dL 0.7 mg/dL
15–<19 yrs 3.0 mmol/L 14.2 mmol/L 0.2 mg/dL 0.8 mg/dL 3.0 mmol/L 14.2 mmol/L 0.2 mg/dL 0.8 mg/dL
Bilirubin, Total-non-US (TBILCO) 0–<15 d 4.5 mmol/L 271.0 mmol/L 0.3 mg/dL 15.8 mg/dL 4.5 mmol/L 271.0 mmol/L 0.3 mg/dL 15.8 mg/dL
15 d–<1 yr 2.2 mmol/L 12.5 mmol/L 0.1 mg/dL 0.7 mg/dL 2.2 mmol/L 12.5 mmol/L 0.1 mg/dL 0.7 mg/dL
1–<9 yrs 2.2 mmol/L 7.9 mmol/L 0.1 mg/dL 0.5 mg/dL 2.2 mmol/L 7.9 mmol/L 0.1 mg/dL 0.5 mg/dL
9–<12 yrs 2.2 mmol/L 10.3 mmol/L 0.1 mg/dL 0.6 mg/dL 2.2 mmol/L 10.3 mmol/L 0.1 mg/dL 0.6 mg/dL
12–<15 yrs 3.0 mmol/L 12.7 mmol/L 0.2 mg/dL 0.7 mg/dL 3.0 mmol/L 12.7 mmol/L 0.2 mg/dL 0.7 mg/dL
15–<19 yrs 3.0 mmol/L 15.1 mmol/L 0.2 mg/dL 0.9 mg/dL 3.0 mmol/L 15.1 mmol/L 0.2 mg/dL 0.9 mg/dL
C-Reactive protein high sensitivity (CRPHS) 0–<15 d 0.3 mg/L 5.8 mg/L 0.3 mg/L 5.8 mg/L 0.3 mg/L 5.8 mg/L 0.3 mg/L 5.8 mg/L
15 d–<15 yrs 0.1 mg/L 0.9 mg/L 0.1 mg/L 0.9 mg/L 0.1 mg/L 0.9 mg/L 0.1 mg/L 0.9 mg/L
15–<19 yrs 0.1 mg/L 1.6 mg/L 0.1 mg/L 1.6 mg/L 0.1 mg/L 1.6 mg/L 0.1 mg/L 1.6 mg/L
Cholesterol-non-US (CHLO) 0–<15 d 1.17 mmol/L 3.43 mmol/L 45 mg/dL 132 mg/dL 0.94 mmol/L 3.18 mmol/L 36 mg/dL 123 mg/dL
15 d–<1 yr 1.68 mmol/L 6.67 mmol/L 65 mg/dL 258 mg/dL 1.68 mmol/L 6.67 mmol/L 65 mg/dL 258 mg/dL
1–<19 yrs 3.06 mmol/L 5.85 mmol/L 118 mg/dL 226 mg/dL 3.06 mmol/L 5.85 mmol/L 118 mg/dL 226 mg/dL
Cholesterol-US (CHOL) 0–<15 d 1.28 mmol/L 3.19 mmol/L 49 mg/dL 123 mg/dL 1.09 mmol/L 2.97 mmol/L 42 mg/dL 115 mg/dL
15 d–<1 yr 1.71 mmol/L 5.91 mmol/L 66 mg/dL 228 mg/dL 1.71 mmol/L 5.91 mmol/L 66 mg/dL 228 mg/dL
1–<19 yrs 2.88 mmol/L 5.23 mmol/L 111 mg/dL 202 mg/dL 2.88 mmol/L 5.23 mmol/L 111 mg/dL 202 mg/dL
Complement component 3 (C3) 0–<15 d 0.57 g/L 1.16 g/L 57 mg/dL 116 mg/dL 0.57 g/L 1.16 g/L 57 mg/dL 116 mg/dL
15 d–<1 yr 0.58 g/L 1.49 g/L 58 mg/dL 149 mg/dL 0.58 g/L 1.49 g/L 58 mg/dL 149 mg/dL
1–<19 yrs 0.85 g/L 1.42 g/L 85 mg/dL 142 mg/dL 0.85 g/L 1.42 g/L 85 mg/dL 142 mg/dL
Complement component 4 (C4) 0 d–<1 yrs 0.05 g/L 0.33 g/L 5 mg/dL 33 mg/dL 0.05 g/L 0.33 g/L 5 mg/dL 33 mg/dL
1–<19 yrs 0.12 g/L 0.41 g/L 12 mg/dL 41 mg/dL 0.12 g/L 0.41 g/L 12 mg/dL 41 mg/dL
Enzymatic creatinine-non-US (CROE) 0–<15 d 25 mmol/L 73 mmol/L 0.3 mg/dL 0.8 mg/dL 25 mmol/L 73 mmol/L 0.3 mg/dL 0.8 mg/dL
15 d–<2 yrs 7 mmol/L 28 mmol/L 0.1 mg/dL 0.3 mg/dL 7 mmol/L 28 mmol/L 0.1 mg/dL 0.3 mg/dL
2–<5 yrs 15 mmol/L 33 mmol/L 0.2 mg/dL 0.4 mg/dL 15 mmol/L 33 mmol/L 0.2 mg/dL 0.4 mg/dL
(continued)
Table 2. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
5–<12 yrs 23 mmol/L 48 mmol/L 0.3 mg/dL 0.5 mg/dL 23 mmol/L 48 mmol/L 0.3 mg/dL 0.5 mg/dL
12–<15 yrs 35 mmol/L 64 mmol/L 0.4 mg/dL 0.7 mg/dL 35 mmol/L 64 mmol/L 0.4 mg/dL 0.7 mg/dL
15–<19 yrs 38 mmol/L 66 mmol/L 0.4 mg/dL 0.7 mg/dL 48 mmol/L 85 mmol/L 0.5 mg/dL 1.0 mg/dL
Creatinine-non-US (CREO) 0–<15 d 32 mmol/L 85 mmol/L 0.4 mg/dL 1.0 mg/dL 32 mmol/L 85 mmol/L 0.4 mg/dL 1.0 mg/dL
15 d–<2 yrs 13 mmol/L 35 mmol/L 0.1 mg/dL 0.4 mg/dL 13 mmol/L 35 mmol/L 0.1 mg/dL 0.4 mg/dL
2–<5 yrs 22 mmol/L 41 mmol/L 0.2 mg/dL 0.5 mg/dL 22 mmol/L 41 mmol/L 0.2 mg/dL 0.5 mg/dL
5–<12 yrs 30 mmol/L 57 mmol/L 0.3 mg/dL 0.6 mg/dL 30 mmol/L 57 mmol/L 0.3 mg/dL 0.6 mg/dL
12–<15 yrs 43 mmol/L 75 mmol/L 0.5 mg/dL 0.8 mg/dL 43 mmol/L 75 mmol/L 0.5 mg/dL 0.8 mg/dL
15–<19 yrs 46 mmol/L 77 mmol/L 0.5 mg/dL 0.9 mg/dL 58 mmol/L 99 mmol/L 0.7 mg/dL 1.1 mg/dL
Creatinine-US (CRE) 0–<15 d 30 mmol/L 81 mmol/L 0.3 mg/dL 0.9 mg/dL 30 mmol/L 81 mmol/L 0.3 mg/dL 0.9 mg/dL
15 d–<2 yrs 10 mmol/L 33 mmol/L 0.1 mg/dL 0.4 mg/dL 10 mmol/L 33 mmol/L 0.1 mg/dL 0.4 mg/dL
2–<5 yrs 19 mmol/L 38 mmol/L 0.2 mg/dL 0.4 mg/dL 19 mmol/L 38 mmol/L 0.2 mg/dL 0.4 mg/dL
5–<12 yrs 28 mmol/L 54 mmol/L 0.3 mg/dL 0.6 mg/dL 28 mmol/L 54 mmol/L 0.3 mg/dL 0.6 mg/dL
12–<15 yrs 40 mmol/L 71 mmol/L 0.5 mg/dL 0.8 mg/dL 40 mmol/L 71 mmol/L 0.5 mg/dL 0.8 mg/dL
15–<19 yrs 43 mmol/L 73 mmol/L 0.5 mg/dL 0.8 mg/dL 55 mmol/L 94 mmol/L 0.6 mg/dL 1.1 mg/dL
Gamma-glutamyl transferase-US (GGT) 0–<15 d 17 U/L 158 U/L 17 U/L 158 U/L 17 U/L 158 U/L 17 U/L 158 U/L
15 d–<1 yr 6 U/L 92 U/L 6 U/L 92 U/L 6 U/L 92 U/L 6 U/L 92 U/L
1–<11 yrs 5 U/L 12 U/L 5 U/L 12 U/L 5 U/L 12 U/L 5 U/L 12 U/L
11–<19 yrs 5 U/L 15 U/L 5 U/L 15 U/L 5 U/L 15 U/L 5 U/L 15 U/L
Gamma-glutamyl transferase-non- 0–<15 d 19 U/L 176 U/L 19 U/L 176 U/L 19 U/L 176 U/L 19 U/L 176 U/L
US-OSR6x19 (GGTA)
15 d–<1 yr 7 U/L 102 U/L 7 U/L 102 U/L 7 U/L 102 U/L 7 U/L 102 U/L
1–<11 yrs 5 U/L 13 U/L 5 U/L 13 U/L 5 U/L 13 U/L 5 U/L 13 U/L
11–<19 yrs 6 U/L 17 U/L 6 U/L 17 U/L 6 U/L 17 U/L 6 U/L 17 U/L
Gamma-glutamyl transferase-non- 0–<15 d 20 U/L 196 U/L 20 U/L 196 U/L 20 U/L 196 U/L 20 U/L 196 U/L
US-OSR6x20 (GGTB)
15 d–<1 yr 7 U/L 113 U/L 7 U/L 113 U/L 7 U/L 113 U/L 7 U/L 113 U/L
1–<11 yrs 5 U/L 14 U/L 5 U/L 14 U/L 5 U/L 14 U/L 5 U/L 14 U/L
11–<19 yrs 6 U/L 18 U/L 6 U/L 18 U/L 6 U/L 18 U/L 6 U/L 18 U/L
HDL-cholesterol-US (HDL) 0–<15 d 0.41 mmol/L 1.05 mmol/L 16 mg/dL 41 mg/dL 0.41 mmol/L 1.05 mmol/L 16 mg/dL 41 mg/dL
15 d–<1 yr 0.32 mmol/L 1.77 mmol/L 12 mg/dL 68 mg/dL 0.32 mmol/L 1.77 mmol/L 12 mg/dL 68 mg/dL
1–<4 yrs 0.82 mmol/L 1.56 mmol/L 32 mg/dL 60 mg/dL 0.82 mmol/L 1.56 mmol/L 32 mg/dL 60 mg/dL
4–<13 yrs 0.90 mmol/L 1.79 mmol/L 35 mg/dL 69 mg/dL 0.90 mmol/L 1.79 mmol/L 35 mg/dL 69 mg/dL
13–<19 yrs 0.81 mmol/L 1.77 mmol/L 31 mg/dL 68 mg/dL 0.97 mmol/L 1.90 mmol/L 37 mg/dL 73 mg/dL
HDL-cholesterol-non-US (HDLO) 0–<15 d 0.42 mmol/L 1.02 mmol/L 16 mg/dL 39 mg/dL 0.42 mmol/L 1.02 mmol/L 16 mg/dL 39 mg/dL
15 d–<1 yr 0.33 mmol/L 1.69 mmol/L 13 mg/dL 65 mg/dL 0.33 mmol/L 1.69 mmol/L 13 mg/dL 65 mg/dL
1–<4 yrs 0.81 mmol/L 1.50 mmol/L 31 mg/dL 58 mg/dL 0.81 mmol/L 1.50 mmol/L 31 mg/dL 58 mg/dL
4–<13 yrs 0.88 mmol/L 1.72 mmol/L 34 mg/dL 66 mg/dL 0.88 mmol/L 1.72 mmol/L 34 mg/dL 66 mg/dL
13–<19 yrs 0.80 mmol/L 1.70 mmol/L 31 mg/dL 66 mg/dL 0.95 mmol/L 1.82 mmol/L 37 mg/dL 70 mg/dL
Haptoglobin (HAPT) 0–<15 d 0.01 g/L 0.11 g/L 1 mg/dL 11 mg/dL 0.01 g/L 0.11 g/L 1 mg/dL 11 mg/dL
15 d–<1 yr 0.08 g/L 2.10 g/L 8 mg/dL 210 mg/dL 0.08 g/L 2.10 g/L 8 mg/dL 210 mg/dL
1–<12 yrs 0.08 g/L 1.55 g/L 8 mg/dL 155 mg/dL 0.08 g/L 1.55 g/L 8 mg/dL 155 mg/dL
12–<19 yrs 0.08 g/L 1.70 g/L 8 mg/dL 170 mg/dL 0.08 g/L 1.70 g/L 8 mg/dL 170 mg/dL
Immunoglobulin A (IgA) 0 d–<1 yr 0.0 g/L 0.3 g/L 0 mg/dL 30 mg/dL 0.0 g/L 0.3 g/L 0 mg/dL 30 mg/dL
1–<3 yrs 0.0 g/L 0.9 g/L 0 mg/dL 90 mg/dL 0.0 g/L 0.9 g/L 0 mg/dL 90 mg/dL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

3–<6 yrs 0.3 g/L 1.5 g/L 30 mg/dL 150 mg/dL 0.3 g/L 1.5 g/L 30 mg/dL 150 mg/dL
6–<14 yrs 0.5 g/L 2.3 g/L 50 mg/dL 230 mg/dL 0.5 g/L 2.3 g/L 50 mg/dL 230 mg/dL
14–<19 yrs 0.5 g/L 3.0 g/L 50 mg/dL 300 mg/dL 0.5 g/L 3.0 g/L 50 mg/dL 300 mg/dL
383

(continued)
Table 2. Continued
384

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Immunoglobulin G (IgG) 0–<15 d 3.0 g/L 13.0 g/L 300 mg/dL 1300 mg/dL 3.0 g/L 13.0 g/L 300 mg/dL 1300 mg/dL
15 d–<1 yr 1.1 g/L 6.5 g/L 110 mg/dL 650 mg/dL 1.1 g/L 6.5 g/L 110 mg/dL 650 mg/dL
1–<4 yrs 3.0 g/L 10.7 g/L 300 mg/dL 1070 mg/dL 3.0 g/L 10.7 g/L 300 mg/dL 1070 mg/dL
K. ADELI ET AL.

4–<10 yrs 5.1 g/L 12.6 g/L 510 mg/dL 1260 mg/dL 5.1 g/L 12.6 g/L 510 mg/dL 1260 mg/dL
10–<19 yrs 6.2 g/L 14.2 g/L 620 mg/dL 1420 mg/dL 6.2 g/L 14.2 g/L 620 mg/dL 1420 mg/dL
Immunoglobulin M (IgM) 0–<15 d 0.2 g/L 0.4 g/L 20 mg/dL 40 mg/dL 0.2 g/L 0.4 g/L 20 mg/dL 40 mg/dL
15 d–<13 wks 0.2 g/L 0.7 g/L 20 mg/dL 70 mg/dL 0.2 g/L 0.7 g/L 20 mg/dL 70 mg/dL
13 wks–<1 yr 0.3 g/L 0.9 g/L 30 mg/dL 90 mg/dL 0.3 g/L 0.9 g/L 30 mg/dL 90 mg/dL
1–<19 yrs 0.5 g/L 1.7 g/L 50 mg/dL 170 mg/dL 0.4 g/L 1.3 g/L 40 mg/dL 130 mg/dL
Iron-US (FE) 0–<14 yrs 3.0 mmol/L 24.7 mmol/L 17 mg/dL 138 mg/dL 3.0 mmol/L 24.7 mmol/L 17 mg/dL 138 mg/dL
14–<19 yrs 3.8 mmol/L 31.3 mmol/L 21 mg/dL 175 mg/dL 6.5 mmol/L 32.4 mmol/L 36 mg/dL 181 mg/dL
Iron-non-US (FEO) 0–<14 yrs 2.9 mmol/L 23.1 mmol/L 16 mg/dL 129 mg/dL 2.9 mmol/L 23.1 mmol/L 16 mg/dL 129 mg/dL
14–<19 yrs 3.6 mmol/L 29.3 mmol/L 20 mg/dL 164 mg/dL 6.2 mmol/L 30.3 mmol/L 35 mg/dL 169 mg/dL
Lactate dehydrogenase-US (LD) 0–<15 d 256 U/L 1017 U/L 256 U/L 1017 U/L 256 U/L 1017 U/L 256 U/L 1017 U/L
15 d–<1 yr 135 U/L 375 U/L 135 U/L 375 U/L 135 U/L 375 U/L 135 U/L 375 U/L
1–<10 yrs 159 U/L 266 U/L 159 U/L 266 U/L 159 U/L 266 U/L 159 U/L 266 U/L
10–<15 yrs 130 U/L 225 U/L 130 U/L 225 U/L 141 U/L 235 U/L 141 U/L 235 U/L
15–<19 yrs 107 U/L 207 U/L 107 U/L 207 U/L 107 U/L 207 U/L 107 U/L 207 U/L
Lactate dehydrogenase-non-US-OSR627 (LDA) 0–<15 d 287 U/L 1128 U/L 287 U/L 1128 U/L 287 U/L 1128 U/L 287 U/L 1128 U/L
15 d–<1 yr 152 U/L 418 U/L 152 U/L 418 U/L 152 U/L 418 U/L 152 U/L 418 U/L
1–<10 yrs 179 U/L 298 U/L 179 U/L 298 U/L 179 U/L 298 U/L 179 U/L 298 U/L
10–<15 yrs 146 U/L 252 U/L 146 U/L 252 U/L 158 U/L 263 U/L 158 U/L 263 U/L
15–<19 yrs 122 U/L 232 U/L 122 U/L 232 U/L 122 U/L 232 U/L 122 U/L 232 U/L
Lactate dehydrogenase-non-US-OSR626 (LDB) 0–<15 d 594 U/L 2298 U/L 594 U/L 2298 U/L 594 U/L 2298 U/L 594 U/L 2298 U/L
15 d–<1 yr 321 U/L 861 U/L 321 U/L 861 U/L 321 U/L 861 U/L 321 U/L 861 U/L
1–<10 yrs 375 U/L 616 U/L 375 U/L 616 U/L 375 U/L 616 U/L 375 U/L 616 U/L
10–<15 yrs 310 U/L 525 U/L 310 U/L 525 U/L 334 U/L 545 U/L 334 U/L 545 U/L
15–<19 yrs 260 U/L 484 U/L 260 U/L 484 U/L 260 U/L 484 U/L 260 U/L 484 U/L
Lactate dehydrogenase-non-US-OSR628 (LDC) 0–<15 d 321 U/L 1264 U/L 321 U/L 1264 U/L 321 U/L 1264 U/L 321 U/L 1264 U/L
15 d–<1 yr 170 U/L 468 U/L 170 U/L 468 U/L 170 U/L 468 U/L 170 U/L 468 U/L
1–<10 yrs 200 U/L 333 U/L 200 U/L 333 U/L 200 U/L 333 U/L 200 U/L 333 U/L
10–<15 yrs 163 U/L 282 U/L 163 U/L 282 U/L 177 U/L 294 U/L 177 U/L 294 U/L
15–<19 yrs 136 U/L 260 U/L 136 U/L 260 U/L 136 U/L 260 U/L 136 U/L 260 U/L
Magnesium-US (MG) 0–<15 d 0.79 mmol/L 1.56 mmol/L 1.9 mg/dL 3.8 mg/dL 0.79 mmol/L 1.56 mmol/L 1.9 mg/dL 3.8 mg/dL
15 d–<1 yr 0.78 mmol/L 1.22 mmol/L 1.9 mg/dL 3.0 mg/dL 0.78 mmol/L 1.22 mmol/L 1.9 mg/dL 3.0 mg/dL
1–<19 yrs 0.83 mmol/L 1.13 mmol/L 2.0 mg/dL 2.7 mg/dL 0.83 mmol/L 1.13 mmol/L 2.0 mg/dL 2.7 mg/dL
Phosphorus-US (PHS) 0–<15 d 1.76 mmol/L 3.37 mmol/L 5.4 mg/dL 10.4 mg/dL 1.76 mmol/L 3.37 mmol/L 5.4 mg/dL 10.4 mg/dL
15 d–<1 yr 1.46 mmol/L 2.66 mmol/L 4.5 mg/dL 8.2 mg/dL 1.46 mmol/L 2.66 mmol/L 4.5 mg/dL 8.2 mg/dL
1–<5 yrs 1.36 mmol/L 2.16 mmol/L 4.2 mg/dL 6.7 mg/dL 1.36 mmol/L 2.16 mmol/L 4.2 mg/dL 6.7 mg/dL
5–<13 yrs 1.26 mmol/L 1.86 mmol/L 3.9 mg/dL 5.8 mg/dL 1.26 mmol/L 1.86 mmol/L 3.9 mg/dL 5.8 mg/dL
13–<16 yrs 0.96 mmol/L 1.76 mmol/L 3.0 mg/dL 5.4 mg/dL 1.06 mmol/L 1.96 mmol/L 3.3 mg/dL 6.1 mg/dL
16–<19 yrs 0.96 mmol/L 1.56 mmol/L 3.0 mg/dL 4.8 mg/dL 0.96 mmol/L 1.56 mmol/L 3.0 mg/dL 4.8 mg/dL
Phosphorus-non-US (PHSO) 0–<15 d 1.87 mmol/L 3.74 mmol/L 5.8 mg/dL 11.6 mg/dL 1.87 mmol/L 3.74 mmol/L 5.8 mg/dL 11.6 mg/dL
15 d–<1 yr 1.52 mmol/L 2.92 mmol/L 4.7 mg/dL 9.0 mg/dL 1.52 mmol/L 2.92 mmol/L 4.7 mg/dL 9.0 mg/dL
1–<5 yrs 1.40 mmol/L 2.33 mmol/L 4.3 mg/dL 7.2 mg/dL 1.40 mmol/L 2.33 mmol/L 4.3 mg/dL 7.2 mg/dL
5–<13 yrs 1.28 mmol/L 1.98 mmol/L 4.0 mg/dL 6.1 mg/dL 1.28 mmol/L 1.98 mmol/L 4.0 mg/dL 6.1 mg/dL
13–<16 yrs 0.93 mmol/L 1.87 mmol/L 2.9 mg/dL 5.8 mg/dL 1.05 mmol/L 2.10 mmol/L 3.3 mg/dL 6.5 mg/dL
16–<19 yrs 0.93 mmol/L 1.63 mmol/L 2.9 mg/dL 5.0 mg/dL 0.93 mmol/L 1.63 mmol/L 2.9 mg/dL 5.0 mg/dL
(continued)
Table 2. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Prealbumin (PAB) 0–<15 d 0.02 g/L 0.11 g/L 2 mg/dL 11 mg/dL 0.02 g/L 0.11 g/L 2 mg/dL 11 mg/dL
15 d–<1 yr 0.05 g/L 0.22 g/L 5 mg/dL 22 mg/dL 0.05 g/L 0.22 g/L 5 mg/dL 22 mg/dL
1–<5 yrs 0.11 g/L 0.21 g/L 11 mg/dL 21 mg/dL 0.11 g/L 0.21 g/L 11 mg/dL 21 mg/dL
5–<13 yrs 0.13 g/L 0.24 g/L 13 mg/dL 24 mg/dL 0.13 g/L 0.24 g/L 13 mg/dL 24 mg/dL
13–<16 yrs 0.17 g/L 0.29 g/L 17 mg/dL 29 mg/dL 0.17 g/L 0.29 g/L 17 mg/dL 29 mg/dL
16–<19 yrs 0.16 g/L 0.31 g/L 16 mg/dL 31 mg/dL 0.19 g/L 0.32 g/L 19 mg/dL 32 mg/dL
Total protein (TP) 0–<15 d 52 g/L 79 g/L 5.2 g/dL 7.9 g/dL 52 g/L 79 g/L 5.2 g/dL 7.9 g/dL
15 d–<1 yr 43 g/L 68 g/L 4.3 g/dL 6.8 g/dL 43 g/L 68 g/L 4.3 g/dL 6.8 g/dL
1–<6 yrs 59 g/L 72 g/L 5.9 g/dL 7.2 g/dL 59 g/L 72 g/L 5.9 g/dL 7.2 g/dL
6–<9 yrs 62 g/L 74 g/L 6.2 g/dL 7.4 g/dL 62 g/L 74 g/L 6.2 g/dL 7.4 g/dL
9–<19 yrs 63 g/L 77 g/L 6.3 g/dL 7.7 g/dL 63 g/L 77 g/L 6.3 g/dL 7.7 g/dL
Transferrin (Trn) 0–<9 wks 0.99 g/L 2.18 g/L 99 mg/dL 218 mg/dL 0.99 g/L 2.18 g/L 99 mg/dL 218 mg/dL
9 wks–<1 yr 1.02 g/L 3.17 g/L 102 mg/dL 317 mg/dL 1.02 g/L 3.17 g/L 102 mg/dL 317 mg/dL
1–<19 yrs 2.14 g/L 3.30 g/L 214 mg/dL 330 mg/dL 2.14 g/L 3.30 g/L 214 mg/dL 330 mg/dL
Triglycerides-US (TG) 0–<15 d 0.97 mmol/L 3.13 mmol/L 86 mg/dL 277 mg/dL 0.97 mmol/L 3.13 mmol/L 86 mg/dL 277 mg/dL
15 d–<1 yr 0.62 mmol/L 3.12 mmol/L 55 mg/dL 276 mg/dL 0.62 mmol/L 3.12 mmol/L 55 mg/dL 276 mg/dL
1–<19 yrs 0.51 mmol/L 2.38 mmol/L 45 mg/dL 211 mg/dL 0.51 mmol/L 2.38 mmol/L 45 mg/dL 211 mg/dL
Triglycerides-non-US (TGO) 0–<15 d 1.05 mmol/L 3.34 mmol/L 93 mg/dL 296 mg/dL 1.05 mmol/L 3.34 mmol/L 93 mg/dL 296 mg/dL
15 d–<1 yr 0.67 mmol/L 3.33 mmol/L 59 mg/dL 295 mg/dL 0.67 mmol/L 3.33 mmol/L 59 mg/dL 295 mg/dL
1–<19 yrs 0.55 mmol/L 2.54 mmol/L 49 mg/dL 225 mg/dL 0.55 mmol/L 2.54 mmol/L 49 mg/dL 225 mg/dL
Urea nitrogen-US (BUN) 0–<15 d 1.1 mmol/L 8.0 mmol/L 3 mg/dL 22 mg/dL 1.1 mmol/L 8.0 mmol/L 3 mg/dL 22 mg/dL
15 d–<1 yr 1.3 mmol/L 5.9 mmol/L 4 mg/dL 17 mg/dL 1.3 mmol/L 5.9 mmol/L 4 mg/dL 17 mg/dL
1–<10 yrs 3.2 mmol/L 7.7 mmol/L 9 mg/dL 22 mg/dL 3.2 mmol/L 7.7 mmol/L 9 mg/dL 22 mg/dL
10–<19 yrs 2.6 mmol/L 6.6 mmol/L 7 mg/dL 18 mg/dL 2.6 mmol/L 7.3 mmol/L 7 mg/dL 20 mg/dL
Urea nitrogen-non-US (BUNO) 0–<15 d 1.1 mmol/L 8.2 mmol/L 3 mg/dL 23 mg/dL 1.1 mmol/L 8.2 mmol/L 3 mg/dL 23 mg/dL
15 d–<1 yr 1.3 mmol/L 6.0 mmol/L 4 mg/dL 17 mg/dL 1.3 mmol/L 6.0 mmol/L 4 mg/dL 17 mg/dL
1–<10 yrs 3.2 mmol/L 7.9 mmol/L 9 mg/dL 22 mg/dL 3.2 mmol/L 7.9 mmol/L 9 mg/dL 22 mg/dL
10–<19 yrs 2.6 mmol/L 6.8 mmol/L 7 mg/dL 19 mg/dL 2.6 mmol/L 7.5 mmol/L 7 mg/dL 21 mg/dL
Uric acid (URIC) 0–<15 d 170 mmol/L 739 mmol/L 2.9 mg/dL 12.4 mg/dL 170 mmol/L 739 mmol/L 2.9 mg/dL 12.4 mg/dL
15 d–<1 yr 103 mmol/L 374 mmol/L 1.7 mg/dL 6.3 mg/dL 103 mmol/L 374 mmol/L 1.7 mg/dL 6.3 mg/dL
1–<10 yrs 114 mmol/L 290 mmol/L 1.9 mg/dL 4.9 mg/dL 114 mmol/L 290 mmol/L 1.9 mg/dL 4.9 mg/dL
10–<19 yrs 160 mmol/L 347 mmol/L 2.7 mg/dL 5.8 mg/dL 162 mmol/L 448 mmol/L 2.7 mg/dL 7.5 mg/dL
Uric acid (URIO) 0–<15 d 164 mmol/L 776 mmol/L 2.8 mg/dL 13.0 mg/dL 164 mmol/L 776 mmol/L 2.8 mg/dL 13.0 mg/dL
15 d–<1 yr 91 mmol/L 384 mmol/L 1.5 mg/dL 6.5 mg/dL 91 mmol/L 384 mmol/L 1.5 mg/dL 6.5 mg/dL
1–<12 yrs 104 mmol/L 293 mmol/L 1.7 mg/dL 4.9 mg/dL 104 mmol/L 293 mmol/L 1.7 mg/dL 4.9 mg/dL
12–<19 yrs 152 mmol/L 355 mmol/L 2.6 mg/dL 6.0 mg/dL 155 mmol/L 463 mmol/L 2.6 mg/dL 7.8 mg/dL
Reference interval value units are in Standard International units (SI units) and Conventional units (CON units).
Colored partitions indicate sex-specific differences within the age partitions. Refer to the original publication [31] for additional information. Approximately 200 patient samples were run on the Beckman Coulter
AU to transfer reference intervals from the Abbott ARCHITECT.
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES
385
Table 3. Pediatric reference intervals for the Beckman DxC – age and sex specific.
386

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Alanine aminotransferase (ALT)a 0–<1 yr 8 U/L 34 U/L 8 U/L 34 U/L 8 U/L 34 U/L 8 U/L 34 U/L
1–<13 yrs 12 U/L 27 U/L 12 U/L 27 U/L 12 U/L 27 U/L 12 U/L 27 U/L
13–<19 yrs 11 U/L 24 U/L 11 U/L 24 U/L 12 U/L 26 U/L 12 U/L 26 U/L
K. ADELI ET AL.

Albumin (ALBm)a 0–<15 d 29 g/L 42 g/L 2.9 g/dL 4.2 g/dL 29 g/L 42 g/L 2.9 g/dL 4.2 g/dL
15 d–<1 yr 26 g/L 47 g/L 2.6 g/dL 4.7 g/dL 26 g/L 47 g/L 2.6 g/dL 4.7 g/dL
1–<8 yrs 36 g/L 46 g/L 3.6 g/dL 4.6 g/dL 36 g/L 46 g/L 3.6 g/dL 4.6 g/dL
8–<15 yrs 38 g/L 48 g/L 3.8 g/dL 4.8 g/dL 38 g/L 48 g/L 3.8 g/dL 4.8 g/dL
15–<19 yrs 36 g/L 50 g/L 3.6 g/dL 5.0 g/dL 39 g/L 51 g/L 3.9 g/dL 5.1 g/dL
Albumin Pa 0–<15 d 28 g/L 42 g/L 2.8 g/dL 4.2 g/dL 28 g/L 42 g/L 2.8 g/dL 4.2 g/dL
15 d–<1 yr 25 g/L 47 g/L 2.5 g/dL 4.7 g/dL 25 g/L 47 g/L 2.5 g/dL 4.7 g/dL
1–<8 yrs 35 g/L 46 g/L 3.5 g/dL 4.6 g/dL 35 g/L 46 g/L 3.5 g/dL 4.6 g/dL
8–<15 yrs 38 g/L 48 g/L 3.8 g/dL 4.8 g/dL 38 g/L 48 g/L 3.8 g/dL 4.8 g/dL
15–<19 yrs 35 g/L 50 g/L 3.5 g/dL 5.0 g/dL 39 g/L 51 g/L 3.9 g/dL 5.1 g/dL
Alkaline phosphatase (ALP)a 0–<15 d 78 U/L 234 U/L 78 U/L 234 U/L 78 U/L 234 U/L 78 U/L 234 U/L
15 d–<1 yr 116 U/L 442 U/L 116 U/L 442 U/L 116 U/L 442 U/L 116 U/L 442 U/L
1–<10 yrs 134 U/L 315 U/L 134 U/L 315 U/L 134 U/L 315 U/L 134 U/L 315 U/L
10–<13 yrs 122 U/L 393 U/L 122 U/L 393 U/L 122 U/L 393 U/L 122 U/L 393 U/L
13–<15 yrs 55 U/L 240 U/L 55 U/L 240 U/L 110 U/L 441 U/L 110 U/L 441 U/L
15–<17 yrs 48 U/L 111 U/L 48 U/L 111 U/L 78 U/L 312 U/L 78 U/L 312 U/L
17–<19 yrs 43 U/L 83 U/L 43 U/L 83 U/L 52 U/L 141 U/L 52 U/L 141 U/L
Amylase (AMY)a 0–<15 d 0 U/L 8 U/L 0 U/L 8 U/L 0 U/L 8 U/L 0 U/L 8 U/L
15 d–<13 wks 0 U/L 22 U/L 0 U/L 22 U/L 0 U/L 22 U/L 0 U/L 22 U/L
13 wks–<1 yr 0 U/L 55 U/L 0 U/L 55 U/L 0 U/L 55 U/L 0 U/L 55 U/L
1–<19 yrs 26 U/L 115 U/L 26 U/L 115 U/L 26 U/L 115 U/L 26 U/L 115 U/L
Antistreptolysin-O (ASO)a,c 0–<6 m 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL
6 m–<1 yr 0 IU/mL 3 IU/mL 0 IU/mL 3 IU/mL 0 IU/mL 3 IU/mL 0 IU/mL 3 IU/mL
1–<6 yrs 0 IU/mL 82 IU/mL 0 IU/mL 82 IU/mL 0 IU/mL 82 IU/mL 0 IU/mL 82 IU/mL
6–<19 yrs 0 IU/mL 328 IU/mL 0 IU/mL 328 IU/mL 0 IU/mL 328 IU/mL 0 IU/mL 328 IU/mL
Apolipoprotein B (APOB)a 0–<15 d 0.1 g/L 0.7 g/L 12 mg/dL 75 mg/dL 0.1 g/L 0.7 g/L 12 mg/dL 75 mg/dL
15 d–<1 yr 0.2 g/L 1.3 g/L 23 mg/dL 134 mg/dL 0.2 g/L 1.3 g/L 23 mg/dL 134 mg/dL
1–<6 yrs 0.5 g/L 1.0 g/L 46 mg/dL 102 mg/dL 0.5 g/L 1.0 g/L 46 mg/dL 102 mg/dL
6–<19 yrs 0.4 g/L 0.9 g/L 35 mg/dL 92 mg/dL 0.4 g/L 0.9 g/L 35 mg/dL 92 mg/dL
Aspartate aminotransferase (AST)a 0–<15 d 35 U/L 159 U/L 35 U/L 159 U/L 35 U/L 159 U/L 35 U/L 159 U/L
15 d–<1 yr 23 U/L 68 U/L 23 U/L 68 U/L 23 U/L 68 U/L 23 U/L 68 U/L
1–<7 yrs 24 U/L 46 U/L 24 U/L 46 U/L 24 U/L 46 U/L 24 U/L 46 U/L
7–<12 yrs 21 U/L 39 U/L 21 U/L 39 U/L 21 U/L 39 U/L 21 U/L 39 U/L
12–<19 yrs 17 U/L 29 U/L 17 U/L 29 U/L 18 U/L 38 U/L 18 U/L 38 U/L
Bilirubin, directa 0–<15 d 4.0 mmol/L 8.8 mmol/L 0.2 mg/dL 0.5 mg/dL 4.0 mmol/L 8.8 mmol/L 0.2 mg/dL 0.5 mg/dL
15 d–<1 yr 0.2 mmol/L 3.6 mmol/L 0.0 mg/dL 0.2 mg/dL 0.2 mmol/L 3.6 mmol/L 0.0 mg/dL 0.2 mg/dL
1–<9 yrs 0.2 mmol/L 2.2 mmol/L 0.0 mg/dL 0.1 mg/dL 0.2 mmol/L 2.2 mmol/L 0.0 mg/dL 0.1 mg/dL
9–<13 yrs 0.2 mmol/L 3.4 mmol/L 0.0 mg/dL 0.2 mg/dL 0.2 mmol/L 3.4 mmol/L 0.0 mg/dL 0.2 mg/dL
13–<19 yrs 0.9 mmol/L 4.7 mmol/L 0.0 mg/dL 0.3 mg/dL 1.1 mmol/L 5.0 mmol/L 0.1 mg/dL 0.3 mg/dL
Bilirubin totala,c 0–<15 d 4 mmol/L 267 mmol/L 0.2 mg/dL 15.6 mg/dL 4 mmol/L 267 mmol/L 0.2 mg/dL 15.6 mg/dL
15 d–<1 yr 2 mmol/L 12 mmol/L 0.1 mg/dL 0.7 mg/dL 2 mmol/L 12 mmol/L 0.1 mg/dL 0.7 mg/dL
1–<9 yrs 2 mmol/L 7 mmol/L 0.1 mg/dL 0.4 mg/dL 2 mmol/L 7 mmol/L 0.1 mg/dL 0.4 mg/dL
9–<12 yrs 2 mmol/L 10 mmol/L 0.1 mg/dL 0.6 mg/dL 2 mmol/L 10 mmol/L 0.1 mg/dL 0.6 mg/dL
12–<15 yrs 3 mmol/L 12 mmol/L 0.1 mg/dL 0.7 mg/dL 3 mmol/L 12 mmol/L 0.1 mg/dL 0.7 mg/dL
15–<19 yrs 3 mmol/L 14 mmol/L 0.1 mg/dL 0.8 mg/dL 3 mmol/L 14 mmol/L 0.1 mg/dL 0.8 mg/dL
(continued)
Table 3. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Calciumb 0–<15 d 1.20 mmol/L 3.24 mmol/L 46 mg/dL 125 mg/dL 1.10 mmol/L 2.83 mmol/L 42 mg/dL 109 mg/dL
15 d–<1 yr 1.66 mmol/L 6.16 mmol/L 64 mg/dL 238 mg/dL 1.66 mmol/L 6.16 mmol/L 64 mg/dL 238 mg/dL
1–<19 yrs 2.91 mmol/L 5.43 mmol/L 112 mg/dL 210 mg/dL 2.91 mmol/L 5.43 mmol/L 112 mg/dL 210 mg/dL
Cholesterola 0–<15 d 1.20 mmol/L 3.24 mmol/L 46 mg/dL 125 mg/dL 1.10 mmol/L 2.83 mmol/L 42 mg/dL 109 mg/dL
15 d–<1 yr 1.66 mmol/L 6.16 mmol/L 64 mg/dL 238 mg/dL 1.66 mmol/L 6.16 mmol/L 64 mg/dL 238 mg/dL
1–<19 yrs 2.91 mmol/L 5.43 mmol/L 112 mg/dL 210 mg/dL 2.91 mmol/L 5.43 mmol/L 112 mg/dL 210 mg/dL
Complement component 3 (C3)a 0–<15 d 0.56 g/L 1.31 g/L 56 mg/dL 131 mg/dL 0.56 g/L 1.31 g/L 56 mg/dL 131 mg/dL
15 d–<1 yr 0.57 g/L 1.71 g/L 57 mg/dL 171 mg/dL 0.57 g/L 1.71 g/L 57 mg/dL 171 mg/dL
1–<19 yrs 0.91 g/L 1.63 g/L 91 mg/dL 163 mg/dL 0.91 g/L 1.63 g/L 91 mg/dL 163 mg/dL
Complement component 4 (C4)a 0 –<1 yrs 0.06 g/L 0.34 g/L 6 mg/dL 34 mg/dL 0.06 g/L 0.34 g/L 6 mg/dL 34 mg/dL
1–<19 yrs 0.13 g/L 0.43 g/L 13 mg/dL 43 mg/dL 0.13 g/L 0.43 g/L 13 mg/dL 43 mg/dL
Creatinine, enzymatica 0–<15 d 27 mmol/L 77 mmol/L 0.3 mg/dL 0.9 mg/dL 27 mmol/L 77 mmol/L 0.3 mg/dL 0.9 mg/dL
15 d–<2 yrs 9 mmol/L 30 mmol/L 0.1 mg/dL 0.3 mg/dL 9 mmol/L 30 mmol/L 0.1 mg/dL 0.3 mg/dL
2–<5 yrs 17 mmol/L 36 mmol/L 0.2 mg/dL 0.4 mg/dL 17 mmol/L 36 mmol/L 0.2 mg/dL 0.4 mg/dL
5–<12 yrs 26 mmol/L 51 mmol/L 0.3 mg/dL 0.6 mg/dL 26 mmol/L 51 mmol/L 0.3 mg/dL 0.6 mg/dL
12–<15 yrs 38 mmol/L 68 mmol/L 0.4 mg/dL 0.8 mg/dL 38 mmol/L 68 mmol/L 0.4 mg/dL 0.8 mg/dL
15–<19 yrs 41 mmol/L 70 mmol/L 0.5 mg/dL 0.8 mg/dL 52 mmol/L 90 mmol/L 0.6 mg/dL 1.0 mg/dL
Gamma-glutamyl transferase (GGT)a 0–<15 d 16 U/L 137 U/L 16 U/L 137 U/L 16 U/L 137 U/L 16 U/L 137 U/L
15 d–<1 yr 7 U/L 80 U/L 7 U/L 80 U/L 7 U/L 80 U/L 7 U/L 80 U/L
1–<11 yrs 5 U/L 12 U/L 5 U/L 12 U/L 5 U/L 12 U/L 5 U/L 12 U/L
11–<19 yrs 6 U/L 15 U/L 6 U/L 15 U/L 6 U/L 15 U/L 6 U/L 15 U/L
High-density lipoprotein cholesterol (HDL-C)a 0–<15 d 0.48 mmol/L 1.07 mmol/L 19 mg/dL 41 mg/dL 0.48 mmol/L 1.07 mmol/L 19 mg/dL 41 mg/dL
15 d–<1 yr 0.39 mmol/L 1.74 mmol/L 15 mg/dL 67 mg/dL 0.39 mmol/L 1.74 mmol/L 15 mg/dL 67 mg/dL
1–<4 yrs 0.86 mmol/L 1.55 mmol/L 33 mg/dL 60 mg/dL 0.86 mmol/L 1.55 mmol/L 33 mg/dL 60 mg/dL
4–<13 yrs 0.93 mmol/L 1.77 mmol/L 36 mg/dL 68 mg/dL 0.93 mmol/L 1.77 mmol/L 36 mg/dL 68 mg/dL
13–<19 yrs 0.86 mmol/L 1.75 mmol/L 33 mg/dL 68 mg/dL 0.85 mmol/L 1.67 mmol/L 33 mg/dL 64 mg/dL
Immunoglobulin A (IgA)a 0–<1 yr 0.0 g/L 0.3 g/L 0 mg/dL 30 mg/dL 0.0 g/L 0.3 g/L 0 mg/dL 30 mg/dL
1–<3 yrs 0.0 g/L 0.9 g/L 0 mg/dL 90 mg/dL 0.0 g/L 0.9 g/L 0 mg/dL 90 mg/dL
3–<6 yrs 0.3 g/L 1.6 g/L 30 mg/dL 160 mg/dL 0.3 g/L 1.6 g/L 30 mg/dL 160 mg/dL
6–<14 yrs 0.5 g/L 2.3 g/L 50 mg/dL 230 mg/dL 0.5 g/L 2.3 g/L 50 mg/dL 230 mg/dL
14–<19 yrs 0.5 g/L 3.1 g/L 50 mg/dL 310 mg/dL 0.5 g/L 3.1 g/L 50 mg/dL 310 mg/dL
Immunoglobulin G (IgG)a 0–<15 d 3.0 g/L 13.6 g/L 300 mg/dL 1360 mg/dL 3.0 g/L 13.6 g/L 300 mg/dL 1360 mg/dL
15 d–<1 yr 1.0 g/L 6.8 g/L 110 mg/dL 680 mg/dL 1.0 g/L 6.8 g/L 110 mg/dL 680 mg/dL
1–<4 yrs 3.0 g/L 11.2 g/L 300 mg/dL 1120 mg/dL 3.0 g/L 11.2 g/L 300 mg/dL 1120 mg/dL
4–<10 yrs 5.2 g/L 13.2 g/L 520 mg/dL 1320 mg/dL 5.2 g/L 13.2 g/L 520 mg/dL 1320 mg/dL
10–<19 yrs 6.4 g/L 14.9 g/L 640 mg/dL 1490 mg/dL 6.4 g/L 14.9 g/L 640 mg/dL 1490 mg/dL
Immunoglobulin M (IgM)a 0–<15 d 0.2 g/L 0.5 g/L 20 mg/dL 50 mg/dL 0.2 g/L 0.5 g/L 20 mg/dL 50 mg/dL
15 d–<13 wks 0.2 g/L 0.7 g/L 20 mg/dL 70 mg/dL 0.2 g/L 0.7 g/L 20 mg/dL 70 mg/dL
13 wks–<1 yr 0.3 g/L 0.9 g/L 30 mg/dL 90 mg/dL 0.3 g/L 0.9 g/L 30 mg/dL 90 mg/dL
1–<19 yrs 0.6 g/L 1.8 g/L 60 mg/dL 180 mg/dL 0.5 g/L 1.5 g/L 50 mg/dL 150 mg/dL
Irona 0–<14 yrs 3.1 mmol/L 23.1 mmol/L 17 mg/dL 129 mg/dL 3.1 mmol/L 23.1 mmol/L 17 mg/dL 129 mg/dL
14–<19 yrs 3.8 mmol/L 29.2 mmol/L 21 mg/dL 163 mg/dL 5.8 mmol/L 30.2 mmol/L 32 mg/dL 169 mg/dL
Lactate dehydrogenase (LDH)a 0–<15 d 254 U/L 982 U/L 254 U/L 982 U/L 254 U/L 982 U/L 254 U/L 982 U/L
15 d–<1 yr 137 U/L 368 U/L 137 U/L 368 U/L 137 U/L 368 U/L 137 U/L 368 U/L
1–<10 yrs 160 U/L 263 U/L 160 U/L 263 U/L 160 U/L 263 U/L 160 U/L 263 U/L
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

10–<15 yrs 132 U/L 224 U/L 132 U/L 224 U/L 143 U/L 233 U/L 143 U/L 233 U/L
15–<19 yrs 111 U/L 207 U/L 111 U/L 207 U/L 111 U/L 207 U/L 111 U/L 207 U/L
(continued)
387
Table 3. Continued
388

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Magnesiumc (MG)a 0–<15 d 0.83 mmol/L 1.65 mmol/L 2.0 mg/dL 4.0 mg/dL 0.83 mmol/L 1.65 mmol/L 2.0 mg/dL 4.0 mg/dL
15 d–<1 yr 0.82 mmol/L 1.29 mmol/L 2.0 mg/dL 3.1 mg/dL 0.82 mmol/L 1.29 mmol/L 2.0 mg/dL 3.1 mg/dL
1–<19 yrs 0.87 mmol/L 1.19 mmol/L 2.1 mg/dL 2.9 mg/dL 0.87 mmol/L 1.19 mmol/L 2.1 mg/dL 2.9 mg/dL
K. ADELI ET AL.

Phosphate (PHS)a 0–<15 d 1.91 mmol/L 3.65 mmol/L 5.9 mg/dL 11.3 mg/dL 1.91 mmol/L 3.65 mmol/L 5.9 mg/dL 11.3 mg/dL
15 d–<1 yr 1.62 mmol/L 2.91 mmol/L 5.0 mg/dL 9.0 mg/dL 1.62 mmol/L 2.91 mmol/L 5.0 mg/dL 9.0 mg/dL
1–<5 yrs 1.45 mmol/L 2.33 mmol/L 4.5 mg/dL 7.2 mg/dL 1.45 mmol/L 2.33 mmol/L 4.5 mg/dL 7.2 mg/dL
5–<13 yrs 1.40 mmol/L 2.04 mmol/L 4.3 mg/dL 6.3 mg/dL 1.40 mmol/L 2.04 mmol/L 4.3 mg/dL 6.3 mg/dL
13–<16 yrs 1.06 mmol/L 1.90 mmol/L 3.3 mg/dL 5.9 mg/dL 1.19 mmol/L 2.11 mmol/L 3.7 mg/dL 6.5 mg/dL
16–<19 yrs 0.98 mmol/L 1.71 mmol/L 3.0 mg/dL 5.3 mg/dL 0.98 mmol/L 1.71 mmol/L 3.0 mg/dL 5.3 mg/dL
Prealbumina 0–<15 d 0.02 g/L 0.12 g/L 2 mg/dL 12 mg/dL 0.02 g/L 0.12 g/L 2 mg/dL 12 mg/dL
15 d–<1 yr 0.05 g/L 0.25 g/L 5 mg/dL 25 mg/dL 0.05 g/L 0.25 g/L 5 mg/dL 25 mg/dL
1–<5 yrs 0.12 g/L 0.24 g/L 12 mg/dL 24 mg/dL 0.12 g/L 0.24 g/L 12 mg/dL 24 mg/dL
5–<13 yrs 0.15 g/L 0.27 g/L 15 mg/dL 27 mg/dL 0.15 g/L 0.27 g/L 15 mg/dL 27 mg/dL
13–<16 yrs 0.19 g/L 0.33 g/L 19 mg/dL 33 mg/dL 0.19 g/L 0.33 g/L 19 mg/dL 33 mg/dL
16–<19 yrs 0.18 g/L 0.35 g/L 18 mg/dL 35 mg/dL 0.21 g/L 0.37 g/L 21 mg/dL 37 mg/dL
Total proteina 0–<15 d 54 g/L 83 g/L 5.4 g/dL 8.3 g/dL 54 g/L 83 g/L 5.4 g/dL 8.3 g/dL
15 d–<1 yr 45 g/L 71 g/L 4.5 g/dL 7.1 g/dL 45 g/L 71 g/L 4.5 g/dL 7.1 g/dL
1–<6 yrs 62 g/L 75 g/L 6.2 g/dL 7.5 g/dL 62 g/L 75 g/L 6.2 g/dL 7.5 g/dL
6–<9 yrs 65 g/L 77 g/L 6.5 g/dL 7.7 g/dL 65 g/L 77 g/L 6.5 g/dL 7.7 g/dL
9–<19 yrs 66 g/L 81 g/L 6.6 g/dL 8.1 g/dL 66 g/L 81 g/L 6.6 g/dL 8.1 g/dL
Total protein (Tpm)a 0–<15 d 52 g/L 81 g/L 5.2 g/dL 8.1 g/dL 52 g/L 81 g/L 5.2 g/dL 8.1 g/dL
15 d–<1 yr 43 g/L 69 g/L 4.3 g/dL 6.9 g/dL 43 g/L 69 g/L 4.3 g/dL 6.9 g/dL
1–<6 yrs 59 g/L 73 g/L 5.9 g/dL 7.3 g/dL 59 g/L 73 g/L 5.9 g/dL 7.3 g/dL
6–<9 yrs 62 g/L 75 g/L 6.2 g/dL 7.5 g/dL 62 g/L 75 g/L 6.2 g/dL 7.5 g/dL
9–<19 yrs 63 g/L 79 g/L 6.3 g/dL 7.9 g/dL 63 g/L 79 g/L 6.3 g/dL 7.9 g/dL
Transferrina 0–<9 wks 1.12 g/L 2.30 g/L 112 mg/dL 230 mg/dL 1.12 g/L 2.30 g/L 112 mg/dL 230 mg/dL
9 wks–<1 yr 1.15 g/L 3.28 g/L 115 mg/dL 328 mg/dL 1.15 g/L 3.28 g/L 115 mg/dL 328 mg/dL
1–<19 yrs 2.26 g/L 3.41 g/L 226 mg/dL 341 mg/dL 2.26 g/L 3.41 g/L 226 mg/dL 341 mg/dL
Triglyceridesa 0–<15 d 0.95 mmol/L 3.19 mmol/L 84 mg/dL 282 mg/dL 0.95 mmol/L 3.19 mmol/L 84 mg/dL 282 mg/dL
15 d–<1 yr 0.58 mmol/L 3.18 mmol/L 51 mg/dL 281 mg/dL 0.58 mmol/L 3.18 mmol/L 51 mg/dL 281 mg/dL
1–<19 yrs 0.47 mmol/L 2.41 mmol/L 41 mg/dL 213 mg/dL 0.47 mmol/L 2.41 mmol/L 41 mg/dL 213 mg/dL
Urea (BUN)a 0–<15 d 1.3 mmol/L 8.6 mmol/L 4 mg/dL 24 mg/dL 1.3 mmol/L 8.6 mmol/L 4 mg/dL 24 mg/dL
15 d–<1 yr 1.5 mmol/L 6.4 mmol/L 4 mg/dL 18 mg/dL 1.5 mmol/L 6.4 mmol/L 4 mg/dL 18 mg/dL
1–<10 yrs 3.5 mmol/L 8.3 mmol/L 10 mg/dL 23 mg/dL 3.5 mmol/L 8.3 mmol/L 10 mg/dL 23 mg/dL
10–<19 yrs 2.9 mmol/L 7.2 mmol/L 8 mg/dL 20 mg/dL 2.9 mmol/L 7.9 mmol/L 8 mg/dL 22 mg/dL
Urea (BUNm)a 0–<15 d 0.7 mmol/L 7.7 mmol/L 2 mg/dL 22 mg/dL 0.7 mmol/L 7.7 mmol/L 2 mg/dL 22 mg/dL
15 d–<1 yr 0.9 mmol/L 5.5 mmol/L 3 mg/dL 15 mg/dL 0.9 mmol/L 5.5 mmol/L 3 mg/dL 15 mg/dL
1–<10 yrs 2.8 mmol/L 7.4 mmol/L 8 mg/dL 21 mg/dL 2.8 mmol/L 7.4 mmol/L 8 mg/dL 21 mg/dL
10–<19 yrs 2.2 mmol/L 6.3 mmol/L 6 mg/dL 18 mg/dL 2.2 mmol/L 7.0 mmol/L 6 mg/dL 20 mg/dL
Uric acid (URIC)a 0–<15 d 168 mmol/L 696 mmol/L 2.8 mg/dL 11.7 mg/dL 168 mmol/L 696 mmol/L 2.8 mg/dL 11.7 mg/dL
15 d–<1 yr 106 mmol/L 358 mmol/L 1.8 mg/dL 6.0 mg/dL 106 mmol/L 358 mmol/L 1.8 mg/dL 6.0 mg/dL
1–<10 yrs 116 mmol/L 279 mmol/L 2.0 mg/dL 4.7 mg/dL 116 mmol/L 279 mmol/L 2.0 mg/dL 4.7 mg/dL
10–<19 yrs 158 mmol/L 333 mmol/L 2.7 mg/dL 5.6 mg/dL 161 mmol/L 426 mmol/L 2.7 mg/dL 7.2 mg/dL
Reference interval value units are in Standard International units (SI units) and Convential units (CON units).
Colored partitions indicate sex-specific differences within the age partitions.
a
Refer to the original publication [30] for additional information.
b
Refer to the original publication [29] for additional information.
Approximately 200 patient samples were run on the Beckman Coulter DxC to transfer reference intervals from the Abbott ARCHITECT.
c
Reference interval did not verify. Use with caution. See origical publication [29,30] for more infornation.
Table 4. Pediatric reference intervals for the Beckman DxI – age and sex specific.
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Alpha-fetoprotin (AFP) 0–<4 m 68 33.8 lg/L >3000 lg/L 33.8 ng/mL >3000 ng/mL 68 33.8 lg/L >3000 lg/L 33.8 ng/mL >3000 ng/mL
4–<9 m 72 1.57 lg/L 113 lg/L 1.57 ng/mL 113 ng/mL 72 1.57 lg/L 113 lg/L 1.57 ng/mL 113 ng/mL
9 m–<2.5 yrs 91 1.16 lg/L 40.1 lg/L 1.16 ng/mL 40.1 ng/mL 91 1.16 lg/L 40.1 lg/L 1.16 ng/mL 40.1 ng/mL
2.5–<19 yrs 448 0.79 lg/L 4.48 lg/L 0.79 ng/mL 4.48 ng/mL 448 0.79 lg/L 4.48 lg/L 0.79 ng/mL 4.48 ng/mL
Creatine kinase-MB (CK-MB) 0–<6 yrs 53 1.44 lg/L 6.05 lg/L 1.44 ng/mL 6.05 ng/mL 63 1.51 lg/L 9.39 lg/L 1.51 ng/mL 9.39 ng/mL
6–<13 yrs 80 0.88 lg/L 4.37 lg/L 0.88 ng/mL 4.37 ng/mL 86 1.26 lg/L 5.56 lg/L 1.26 ng/mL 5.56 ng/mL
13–<19 yrs 72 0.46 lg/L 2.04 lg/L 0.46 ng/mL 2.04 ng/mL 68 0.70 lg/L 4.59 lg/L 0.70 ng/mL 4.59 ng/mL
Cortisol 0–<3 m 66 31.5 nmol/l 519.0 nmol/l 1.14 lg/dL 18.8 lg/dL 66 31.5 nmol/l 519.2 nmol/l 1.14 lg/dL 18.8 lg/dL
3 m–<1 yr 120 72.6 nmol/l 634.0 nmol/l 2.63 lg/dL 23.0 lg/dL 120 72.6 nmol/l 634.0 nmol/l 2.63 lg/dL 23.0 lg/dL
1–<13 yrs 351 60.4 nmol/l 353.2 nmol/l 2.19 lg/dL 12.8 lg/dL 351 60.4 nmol/l 353.2 nmol/l 2.19 lg/dL 12.8 lg/dL
13–<16 yrs 89 83.6 nmol/l 472.1 nmol/l 3.03 lg/dL 17.1 lg/dL 89 83.6 nmol/l 472.1 nmol/l 3.03 lg/dL 17.1 lg/dL
16–<19 yrs 85 104 nmol/l 535 nmol/l 3.78 lg/dL 19.4 lg/dL 85 104 nmol/l 535 nmol/l 3.78 lg/dL 19.4 lg/dL
Dehydroepiandrosterone sulfate (DHEA-S) 0–<15 d 76 3.28 lmol/L >27.1 lmol/L 1.21 lg/mL >10.0 lg/mL 76 3.28 lmol/L >27.1 lmol/L 1.21 lg/mL >10.0 lg/mL
15 d–<6 m 42 0.01 lmol/L 8.71 lmol/L 0 lg/mL 3.21 lg/mL 42 0.01 lmol/L 8.71 lmol/L 0 lg/mL 3.21 lg/mL
6 m–<1 yr 49 0.01 lmol/L 1.24 lmol/L 0 lg/mL 0.46 lg/mL 49 0.01 lmol/L 1.24 lmol/L 0 lg/mL 0.46 lg/mL
1–<6 yrs 166 <0.05 lmol/L 1.01 lmol/L <0.02 lg/mL 0.37 lg/mL 166 <0.05 lmol/L 1.01 lmol/L <0.02 lg/mL 0.37 lg/mL
6–<9 yrs 87 0.13 lmol/L 2.55 lmol/L 0.05 lg/mL 0.94 lg/mL 87 0.13 lmol/L 2.55 lmol/L 0.05 lg/mL 0.94 lg/mL
9–<13 yrs 107 0.43 lmol/L 5.62 lmol/L 0.16 lg/mL 0.06 lg/mL 107 0.43 lmol/L 5.62 lmol/L 0.16 lg/mL 0.06 lg/mL
13–<16 yrs 46 1.03 lmol/L 9.13 lmol/L 0.38 lg/mL 0.14 lg/mL 43 1.79 lmol/L 11.29 lmol/L 0.66 lg/mL 4.16 lg/mL
16–<19 yrs 44 1.97 lmol/L 16.1 lmol/L 0.73 lg/mL 0.27 lg/mL 41 3.06 lmol/L 16.6 lmol/L 1.13 lg/mL 6.10 lg/mL
Estradiol 0–<1 y 146 <73 pmol/L 193 pmol/L <19.9 pg/mL 52.5 pg/mL 146 <73 pmol/L 193 pmol/L <19.9 pg/mL 52.5 pg/mL
1 yr–<12 yrs 321 <73 pmol/L <73 pmol/L <19.9 pg/mL <19.9 pg/mL 321 <73 pmol/L <73 pmol/L <19.9 pg/mL <19.9 pg/mL
12–<19 yrs 96 <73 pmol/L 728 pmol/L <19.9 pg/mL 198 pg/mL 95 <73 pmol/L 153 pmol/L <19.9 pg/mL 42.8 pg/mL
Ferritin 0–<15 d 146 89.4 pmol/L 1213 pmol/L 39.8 ng/mL 540 ng/mL 146 89.4 pmol/L 1213 pmol/L 39.8 ng/mL 540 ng/mL
15 d–<6 m 321 34.4 pmol/L 843 pmol/L 15.3 ng/mL 375 ng/mL 321 34.4 pmol/L 843 pmol/L 15.3 ng/mL 375 ng/mL
6 m–<1 yr 146 29.9 pmol/L 431 pmol/L 13.3 ng/mL 192 ng/mL 146 29.9 pmol/L 431 pmol/L 13.3 ng/mL 192 ng/mL
1–<16 yrs 321 23.1 pmol/L 125 pmol/L 10.3 ng/mL 55.8 ng/mL 321 23.1 pmol/L 125 pmol/L 10.3 ng/mL 55.8 ng/mL
16–<19 yrs 43 7.19 pmol/L 169 pmol/L 3.20 ng/mL 75.1 ng/mL 41 42.0 pmol/L 229 pmol/L 18.7 ng/mL 102 ng/mL
Folate 0–<14 yrs 419 27.6 nmol/L >56.2 nmol/L 12.2 ng/mL >24.8 ng/mL 419 27.6 nmol/L >56.2 nmol/L 12.2 ng/mL >24.8 ng/mL
14–<19 yrs 132 20.1 nmol/L >56.2 nmol/L 8.88 ng/mL >24.8 ng/mL 132 20.1 nmol/L >56.2 nmol/L 8.88 ng/mL >24.8 ng/mL
Follicle stimulating hormone (FSH) 0–<1 yr 53 0.20 IU/L 15.7 IU/L 0.20 mIU/mL 15.7 mIU/mL 105 <0.20 IU/L 3.98 IU/L <0.20 mIU/mL 3.98 mIU/mL
1–<9 yrs 114 0.62 IU/L 6.37 IU/L 0.62 mIU/mL 6.37 mIU/mL 130 0.23 IU/L 2.32 IU/L 0.23 mIU/mL 2.32 mIU/mL
9–<12 yrs 41 0.91 IU/L 7.83 IU/L 0.91 mIU/mL 7.83 mIU/mL 41 0.56 IU/L 4.98 IU/L 0.56 mIU/mL 4.98 mIU/mL
12–<19 yrs 100 0.59 IU/L 10.2 IU/L 0.59 mIU/mL 10.2 mIU/mL 94 1.26 IU/L 7.40 IU/L 1.26 mIU/mL 7.40 mIU/mL
Growth hormone (GH) 0–<3 m 60 0.80 lg/L 33.54 lg/L 0.80 ng/mL 33.54 ng/mL 60 0.80 lg/L 33.54 lg/L 0.80 ng/mL 33.54 ng/mL
3 m–<2 yrs 81 0.14 lg/L 6.27 lg/L 0.14 ng/mL 6.27 ng/mL 81 0.14 lg/L 6.27 lg/L 0.14 ng/mL 6.27 ng/mL
2–<7 yrs 141 0.05 lg/L 5.11 lg/L 0.05 ng/mL 5.11 ng/mL 141 0.05 lg/L 5.11 lg/L 0.05 ng/mL 5.11 ng/mL
7–<12 yrs 144 0.02 lg/L 4.76 lg/L 0.02 ng/mL 4.76 ng/mL 144 0.02 lg/L 4.76 lg/L 0.02 ng/mL 4.76 ng/mL
12–<14 yrs 53 0.01 lg/L 6.20 lg/L 0.01 ng/mL 6.20 ng/mL 53 0.01 lg/L 6.20 lg/L 0.01 ng/mL 6.20 ng/mL
14–<19 yrs 74 0.03 lg/L 5.22 lg/L 0.03 ng/mL 5.22 ng/mL 68 0.02 lg/L 3.81 lg/L 0.02 ng/mL 3.81 ng/mL
Luteinzing hormone (LH) 0–<1 yr 63 <0.2 IU/L 3.28 IU/L <0.2 mIU/mL 3.28 mIU/mL 110 <0.2 U/L 6.79 IU/L <0.2 mIU/mL 6.79 mIU/mL
1–<5 yrs 114 <0.2 IU/L 2.14 IU/L <0.2 mIU/mL 2.14 mIU/mL 114 <0.2 IU/L 2.14 IU/L <0.2 mIU/mL 2.14 mIU/mL
5–<10 yrs 131 <0.2 IU/L 1.67 IU/L <0.2 mIU/mL 1.67 mIU/mL 131 <0.2 IU/L 1.67 IU/L <0.2 mIU/mL 1.67 mIU/mL
10–<14 yrs 51 <0.2 IU/L 8.09 IU/L <0.2 mIU/mL 8.09 mIU/mL 56 <0.2 IU/L 3.28 IU/L <0.2 mIU/mL 3.28 mIU/mL
14–<19 yrs 67 1.59 IU/L 19.0 IU/L 1.59 mIU/mL 19.0 mIU/mL 70 0.81 IU/L 8.96 IU/L 0.81 mIU/mL 8.96 mIU/mL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

(continued)
389
Table 4. Continued
390

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Immunoglobulin E, total (IgE) 0–<2 yrs 129 0.15 IU/mL 809 IU/mL 0.15 kU/L 809 kU/L 129 0.15 IU/mL 809 IU/mL 0.15 kU/L 809 kU/L
2–<6 yrs 174 1.00 IU/mL 347 IU/mL 1.00 kU/L 347 kU/L 174 1.00 IU/mL 347 IU/mL 1.00 kU/L 347 kU/L
6–<19 yrs 297 2.61 IU/mL 1620 IU/mL 2.61 kU/L 1620 kU/L 297 2.61 IU/mL 1620 IU/mL 2.61 kU/L 1620 kU/L
K. ADELI ET AL.

Insulin 0–<2 yrs 111 5.81 pmol/L 216 pmol/L 0.84 lIU/mL 31.1 lIU/mL 111 5.81 pmol/L 216 pmol/L 0.84 lIU/mL 31.1 lIU/mL
2–<10 yrs 231 10.6 pmol/L 220 pmol/L 1.53 lIU/mL 31.7 lIU/mL 231 10.6 pmol/L 220 pmol/L 1.53 lIU/mL 31.7 lIU/mL
10–<19 yrs 252 20.1 pmol/L 571 pmol/L 2.89 lIU/mL 82.2 lIU/mL 252 20.1 pmol/L 571 pmol/L 2.89 lIU/mL 82.2 lIU/mL
Ostase (bone-specific alkaline 0–<12 yrs 371 48.1 lg/L >120 lg/L 48.1 lg/L >120 lg/L 371 48.1 lg/L >120 lg/L 48.1 lg/L >120 lg/L
phosphatase (BAP)) 12–<15 yrs 44 11.3 lg/L >120 lg/L 11.3 lg/L >120 lg/L 40 62.1 lg/L >120 lg/L 62.1 lg/L >120 lg/L
15–<19 yrs 59 8.14 lg/L 35.8 lg/L 8.14 lg/L 35.8 lg/L 43 22.5 lg/L >120 lg/L 22.5 lg/L >120 lg/L
Prolactin 0–<30 d 91 50.9 lg/L >200 lg/L 50.9 ng/mL >200 ng/mL 91 50.9 lg/L >200 lg/L 50.9 ng/mL >200 ng/mL
30 d–<1 yr 76 3.97 lg/L 71.0 lg/L 3.97 ng/mL 71.0 ng/mL 76 3.97 lg/L 71.0 lg/L 3.97 ng/mL 71.0 ng/mL
1–<19 yrs 516 3.21 lg/L 18.5 lg/L 3.21 ng/mL 18.5 ng/mL 516 3.21 lg/L 18.5 lg/L 3.21 ng/mL 18.5 ng/mL
Progesterone 4 d–<1 yr 56 0.92 nmol/L 27.6 nmol/L 28.9 ng/dL 867 ng/dL 84 0.57 nmol/L 19.2 nmol/L 17.9 ng/dL 604 ng/dL
1–<9 yrs 241 <0.32 nmol/L 2.73 nmol/L <10.1 ng/dL 85.9 ng/dL 240 <0.32 nmol/L 2.73 nmol/L <10.1 ng/dL 85.9 ng/dL
9–<13 yrs 112 <0.32 nmol/L 4.48 nmol/L <10.1 ng/dL 85.9 ng/dL 112 <0.32 nmol/L 4.48 nmol/L <10.1 ng/dL 85.9 ng/dL
13–<19 yrs 84 0.80 nmol/L 38.5 nmol/L 25.2 ng/dL 791 ng/dL 80 0.60 nmol/L 5.22 nmol/L 18.9 ng/dL 164 ng/dL
Parathyroid hormone (PTH) 0 –<1 yr 55 0.77 pmol/L 6.14 pmol/L 7.26 pg/mL 57.9 pg/mL 55 0.77 pmol/L 6.14 pmol/L 7.26 pg/mL 57.9 pg/mL
1–<8 yrs 194 1.25 pmol/L 5.80 pmol/L 11.8 pg/mL 111 pg/mL 194 1.25 pmol/L 5.80 pmol/L 11.8 pg/mL 111 pg/mL
8–<19 yrs 306 1.28 pmol/L 7.53 pmol/L 12.1 pg/mL 114 pg/mL 306 1.28 pmol/L 7.53 pmol/L 12.1 pg/mL 114 pg/mL
Sex hormone binding globulin (SHBG) 0–<1 m 59 12.4 nmol/L 116 nmol/L 12.4 nmol/L 116 nmol/L 59 12.4 nmol/L 116 nmol/L 12.4 nmol/L 116 nmol/L
1 m–<1 yr 128 32.0 nmol/L >200 nmol/L 32.0 nmol/L >200 nmol/L 128 32.0 nmol/L >200 nmol/L 32.0 nmol/L >200 nmol/L
1–<8 yrs 212 53.2 nmol/L 174 nmol/L 53.2 nmol/L 174 nmol/L 212 53.2 nmol/L 174 nmol/L 53.2 nmol/L 174 nmol/L
8–<11 yrs 80 45.4 nmol/L 144 nmol/L 45.4 nmol/L 144 nmol/L 80 45.4 nmol/L 144 nmol/L 45.4 nmol/L 144 nmol/L
11–<13 yrs 57 15.9 nmol/L 132 nmol/L 15.9 nmol/L 132 nmol/L 57 15.9 nmol/L 132 nmol/L 15.9 nmol/L 132 nmol/L
13–<19 yrs 85 18.1 nmol/L 95.8 nmol/L 18.1 nmol/L 95.8 nmol/L 84 10.5 nmol/L 75.3 nmol/L 10.5 nmol/L 75.3 nmol/L
Soluble transferrin receptor (sTfR) 0–<1 yr 46 0.98 mg/L 1.99 mg/L 0.98 mg/L 1.99 mg/L 46 0.98 mg/L 1.99 mg/L 0.98 mg/L 1.99 mg/L
1–<2.5 yrs 41 1.37 mg/L 2.64 mg/L 1.37 mg/L 2.64 mg/L 41 1.37 mg/L 2.64 mg/L 1.37 mg/L 2.64 mg/L
2.5–<14 yrs 312 1.03 mg/L 2.09 mg/L 1.03 mg/L 2.09 mg/L 312 1.03 mg/L 2.09 mg/L 1.03 mg/L 2.09 mg/L
14–<19 yrs 123 0.79 mg/L 1.68 mg/L 0.79 mg/L 1.68 mg/L 123 0.79 mg/L 1.68 mg/L 0.79 mg/L 1.68 mg/L
Thyroxine, free (FT4) 0–<20 d 40 17.4 pmol/L 57.7 pmol/L 1.35 ng/dL 4.48 ng/dL 40 17.4 pmol/L 57.7 pmol/L 1.35 ng/dL 4.48 ng/dL
20 d–<3 yrs 215 9.52 pmol/L 17.8 pmol/L 0.74 ng/dL 1.38 ng/dL 215 9.52 pmol/L 17.8 pmol/L 0.74 ng/dL 1.38 ng/dL
3–<19 yrs 455 7.85 pmol/L 13.6 pmol/L 0.61 ng/dL 1.06 ng/dL 455 7.85 pmol/L 13.6 pmol/L 0.61 ng/dL 1.06 ng/dL
Thyroxine, total (TT4) 0–<4 yrs 163 76.3 nmol/L 168 nmol/L 5.93 lg/dL 13.1 lg/dL 163 76.3 nmol/L 168 nmol/L 5.93 lg/dL 13.1 lg/dL
4–<14 yrs 279 70.0 nmol/L 130 nmol/L 5.44 lg/dL 10.1 lg/dL 279 70.0 nmol/L 130 nmol/L 5.44 lg/dL 10.1 lg/dL
14–<19 yrs 71 75.0 nmol/L 141 nmol/L 5.83 lg/dL 11.0 lg/dL 66 68.1 nmol/L 119 nmol/L 5.29 lg/dL 9.2 lg/dL
Triiodothyronine, free (FT3) 0–<1 y 81 4.32 pmol/L 6.85 pmol/L 2.81 pg/mL 4.46 pg/mL 81 4.32 pmol/L 6.85 pmol/L 2.81 pg/mL 4.46 pg/mL
1–<15 yrs 405 3.98 pmol/L 6.19 pmol/L 2.59 pg/mL 4.03 pg/mL 405 3.98 pmol/L 6.19 pmol/L 2.59 pg/mL 4.03 pg/mL
15–<19 yrs 56 3.47 pmol/L 5.31 pmol/L 2.26 pg/mL 3.46 pg/mL 55 3.81 pmol/L 5.67 pmol/L 2.48 pg/mL 3.69 pg/mL
Triiodothyronine, total (TT3) 0–<1 yr 161 1.40 nmol/L 3.96 nmol/L 91.1 ng/dL 258 ng/dL 161 1.40 nmol/L 3.96 nmol/L 91.1 ng/dL 258 ng/dL
1–<12 yrs 326 1.84 nmol/L 3.12 nmol/L 120 ng/dL 203 ng/dL 326 1.84 nmol/L 3.12 nmol/L 120 ng/dL 203 ng/dL
12–<16 yrs 59 1.54 nmol/L 3.00 nmol/L 100 ng/dL 195 ng/dL 54 1.77 nmol/L 3.16 nmol/L 115 ng/dL 206 ng/dL
16–<19 yrs 82 1.51 nmol/L 2.95 nmol/L 98.3 ng/dL 192 ng/dL 82 1.51 nmol/L 2.95 nmol/L 98.3 ng/dL 192 ng/dL
Thyroid stimulating hormone (TSH) 0–<12 yrs 423 0.79 mIU/L 5.85 mIU/L 0.79 mIU/L 5.85 mIU/L 423 0.79 mIU/L 5.85 mIU/L 0.79 mIU/L 5.85 mIU/L
12–<19 yrs 182 0.68 mIU/L 3.35 mIU/L 0.68 mIU/L 3.35 mIU/L 182 0.68 mIU/L 3.35 mIU/L 0.68 mIU/L 3.35 mIU/L
(continued)
Table 4. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Testosterone 0–<1.5 yrs 48 <0.35 nmol/L 2.19 nmol/L <10.1 ng/dL 63.1 ng/dL 46 <0.35 nmol/L 9.85 nmol/L <10.1 ng/dL 284 ng/dL
1.5–<7 yrs 169 <0.35 nmol/L 0.35 nmol/L <10.1 ng/dL 10.1 ng/dL 169 <0.35 nmol/L 0.35 nmol/L <10.1 ng/dL 10.1 ng/dL
7–<9 yrs 58 <0.35 nmol/L 0.62 nmol/L <10.1 ng/dL 17.9 ng/dL 58 <0.35 nmol/L 0.62 nmol/L <10.1 ng/dL 17.9 ng/dL
9–<12 yrs 79 <0.35 nmol/L 1.63 nmol/L <10.1 ng/dL 47.0 ng/dL 79 <0.35 nmol/L 1.63 nmol/L <10.1 ng/dL 47.0 ng/dL
12–<15 yrs 43 0.35 nmol/L 2.26 nmol/L 10.1 ng/dL 65.1 ng/dL
15–<19 yrs 59 0.62 nmol/L 2.98 nmol/L 17.9 ng/dL 85.9 ng/dL
12–<19 yrs 94 0.38 nmol/L 19.6 nmol/L 11.0 ng/dL 566 ng/dL
Thyroglobulin 0–<2 yrs 52 7.82 ng/mL 79.5 ng/mL 7.82 ng/mL 79.5 ng/mL 48 2.99 ng/mL 56.0 ng/mL 2.99 ng/mL 56.0 ng/mL
2–<6 yrs 107 6.74 ng/mL 34.2 ng/mL 6.74 ng/mL 34.2 ng/mL 107 6.74 ng/mL 34.2 ng/mL 6.74 ng/mL 34.2 ng/mL
6–<9 yrs 85 5.01 ng/mL 28.5 ng/mL 5.01 ng/mL 28.5 ng/mL 85 5.01 ng/mL 28.5 ng/mL 5.01 ng/mL 28.5 ng/mL
9–<19 yrs 268 2.50 ng/mL 25.8 ng/mL 2.50 ng/mL 25.8 ng/mL 268 2.50 ng/mL 25.8 ng/mL 2.50 ng/mL 25.8 ng/mL
Thyroid uptake 0–<12 yrs 362 38.1% 49.5% 38.1% 49.5 % 362 38.1% 49.5% 38.1% 49.5%
12–<19 yrs 94 38.1% 48.5% 38.1% 48.5 % 92 39.6% 48.8% 39.6% 48.8%
Troponin-I 0–<4 m 41 <10 ng/L 90 ng/L <10 ng/L 90 ng/L 41 <10 ng/L 90 ng/L <10 ng/L 90 ng/L
4 m–<1 yr 58 <10 ng/L 30 ng/L <10 ng/L 30 ng/L 58 <10 ng/L 30 ng/L <10 ng/L 30 ng/L
1–<19 yrs 411 <10 ng/L 10 ng/L <10 ng/L 10 ng/L 411 <10 ng/L 10 ng/L <10 ng/L 10 ng/L
Vitamin B12 0–<1 yr 166 118 pmol/L >1107 pmol/L 159 pg/mL >1500 pg/mL 166 118 pmol/L >1107 pmol/L 159 pg/mL >1500 pg/mL
1–<2 yrs 40 197 pmol/L >1107 pmol/L 267 pg/mL >1500 pg/mL 40 197 pmol/L >1107 pmol/L 267 pg/mL >1500 pg/mL
2–<8 yrs 158 190 pmol/L 747 pmol/L 258 pg/mL 1013 pg/mL 158 190 pmol/L 747 pmol/L 258 pg/mL 1013 pg/mL
8–<14 yrs 168 149 pmol/L 772 pmol/L 201 pg/mL 1046 pg/mL 168 149 pmol/L 772 pmol/L 201 pg/mL 1046 pg/mL
14–<19 yrs 136 132 pmol/L 531 pmol/L 179 pg/mL 719 pg/mL 136 132 pmol/L 531 pmol/L 179 pg/mL 719 pg/mL
Vitamin D (25-(OH)D) 0–<1 yr 154 27.5 nmol/L 159 nmol/L 11.0 ng/mL 63.6 ng/mL 154 27.5 nmol/L 159 nmol/L 11.0 ng/mL 63.6 ng/mL
1–<12 yrs 265 43.4 nmol/L 121 nmol/L 17.4 ng/mL 48.6 ng/mL 265 43.4 nmol/L 121 nmol/L 17.4 ng/mL 48.6 ng/mL
12–<19 yrs 173 29.0 nmol/L 105 nmol/L 11.6 ng/mL 42.1 ng/mL 173 29.0 nmol/L 105 nmol/L 11.6 ng/mL 42.1 ng/mL
Reference interval value units are in Stansard International units (SI units) and Convential units (CON units).
Colored partitions indicate sex-specific differences within the age partitions. Refer to the original publication [11] for additional information.
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES
391
Table 5. Pediatric reference intervals for the Ortho VITROS 5600 – age and sex specific.
392

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Alpha-1 antitrypsin (A1AT)a 0–<19 yrs NA 1.07 g/L 1.81 g/L 107 mg/dL 181 mg/dL NA 1.07 g/L 1.81 g/L 107 mg/dL 181 mg/dL
Alpha-fetoprotein (AFP)b 0–<1 m 68 NA >520 mg/L NA >520 ng/mL 68 NA >520 mg/L NA >520 ng/mL
1–<6 m 46 4.78 mg/L >520 mg/L 4.78 ng/mL >520 ng/mL 46 4.78 mg/L >520 mg/L 4.78 ng/mL >520 ng/mL
K. ADELI ET AL.

6 m–<1 yr 65 0.85 mg/L 82.9 mg/L 0.85 ng/mL 82.9 ng/mL 65 0.85 mg/L 82.9 mg/L 0.85 ng/mL 82.9 ng/mL
1–<19 yrs 540 0.52 mg/L 5.82 mg/L 0.52 ng/mL 5.82 ng/mL 540 0.52 mg/L 5.82 mg/L 0.52 ng/mL 5.82 ng/mL
Alanine aminotransferase with pyridoxal phosphate (ALT ACT)a 0–<1 yr NA 17 U/L 69 U/L 17 U/L 69 U/L NA 17 U/L 69 U/L 17 U/L 69 U/L
1–<13 yrs NA 24 U/L 45 U/L 24 U/L 45 U/L NA 24 U/L 45 U/L 24 U/L 45 U/L
13–<19 yrs NA 20 U/L 38 U/L 20 U/L 38 U/L NA 22 U/L 49 U/L 22 U/L 49 U/L
Albumin G (bromcresol green)a 0–<15 d NA 34 g/L 47 g/L 3.4 g/dL 4.7 g/dL NA 34 g/L 47 g/L 3.4 g/dL 4.7 g/dL
15–<1 yr NA 29 g/L 49 g/L 2.9 g/dL 4.9 g/dL NA 29 g/L 49 g/L 2.9 g/dL 4.9 g/dL
1–<8 yrs NA 39 g/L 49 g/L 3.9 g/dL 4.9 g/dL NA 39 g/L 49 g/L 3.9 g/dL 4.9 g/dL
8–<15 yrs NA 42 g/L 50 g/L 4.2 g/dL 5.0 g/dL NA 42 g/L 50 g/L 4.2 g/dL 5.0 g/dL
15–<19 yrs NA 41 g/L 51 g/L 4.1 g/dL 5.1 g/dL NA 42 g/L 53 g/L 4.2 g/dL 5.3 g/dL
Alkaline phosphatase (ALP)a 0–<15 d NA 89 U/L 239 U/L 89 U/L 239 U/L NA 89 U/L 239 U/L 89 U/L 239 U/L
15 d–<1 yr NA 125 U/L 440 U/L 125 U/L 440 U/L NA 125 U/L 440 U/L 125 U/L 440 U/L
1–<10 yrs NA 143 U/L 318 U/L 143 U/L 318 U/L NA 143 U/L 318 U/L 143 U/L 318 U/L
10–<13 yrs NA 131 U/L 393 U/L 131 U/L 393 U/L NA 131 U/L 393 U/L 131 U/L 393 U/L
13–<15 yrs NA 66 U/L 245 U/L 66 U/L 245 U/L NA 119 U/L 440 U/L 119 U/L 440 U/L
15–<17 yrs NA 59 U/L 120 U/L 59 U/L 120 U/L NA 88 U/L 315 U/L 88 U/L 315 U/L
17–<19 yrs NA 55 U/L 93 U/L 55 U/L 93 U/L NA 64 U/L 150 U/L 64 U/L 150 U/L
Amylasea 0–<15 d NA NA <30 U/L NA <30 U/L NA NA <30 U/L NA <30 U/L
15 d–<13 wks NA NA <30 U/L NA <30 U/L NA NA <30 U/L NA <30 U/L
13 wks–<1 yr NA <30 U/L 46 U/L <30 U/L 46 U/L NA <30 U/L 46 U/L <30 U/L 46 U/L
1–<19 yrs NA <30 U/L 102 U/L <30 U/L 102 U/L NA <30 U/L 102 U/L <30 U/L 102 U/L
Antistreptolysin-O (ASO)a 0–<6 m NA NA <25 IU/mL NA <25 IU/mL NA NA <25 IU/mL NA <25 IU/mL
6 m–<1 yr NA NA <25 IU/mL NA <25 IU/mL NA NA <25 IU/mL NA <25 IU/mL
1–<6 yrs NA <25 IU/mL 140 IU/mL <25 IU/mL 140 IU/mL NA <25 IU/mL 140 IU/mL <25 IU/mL 140 IU/mL
6–<19 yrs NA <25 IU/mL 527 IU/mL <25 IU/mL 527 IU/mL NA <25 IU/mL 527 IU/mL <25 IU/mL 527 IU/mL
Apolipoprotein A1a 0–<15 d NA 0.69 g/L 0.99 g/L 69 mg/dL 99 mg/dL NA 0.59 g/L 0.93 g/L 59 mg/dL 93 mg/dL
15 d–<1 yr NA 0.49 g/L 1.89 g/L 49 mg/dL 189 mg/dL NA 0.49 g/L 1.89 g/L 49 mg/dL 189 mg/dL
1–<14 yrs NA 0.80 g/L 1.77 g/L 80 mg/dL 177 mg/dL NA 0.80 g/L 1.77 g/L 80 mg/dL 177 mg/dL
14–<19 yrs NA 0.71 g/L 1.65 g/L 71 mg/dL 165 mg/dL NA 0.71 g/L 1.65 g/L 71 mg/dL 165 mg/dL
Apolipoprotein Ba 0–<15 d NA <0.35 g/L 0.76 g/L <35 mg/dL 76 mg/dL NA <0.35 g/L 0.76 g/L <35 mg/dL 76 mg/dL
15 d–<1 yr NA <0.35 g/L 1.34 g/L <35 mg/dL 134 mg/dL NA <0.35 g/L 1.34 g/L <35 mg/dL 134 mg/dL
1–<6 yrs NA 0.50 g/L 1.03 g/L 50 mg/dL 103 mg/dL NA 0.50 g/L 1.03 g/L 50 mg/dL 103 mg/dL
6–<19 yrs NA 0.39 g/L 0.94 g/L 39 mg/dL 94 mg/dL NA 0.39 g/L 0.94 g/L 39 mg/dL 94 mg/dL
Aspartate aminotransferase with pyridoxal phosphate (AST ACT)a 0–<15 d NA 29 U/L 213 U/L 29 U/L 213 U/L NA 29 U/L 213 U/L 29 U/L 213 U/L
15 d–<1 yr NA 29 U/L 97 U/L 29 U/L 97 U/L NA 29 U/L 97 U/L 29 U/L 97 U/L
1–<7 yrs NA 33 U/L 66 U/L 33 U/L 66 U/L NA 33 U/L 66 U/L 33 U/L 66 U/L
7–<12 yrs NA 28 U/L 50 U/L 28 U/L 50 U/L NA 28 U/L 50 U/L 28 U/L 50 U/L
12–<19 yrs NA 23 U/L 41 U/L 23 U/L 41 U/L NA 24 U/L 49 U/L 24 U/L 49 U/L
b-Hydroxybutyratec 0–<1 yr 91 0 mmol/L 1.73 mmol/L 0 mg/dL 17.8 mg/dL 91 0 mmol/L 1.73 mmol/L 0 mg/dL 17.8 mg/dL
1–<19 yrs 219 0 mmol/L 0.12 mmol/L 0 mg/dL 1.24 mg/dL 219 0 mmol/L 0.12 mmol/L 0 mg/dL 1.24 mg/dL
b
Beta human chorionic gonadotropin (b-hCG) 0–<19 yrs 532 <2.39 IU/L NA <2.39 mIU/mL NA 532 <2.39 IU/L NA <2.39 mIU/mL NA
(continued)
Table 5. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Calciumd 0–<1 yrs NA 2.08 mmol/L 2.64 mmol/L 8.32 mg/dL 10.6 mg/dL NA 2.08 mmol/L 2.64 mmol/L 8.32 mg/dL 10.6 mg/dL
1–<19 yrs NA 2.22 mmol/L 2.54 mmol/L 8.88 mg/dL 10.2 mg/dL NA 2.22 mmol/L 2.54 mmol/L 8.88 mg/dL 10.2 mg/dL
Cancer antigen 125 (CA125)b 0–<6 m 66 <5.5 kIU/L 36.9 kIU/L <5.5 IU/mL 36.9 IU/mL 66 <5.5 kIU/L 36.9 kIU/L <5.5 IU/mL 36.9 IU/mL
6 m–<5 yrs 123 <5.5 kIU/L 30.9 kIU/L <5.5 IU/mL 30.9 IU/mL 123 <5.5 kIU/L 30.9 kIU/L <5.5 IU/mL 30.9 IU/mL
5–<11 yrs 189 <5.5 kIU/L 29.4 kIU/L <5.5 IU/mL 29.4 IU/mL 189 <5.5 kIU/L 29.4 kIU/L <5.5 IU/mL 29.4 IU/mL
11–<19 yrs 147 <5.5 kIU/L 31.9 kIU/L <5.5 IU/mL 31.9 IU/mL 144 <5.5 kIU/L 19.0 kIU/L <5.5 IU/mL 19.0 IU/mL
Cancer antigen 15-3 (CA15-3)b 0–<19 yrs 658 6.60 kIU/L 29.1 kIU/L 6.60 IU/mL 29.1 IU/mL 658 6.60 kIU/L 29.1 kIU/L 6.60 IU/mL 29.1 IU/mL
Carcinoembryonic antigen (CEA)b 0–<1 m 76 2.30 mg/L 72.4 mg/L 2.30 ng/mL 72.4 ng/mL 76 2.30 mg/L 72.4 mg/L 2.30 ng/mL 72.4 ng/mL
1 m–<19 yrs 576 <0.31 mg/L 3.51 mg/L <0.31 ng/mL 3.51 ng/mL 576 <0.31 mg/L 3.51 mg/L <0.31 ng/mL 3.51 ng/mL
Cholesterola 0–<15 d NA <1.29 mmol/L 3.20 mmol/L <50 mg/dL 124 mg/dL NA <1.29 mmol/L 2.80 mmol/L <50 mg/dL 108 mg/dL
15 d–<1 yr NA 1.68 mmol/L 5.99 mmol/L 64.9 mg/dL 231 mg/dL NA 1.68 mmol/L 5.99 mmol/L 64.9 mg/dL 231 mg/dL
1–<19 yrs NA 2.88 mmol/L 5.29 mmol/L 111 mg/dL 204 mg/dL NA 2.88 mmol/L 5.29 mmol/L 111 mg/dL 204 mg/dL
Cholinesterasea 0–<15 d NA 3542 U/L 7370 U/L 3542 U/L 7370 U/L NA 3542 U/L 7370 U/L 3542 U/L 7370 U/L
15 d–<1 yr NA 4092 U/L 11922 U/L 4092 U/L 11922 U/L NA 4092 U/L 11922 U/L 4092 U/L 11922 U/L
1–<17 yrs NA 5960 U/L 11329 U/L 5960 U/L 11329 U/L NA 5960 U/L 11329 U/L 5960 U/L 11329 U/L
17–<19 yrs NA 5773 U/L 8223 U/L 5773 U/L 8223 U/L NA 6261 U/L 9476 U/L 6261 U/L 9476 U/L
Creatine kinase-MB (CK-MB)b 0–<2 wks 54 1.57 mg/L 31.8 mg/L 1.57 ng/mL 31.8 ng/mL 54 1.57 mg/L 31.8 mg/L 1.57 ng/mL 31.8 ng/mL
2 wks–<2 yrs 61 0.47 mg/L 9.66 mg/L 0.47 ng/mL 9.66 ng/mL 61 0.47 mg/L 9.66 mg/L 0.47 ng/mL 9.66 ng/mL
2–<10 yrs 218 0.79 mg/L 4.13 mg/L 0.79 ng/mL 4.13 ng/mL 218 0.79 mg/L 4.13 mg/L 0.79 ng/mL 4.13 ng/mL
10–<19 yrs 165 0.29 mg/L 3.63 mg/L 0.29 ng/mL 3.63 ng/mL 150 0.47 mg/L 3.26 mg/L 0.47 ng/mL 3.26 ng/mL
Complement 3 (C3)a 0–<15 d NA 0.60 g/L 1.26 g/L 60 mg/dL 126 mg/dL NA 0.60 g/L 1.26 g/L 60 mg/dL 126 mg/dL
15 d–<1 yr NA 0.61 g/L 1.62 g/L 61 mg/dL 162 mg/dL NA 0.61 g/L 1.62 g/L 61 mg/dL 162 mg/dL
1–<19 yrs NA 0.90 g/L 1.54 g/L 90 mg/dL 154 mg/dL NA 0.90 g/L 1.54 g/L 90 mg/dL 154 mg/dL
Complement 4 (C4)a 0 d–<1 yrs NA 0.08 g/L 0.34 g/L 8 mg/dL 34 mg/dL NA 0.08 g/L 0.34 g/L 8 mg/dL 34 mg/dL
1–<19 yrs NA 0.15 g/L 0.42 g/L 15 mg/dL 42 mg/dL NA 0.15 g/L 0.42 g/L 15 mg/dL 42 mg/dL
Cortisolb 0–<1 yr 89 13.1 nmol/L 919 nmol/L 0.47 mg/dL 33.3 mg/dL 89 13.1 nmol/L 919 nmol/L 0.47 mg/dL 33.3 mg/dL
1–<12 yrs 311 41.1 nmol/L 338 nmol/L 1.49 mg/dL 12.3 mg/dL 311 41.1 nmol/L 338 nmol/L 1.49 mg/dL 12.3 mg/dL
12–<19 yrs 229 80.2 nmol/L 510 nmol/L 2.91 mg/dL 18.5 mg/dL 229 80.2 nmol/L 510 nmol/L 2.91 mg/dL 18.5 mg/dL
C-Reactive protein high sensitivity (CRP)a 0–<15 d NA 0.20 mg/L 6.14 mg/L 0.20 mg/L 6.14 mg/L NA 0.20 mg/L 6.14 mg/L 0.20 mg/L 6.14 mg/L
15 d–<15 yrs NA <0.10 mg/L 0.91 mg/L <0.10 mg/L 0.91 mg/L NA <0.10 mg/L 0.91 mg/L <0.10 mg/L 0.91 mg/L
15–<19 yrs NA <0.10 mg/L 1.63 mg/L <0.10 mg/L 1.63 mg/L NA <0.10 mg/L 1.63 mg/L <0.10 mg/L 1.63 mg/L
Creatinine (enzymatic)a 0–<14 d NA 27 mmol/L 76 mmol/L 0.31 mg/dL 0.86 mg/dL NA 27 mmol/L 76 mmol/L 0.31 mg/dL 0.86 mg/dL
15 d–<2 yrs NA 8 mmol/L 29 mmol/L 0.09 mg/dL 0.33 mg/dL NA 8 mmol/L 29 mmol/L 0.09 mg/dL 0.33 mg/dL
2–<5 yrs NA 16 mmol/L 35 mmol/L 0.18 mg/dL 0.40 mg/dL NA 16 mmol/L 35 mmol/L 0.18 mg/dL 0.40 mg/dL
5–<12 yrs NA 25 mmol/L 50 mmol/L 0.28 mg/dL 0.57 mg/dL NA 25 mmol/L 50 mmol/L 0.28 mg/dL 0.57 mg/dL
12–<15 yrs NA 37 mmol/L 67 mmol/L 0.42 mg/dL 0.76 mg/dL NA 37 mmol/L 67 mmol/L 0.42 mg/dL 0.76 mg/dL
15–<19 yrs NA 40 mmol/L 69 mmol/L 0.45 mg/dL 0.78 mg/dL NA 51 mmol/L 89 mmol/L 0.58 mg/dL 1.01 mg/dL
Estradiolb 0–<1 m 68 162 pmol/L 1382 pmol/L 44.2 pg/mL 376 pg/mL 68 162 pmol/L 1382 pmol/L 44.2 pg/mL 376 pg/mL
1 m–<6 yrs 196 <23.4 pmol/L 177 pmol/L <6.36 pg/mL 48.2 pg/mL 196 <23.4 pmol/L 177 pmol/L <6.36 pg/mL 48.2 pg/mL
6–<11 yrs 144 <23.4 pmol/L 67.9 pmol/L <6.36 pg/mL 18.5 pg/mL 144 <23.4 pmol/L 67.9 pmol/L <6.36 pg/mL 18.5 pg/mL
11–<15 yrs 86 68.4 pmol/L 344 pmol/L 18.6 pg/mL 93.6 pg/mL 105 25.4 pmol/L 145 pmol/L 6.92 pg/mL 39.6 pg/mL
15–<19 yrs 85 44.9 pmol/L 663 pmol/L 12.2 pg/mL 181 pg/mL 88 48.3 pmol/L 144 pmol/L 13.2 pg/mL 39.2 pg/mL
Ferritinb 0–<2 wks 46 69.3 mg/L 527 mg/L 69.3 ng/mL 527 ng/mL 46 69.3 mg/L 527 mg/L 69.3 ng/mL 527 ng/mL
2 wks –<13 yrs 382 9.51 mg/L 75.6 mg/L 9.51 ng/mL 75.6 ng/mL 382 9.51 mg/L 75.6 mg/L 9.51 ng/mL 75.6 ng/mL
13–<19 yrs 92 8.28 mg/L 70.0 mg/L 8.28 ng/mL 70.0 ng/mL 105 12.5 mg/L 114 mg/L 12.5 ng/mL 114 ng/mL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

(continued)
393
Table 5. Continued
394

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Serum folateb 0–<13 yrs 338 22.8 nmol/L >45.3 nmol/L 10.1 ng/mL >20.0 ng/mL 338 22.8 nmol/L >45.3 nmol/L 10.1 ng/mL >20.0 ng/mL
13–<19 yrs 156 17.7 nmol/L >45.3 nmol/L 7.80 ng/mL >20.0 ng/mL 156 17.7 nmol/L >45.3 nmol/L 7.80 ng/mL >20.0 ng/mL
Follice-stimulating hormone (FSH)b 0–<1 yr 64 <0.66 IU/L 12.3 IU/L <0.66 mIU/mL 12.3 mIU/mL 44 <0.66 IU/L 2.12 IU/L <0.66 mIU/mL 2.12 mIU/mL
K. ADELI ET AL.

1–<9 yrs 97 <0.66 IU/L 3.01 IU/L <0.66 mIU/mL 3.01 mIU/mL 127 <0.66 IU/L 3.26 IU/L <0.66 mIU/mL 3.26 mIU/mL
9–<12 yrs 85 <0.66 IU/L 11.4 IU/L <0.66 mIU/mL 11.4 mIU/mL 87 <0.66 IU/L 4.47 IU/L <0.66 mIU/mL 4.47 mIU/mL
12–<19 yrs 142 1.16 IU/L 7.23 IU/L 1.16 mIU/mL 7.23 mIU/mL 134 1.06 IU/L 7.22 IU/L 1.06 mIU/mL 7.22 mIU/mL
Free fatty acidsc 0–<1 yr 88 0.13 mmol/L 1.60 mmol/L 0.13 mEq/L 1.60 mEq/L 88 0.13 mmol/L 1.60 mmol/L 0.13 mEq/L 1.60 mEq/L
1–<19 yrs 235 0.10 mmol/L 0.77 mmol/L 0.10 mEq/L 0.77 mEq/L 235 0.10 mmol/L 0.77 mmol/L 0.10 mEq/L 0.77 mEq/L
Gamma-glutamyl transferase (GGT)a 0–<15 d NA 19 U/L 196 U/L 19 U/L 196 U/L NA 19 U/L 196 U/L 19 U/L 196 U/L
15–<1 yr NA <10 U/L 113 U/L <10 U/L 113 U/L NA <10 U/L 113 U/L <10 U/L 113 U/L
1–<11 yrs NA <10 U/L 13 U/L <10 U/L 13 U/L NA <10 U/L 13 U/L <10 U/L 13 U/L
11–<19 yrs NA <10 U/L 17 U/L <10 U/L 17 U/L NA <10 U/L 17 U/L <10 U/L 17 U/L
High-density lipoprotein cholesterol (HDL-C)a 0–<15 d NA 0.38 mmol/L 1.03 mmol/L 14.7 mg/dL 39.8 mg/dL NA 0.38 mmol/L 1.03 mmol/L 14.7 mg/dL 39.8 mg/dL
15 d–<1 yr NA 0.28 mmol/L 1.78 mmol/L 10.8 mg/dL 68.7 mg/dL NA 0.28 mmol/L 1.78 mmol/L 10.8 mg/dL 68.7 mg/dL
1–<4 yrs NA 0.80 mmol/L 1.56 mmol/L 30.9 mg/dL 60.2 mg/dL NA 0.80 mmol/L 1.56 mmol/L 30.9 mg/dL 60.2 mg/dL
4–<13 yrs NA 0.88 mmol/L 1.81 mmol/L 34.0 mg/dL 69.9 mg/dL NA 0.88 mmol/L 1.81 mmol/L 34.0 mg/dL 69.9 mg/dL
13–<19 yrs NA 0.79 mmol/L 1.79 mmol/L 30.5 mg/dL 69.1 mg/dL NA 0.78 mmol/L 1.70 mmol/L 30.1 mg/dL 65.6 mg/dL
Immunoglobulin A (IgA)a 0 d–<1 yr NA NA <0.4 g/L NA <40 mg/dL NA NA <0.4 g/L NA <40 mg/dL
1–<3 yrs NA <0.4 g/L 0.9 g/L <40 mg/dL 94 mg/dL NA <0.4 g/L 0.9 g/L <40 mg/dL 94 mg/dL
3–<6 yrs NA <0.4 g/L 1.7 g/L <40 mg/dL 168 mg/dL NA <0.4 g/L 1.7 g/L <40 mg/dL 168 mg/dL
6–<14 yrs NA 0.4 g/L 2.6 g/L 44 mg/dL 255 mg/dL NA 0.4 g/L 2.6 g/L 44 mg/dL 255 mg/dL
14–<19 yrs NA 0.4 g/L 3.4 g/L 44 mg/dL 343 mg/dL NA 0.4 g/L 3.4 g/L 44 mg/dL 343 mg/dL
Immunoglobulin G (IgG)a 0–<15 d NA 3.3 g/L 15.3 g/L 334 mg/dL 1530 mg/dL NA 3.3 g/L 15.3 g/L 334 mg/dL 1530 mg/dL
15 d–<1 yr NA <2.7 g/L 7.6 g/L <270 mg/dL 755 mg/dL NA <2.7 g/L 7.6 g/L <270 mg/dL 755 mg/dL
1–<4 yrs NA 3.3 g/L 12.5 g/L 334 mg/dL 1250 mg/dL NA 3.3 g/L 12.5 g/L 334 mg/dL 1250 mg/dL
4–<10 yrs NA 5.8 g/L 14.9 g/L 578 mg/dL 1490 mg/dL NA 5.8 g/L 14.9 g/L 578 mg/dL 1490 mg/dL
10–<19 yrs NA 7.1 g/L 16.8 g/L 711 mg/dL 1680 mg/dL NA 7.1 g/L 16.8 g/L 711 mg/dL 1680 mg/dL
Immunoglobulin M (IgM)a 0–<15 d NA <0.25 g/L 0.48 g/L <25 mg/dL 48 mg/dL NA <0.25 g/L 0.48 g/L <25 mg/dL 48 mg/dL
15 d–<13 wks NA <0.25 g/L 0.79 g/L <25 mg/dL 79 mg/dL NA <0.25 g/L 0.79 g/L <25 mg/dL 79 mg/dL
13 wks–<1 yr NA 0.27 g/L 1.00 g/L 27 mg/dL 100 mg/dL NA 0.27 g/L 1.00 g/L 27 mg/dL 100 mg/dL
1–<19 yrs NA 0.58 g/L 2.04 g/L 58 mg/dL 204 mg/dL NA 0.48 g/L 1.62 g/L 48 mg/dL 162 mg/dL
Intact parathyroid hormone (iPTH)b 0–<2 wks 45 0.57 pmol/L 11.5 pmol/L 5.38 pg/mL 108 pg/mL 45 0.57 pmol/L 11.5 pmol/L 5.38 pg/mL 108 pg/mL
2 wks–<9 yrs 203 1.23 pmol/L 7.14 pmol/L 11.6 pg/mL 67.3 pg/mL 203 1.23 pmol/L 7.14 pmol/L 11.6 pg/mL 67.3 pg/mL
9–<15 yrs 269 1.90 pmol/L 12.9 pmol/L 17.9 pg/mL 122 pg/mL 269 1.90 pmol/L 12.9 pmol/L 17.9 pg/mL 122 pg/mL
15–<19 yrs 84 1.44 pmol/L 6.67 pmol/L 13.6 pg/mL 62.9 pg/mL 82 1.66 pmol/L 8.41 pmol/L 15.7 pg/mL 79.3 pg/mL
Irona 0–<14 yrs NA 4.8 mmol/L 25.3 mmol/L 26.8 mg/dL 141 mg/dL NA 4.8 mmol/L 25.3 mmol/L 26.8 mg/dL 141 mg/dL
14–<19 yrs NA 5.5 mmol/L 31.5 mmol/L 30.7 mg/dL 176 mg/dL NA 7.5 mmol/L 32.6 mmol/L 41.9 mg/dL 182 mg/dL
Lipasea 0–<19 yrs NA <10 U/L 148 U/L <10 U/L 148 U/L NA <10 U/L 148 U/L <10 U/L 148 U/L
Luteinizing hormone (LH)b 0–<6 m 62 <0.216 IU/L 8.17 IU/L <0.216 mIU/mL 8.17 mIU/mL 62 <0.216 IU/L 8.17 IU/L <0.216 mIU/mL 8.17 mIU/mL
6 m–<11 yrs 319 <0.216 IU/L NA <0.216 mIU/mL NA 319 <0.216 IU/L NA <0.216 mIU/mL NA
11–<13 yrs 84 <0.216 IU/L 6.53 IU/L <0.216 mIU/mL 6.53 mIU/mL 82 <0.216 IU/L 2.69 IU/L <0.216 mIU/mL 2.69 mIU/mL
13–<16 yrs 81 0.31 IU/L 14.3 IU/L 0.31 mIU/mL 14.3 mIU/mL 91 0.22 IU/L 5.76 IU/L 0.22 mIU/mL 5.76 mIU/mL
16–<19 yrs 85 0.22 IU/L 29.1 IU/L 0.22 mIU/mL 29.1 mIU/mL 87 0.71 IU/L 7.20 IU/L 0.71 mIU/mL 7.20 mIU/mL
Myoglobinb 0–<2 wks 52 13.9 mg/L 234 mg/L 13.9 ng/mL 234 ng/mL 52 13.9 mg/L 234 mg/L 13.9 ng/mL 234 ng/mL
2 wks–<1 yr 56 7.29 mg/L 60.9 mg/L 7.29 ng/mL 60.9 ng/mL 56 7.29 mg/L 60.9 mg/L 7.29 ng/mL 60.9 ng/mL
1–<13 yrs 326 15.1 mg/L 50.3 mg/L 15.1 ng/mL 50.3 ng/mL 326 15.1 mg/L 50.3 mg/L 15.1 ng/mL 50.3 ng/mL
13–<19 yrs 100 11.7 mg/L 47.3 mg/L 11.7 ng/mL 47.3 ng/mL 114 16.7 mg/L 206 mg/L 16.7 ng/mL 206 ng/mL
(continued)
Table 5. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Phosphatea 0–<15 d NA 1.89 mmol/L 3.53 mmol/L 5.85 mg/dL 10.9 mg/dL NA 1.89 mmol/L 3.53 mmol/L 5.85 mg/dL 10.9 mg/dL
15 d–<1 yr NA 1.63 mmol/L 2.83 mmol/L 5.05 mg/dL 8.76 mg/dL NA 1.63 mmol/L 2.83 mmol/L 5.05 mg/dL 8.76 mg/dL
1–<5 yrs NA 1.46 mmol/L 2.29 mmol/L 4.52 mg/dL 7.09 mg/dL NA 1.46 mmol/L 2.29 mmol/L 4.52 mg/dL 7.09 mg/dL
5–<13 yrs NA 1.41 mmol/L 2.02 mmol/L 4.37 mg/dL 6.25 mg/dL NA 1.41 mmol/L 2.02 mmol/L 4.37 mg/dL 6.25 mg/dL
13–<16 yrs NA 1.10 mmol/L 1.88 mmol/L 3.41 mg/dL 5.82 mg/dL NA 1.22 mmol/L 2.09 mmol/L 3.78 mg/dL 6.47 mg/dL
16–<19 yrs NA 1.03 mmol/L 1.71 mmol/L 3.19 mg/dL 5.29 mg/dL NA 1.03 mmol/L 1.71 mmol/L 3.19 mg/dL 5.29 mg/dL
Prealbumina 0–<15 d NA <0.03 g/L 0.13 g/L <3 mg/dL 13 mg/dL NA <0.03 g/L 0.13 g/L <3 mg/dL 13 mg/dL
15 d–<1 yr NA 0.05 g/L 0.26 g/L 5 mg/dL 26 mg/dL NA 0.05 g/L 0.26 g/L 5 mg/dL 26 mg/dL
1–<5 yrs NA 0.13 g/L 0.25 g/L 13 mg/dL 25 mg/dL NA 0.13 g/L 0.25 g/L 13 mg/dL 25 mg/dL
5–<13 yrs NA 0.15 g/L 0.28 g/L 15 mg/dL 28 mg/dL NA 0.15 g/L 0.28 g/L 15 mg/dL 28 mg/dL
13–<16 yrs NA 0.19 g/L 0.34 g/L 19 mg/dL 34 mg/dL NA 0.19 g/L 0.34 g/L 19 mg/dL 34 mg/dL
16–<19 yrs NA 0.18 g/L 0.36 g/L 18 mg/dL 36 mg/dL NA 0.22 g/L 0.38 g/L 22 mg/dL 38 mg/dL
Progesteroneb 0–<2 wks 60 7.90 nmol/L >178 nmol/L 2.50 ng/mL >56 ng/mL 60 7.90 nmol/L >178 nmol/L 2.50 ng/mL >56 ng/mL
2 wks–<11 yrs 312 0.49 nmol/L 12.0 nmol/L 0.15 ng/mL 3.80 ng/mL 312 0.49 nmol/L 12.0 nmol/L 0.15 ng/mL 3.80 ng/mL
11–<15 yrs 138 1.10 nmol/L 13.0 nmol/L 0.35 ng/mL 4.90 ng/mL 138 1.10 nmol/L 13.0 nmol/L 0.35 ng/mL 4.20 ng/mL
15–<19 yrs 79 2.30 nmol/L 31.0 nmol/L 0.73 ng/mL 9.80 ng/mL 155 2.70 nmol/L 27.0 nmol/L 0.87 ng/mL 2.90 ng/mL
Prolactinb 0–<2 wks 76 20.2 mg/L >329 mg/L 20.2 ng/mL >329 ng/mL 76 20.2 mg/L >329 mg/L 20.2 ng/mL >329 ng/mL
2 wks–<19 yrs 552 6.02 mg/L 33.0 mg/L 6.02 ng/mL 33.0 ng/mL 552 6.02 mg/L 33.0 mg/L 6.02 ng/mL 33.0 ng/mL
Prostate-specific antigen, free (fPSA)b 0–<12 yrs 420 <0.015 mg/L 0.052 mg/L <0.015 ng/mL 0.052 ng/mL 420 <0.015 mg/L 0.052 mg/L <0.015 ng/mL 0.052 ng/mL
12–<15 yrs 63 <0.015 mg/L 0.054 mg/L <0.015 ng/mL 0.054 ng/mL 62 <0.015 mg/L 0.349 mg/L <0.015 ng/mL 0.349 ng/mL
15–<19 yrs 61 <0.015 mg/L 0.214 mg/L <0.015 ng/mL 0.214 ng/mL 70 0.076 mg/L 0.519 mg/L 0.076 ng/mL 0.519 ng/mL
Prostate-specific antigen, total (tPSA)b 0–<12 yrs 376 <0.01 mg/L NA <0.01 ng/mL NA 376 <0.01 mg/L NA <0.01 ng/mL NA
12–<15 yrs 51 <0.01 mg/L NA <0.01 ng/mL NA 61 <0.01 mg/L 0.502 mg/L <0.01 ng/mL 0.502 ng/mL
15–<19 yrs 65 <0.01 mg/L 0.388 mg/L <0.01 ng/mL 0.388 ng/mL 69 0.0148 mg/L 1.28 mg/L 0.0148 ng/mL 1.28 ng/mL
Rubella IgGb 0–<19 yrs 530 10.7 kIU/L >350 kIU/L 10.7 IU/mL >350 IU/mL 530 10.7 kIU/L >350 kIU/L 10.7 IU/mL >350 IU/mL
Testosteroneb 0–<6 m 55 0.192 nmol/L 13.9 nmol/L 5.54 ng/dL 401 ng/dL 68 0.279 nmol/L 22.3 nmol/L 8.05 ng/dL 642 ng/dL
6 m–<12 yrs 388 <0.170 nmol/L 1.60 nmol/L <4.90 ng/dL 46.1 ng/dL 388 <0.170 nmol/L 1.60 nmol/L <4.90 ng/dL 46.1 ng/dL
12–<19 yrs 153 0.530 nmol/L 2.21 nmol/L 15.3 ng/dL 63.7 ng/dL
12–<15 yrs 86 0.359 nmol/L 24.9 nmol/L 10.4 ng/dL 717 ng/dL
15–<19 yrs 83 4.07 nmol/L 27.1 nmol/L 117 ng/dL 782 ng/dL
Thyroid uptakeb 0–<6 m 77 26.9 % 46.1 % 26.9 % 46.1 % 77 26.9 % 46.1 % 26.9 % 46.1 %
6 m–<2 yrs 50 26.2 % 44.0 % 26.2 % 44.0 % 50 26.2 % 44.0 % 26.2 % 44.0 %
2–<15 yrs 433 30.4 % 40.3 % 30.4 % 40.3 % 433 30.4 % 40.3 % 30.4 % 40.3 %
15–<19 yrs 63 24.1 % 41.8 % 24.1 % 41.8 % 67 32.1 % 41.9 % 32.1 % 41.9 %
Total proteina 0–<15 d NA 54 g/L 85 g/L 5.41 g/dL 8.49 g/dL NA 54 g/L 85 g/L 5.41 g/dL 8.49 g/dL
15 d–<1 yr NA 45 g/L 73 g/L 4.49 g/dL 7.26 g/dL NA 45 g/L 73 g/L 4.49 g/dL 7.26 g/dL
1–<6 yrs NA 62 g/L 77 g/L 6.23 g/dL 7.67 g/dL NA 62 g/L 77 g/L 6.23 g/dL 7.67 g/dL
6–<9 yrs NA 65 g/L 79 g/L 6.54 g/dL 7.87 g/dL NA 65 g/L 79 g/L 6.54 g/dL 7.87 g/dL
9–<19 yrs NA 66 g/L 83 g/L 6.64 g/dL 8.28 g/dL NA 66 g/L 83 g/L 6.64 g/dL 8.28 g/dL
Transferrina 0–<9 wks NA 1.16 g/L 2.42 g/L 116 mg/dL 242 mg/dL NA 1.16 g/L 2.42 g/L 116 mg/dL 242 mg/dL
9 wks–<1 yr NA 1.19 g/L 3.47 g/L 119 mg/dL 347 mg/dL NA 1.19 g/L 3.47 g/L 119 mg/dL 347 mg/dL
1–<19 yrs NA 2.38 g/L 3.60 g/L 238 mg/dL 360 mg/dL NA 2.38 g/L 3.60 g/L 238 mg/dL 360 mg/dL
Triglyceridesa 0–<15 d NA 0.99 mmol/L 3.21 mmol/L 87.6 mg/dL 284 mg/dL NA 0.99 mmol/L 3.21 mmol/L 87.6 mg/dL 284 mg/dL
15 d–<1 yr NA 0.62 mmol/L 3.20 mmol/L 54.9 mg/dL 283 mg/dL NA 0.62 mmol/L 3.20 mmol/L 54.9 mg/dL 283 mg/dL
1–<19 yrs NA 0.51 mmol/L 2.43 mmol/L 45.1 mg/dL 215 mg/dL NA 0.51 mmol/L 2.43 mmol/L 45.1 mg/dL 215 mg/dL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

(continued)
395
Table 5. Continued
396

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Troponin Ib 0–<2 wks 41 <0.012 mg/L 0.154 mg/L <0.012 ng/mL 0.154 ng/mL 41 <0.012 mg/L 0.154 mg/L <0.012 ng/mL 0.154 ng/mL
2 wks–<19 yrs 511 <0.012 mg/L NA <0.012 ng/mL NA 511 <0.012 mg/L NA <0.012 ng/mL NA
Thyroid-stimulating hormone (TSH)b 0–<1 wk 51 1.05 mIU/L 36.1 mIU/L 1.05 mIU/mL 36.1 mIU/mL 51 1.05 mIU/L 36.1 mIU/L 1.05 mIU/mL 36.1 mIU/mL
K. ADELI ET AL.

1 wk–<19 yrs 600 0.860 mIU/L 5.7 mIU/L 0.860 mIU/mL 5.70 mIU/mL 600 0.860 mIU/L 5.7 mIU/L 0.860 mIU/mL 5.70 mIU/mL
Thyroxine, free (FT4)b 0–<2 wks 60 12.4 pmol/L 72.4 pmol/L 0.97 ng/dL 5.63 ng/dL 60 12.4 pmol/L 72.4 pmol/L 0.97 ng/dL 5.63 ng/dL
2 wks–<5 yrs 136 11.4 pmol/L 29.2 pmol/L 0.89 ng/dL 2.27 ng/dL 136 11.4 pmol/L 29.2 pmol/L 0.89 ng/dL 2.27 ng/dL
5–<19 yrs 434 9.7 pmol/L 17.1 pmol/L 0.76 ng/dL 1.33 ng/dL 434 9.7 pmol/L 17.1 pmol/L 0.76 ng/dL 1.33 ng/dL
Thyroxine, total (TT4)b 0–<2 wks 47 40.6 nmol/L 318 nmol/L 3.15 mg/dL 24.7 mg/dL 47 40.6 nmol/L 318 nmol/L 3.15 mg/dL 24.7 mg/dL
2 wks–<4 yrs 129 88.4 nmol/L 240 nmol/L 6.87 mg/dL 18.7 mg/dL 129 88.4 nmol/L 240 nmol/L 6.87 mg/dL 18.7 mg/dL
4–<15 yrs 370 79.2 nmol/L 139 nmol/L 6.15 mg/dL 10.8 mg/dL 370 79.2 nmol/L 139 nmol/L 6.15 mg/dL 10.8 mg/dL
15–<19 yrs 62 76.7 nmol/L 199 nmol/L 5.96 mg/dL 15.5 mg/dL 63 73.9 nmol/L 120 nmol/L 5.74 mg/dL 9.30 mg/dL
Triiodothyronine, free (FT3)b 0–<2 wks 59 4.67 pmol/L 19.1 pmol/L 3.04 pg/mL 12.4 pg/mL 59 4.67 pmol/L 19.1 pmol/L 3.04 pg/mL 12.4 pg/mL
2 wks–<4 yrs 124 5.36 pmol/L 11.4 pmol/L 3.49 pg/mL 7.42 pg/mL 124 5.36 pmol/L 11.4 pmol/L 3.49 pg/mL 7.42 pg/mL
4–<13 yrs 279 6.67 pmol/L 10.7 pmol/L 4.34 pg/mL 6.97 pg/mL 279 6.67 pmol/L 10.7 pmol/L 4.34 pg/mL 6.97 pg/mL
13–<19 yrs 98 5.69 pmol/L 9.32 pmol/L 3.70 pg/mL 6.07 pg/mL 111 6.34 pmol/L 10.3 pmol/L 4.13 pg/mL 6.72 pg/mL
Triiodothyronine, total (TT3)b 0–<2 wks 77 0.483 nmol/L 4.62 nmol/L 0.310 ng/mL 3.01 ng/mL 77 0.483 nmol/L 4.62 nmol/L 0.310 ng/mL 3.01 ng/mL
2 wks–<10 yrs 294 2.14 nmol/L 4.62 nmol/L 1.39 ng/mL 3.01 ng/mL 294 2.14 nmol/L 4.62 nmol/L 1.39 ng/mL 3.01 ng/mL
10–<19 yrs 164 1.72 nmol/L 3.19 nmol/L 1.12 ng/mL 2.08 ng/mL 151 1.95 nmol/L 5.20 nmol/L 1.27 ng/mL 3.39 ng/mL
Vitamin B12b 0–<1 yr 80 136 pmol/L >738 pmol/L 184 pg/mL >1000 pg/mL 80 136 pmol/L >738 pmol/L 184 pg/mL >1000 pg/mL
1–<12 yrs 281 239 pmol/L >738 pmol/L 324 pg/mL >1000 pg/mL 281 239 pmol/L >738 pmol/L 324 pg/mL >1000 pg/mL
12–<19 yrs 214 175 pmol/L 673 pmol/L 237 pg/mL 912 pg/mL 214 175 pmol/L 673 pmol/L 237 pg/mL 912 pg/mL
Vitamin Db 0–<19 yrs 598 34.8 nmol/L 126 nmol/L 13.9 ng/mL 50.4 ng/mL 598 34.8 nmol/L 126 nmol/L 13.9 ng/mL 50.4 ng/mL
Ureaa 0–<15 d NA 1.2 mmol/L 8.4 mmol/L 3.36 mg/dL 23.5 mg/dL NA 1.2 mmol/L 8.4 mmol/L 3.36 mg/dL 23.5 mg/dL
15 d–<1 yr NA 1.4 mmol/L 6.2 mmol/L 3.92 mg/dL 17.4 mg/dL NA 1.4 mmol/L 6.2 mmol/L 3.92 mg/dL 17.4 mg/dL
1–<10 yrs NA 3.4 mmol/L 8.1 mmol/L 9.52 mg/dL 22.7 mg/dL NA 3.4 mmol/L 8.1 mmol/L 9.52 mg/dL 22.7 mg/dL
10–<19 yrs NA 2.8 mmol/L 7.0 mmol/L 7.84 mg/dL 19.6 mg/dL NA 2.8 mmol/L 7.7 mmol/L 7.84 mg/dL 21.6 mg/dL
Uric acida 0–<15 d NA 168 mmol/L 751 mmol/L 2.82 mg/dL 12.6 mg/dL NA 168 mmol/L 751 mmol/L 2.82 mg/dL 12.6 mg/dL
15 d–<1 yr NA 99 mmol/L 377 mmol/L 1.66 mg/dL 6.33 mg/dL NA 99 mmol/L 377 mmol/L 1.66 mg/dL 6.33 mg/dL
1–<12 yrs NA 111 mmol/L 291 mmol/L 1.86 mg/dL 4.89 mg/dL NA 111 mmol/L 291 mmol/L 1.86 mg/dL 4.89 mg/dL
12–<19 yrs NA 157 mmol/L 350 mmol/L 2.64 mg/dL 5.88 mg/dL NA 160 mmol/L 453 mmol/L 2.69 mg/dL 7.61 mg/dL
Reference interval value units are in Standard International units (SI units) and Conventional units (CON units).
Colored partitions indicate sex-specific differences within the age partitions.
a
Refer to the original publication (Higgins et al.; manuscript submitted for publication) for additional information.
b
Refer to the original publication [18] for additional information.
c
Refer to the original publication [16] for additional information.
d
Refer to the original publication [29] for additional information.
For analytes with sample size “NA”, approximately 200 patient samples were run on the Ortho Vitros to transfer reference intervals from the Abbott Architect.
Table 6. Pediatric reference intervals for the Roche cobas 6000 – age and sex specific.
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Alanine aminotransferase (ALT)a,c 0–<1 yr 0 U/L 25 U/L 0 U/L 25 U/L 0 U/L 25 U/L 0 U/L 25 U/L
1–<13 yrs 0 U/L 19 U/L 0 U/L 19 U/L 0 U/L 19 U/L 0 U/L 19 U/L
13–<19 yrs 0 U/L 17 U/L 0 U/L 17 U/L 0 U/L 18 U/L 0 U/L 18 U/L
Albumin P (bromcresol purple)b 0–<15 d 34 g/L 47 g/L 3.4 g/dL 4.7 g/dL 34 g/L 47 g/L 3.4 g/dL 4.7 g/dL
15 d–<1 yr 30 g/L 53 g/L 3.0 g/dL 5.3 g/dL 30 g/L 53 g/L 3.0 g/dL 5.3 g/dL
1–<8 yrs 41 g/L 52 g/L 4.1 g/dL 5.2 g/dL 41 g/L 52 g/L 4.1 g/dL 5.2 g/dL
8–<15 yrs 43 g/L 54 g/L 4.3 g/dL 5.4 g/dL 43 g/L 54 g/L 4.3 g/dL 5.4 g/dL
15–<19 yrs 41 g/L 56 g/L 4.1 g/dL 5.6 g/dL 44 g/L 57 g/L 4.4 g/dL 5.7 g/dL
Alkaline phosphatase (ALP)a 0–<15 d 83 U/L 248 U/L 83 U/L 248 U/L 83 U/L 248 U/L 83 U/L 248 U/L
15 d–<1 yr 122 U/L 469 U/L 122 U/L 469 U/L 122 U/L 469 U/L 122 U/L 469 U/L
1–<10 yrs 142 U/L 335 U/L 142 U/L 335 U/L 142 U/L 335 U/L 142 U/L 335 U/L
10–<13 yrs 129 U/L 417 U/L 129 U/L 417 U/L 129 U/L 417 U/L 129 U/L 417 U/L
13–<15 yrs 57 U/L 254 U/L 57 U/L 254 U/L 116 U/L 468 U/L 116 U/L 468 U/L
15–<17 yrs 50 U/L 117 U/L 50 U/L 117 U/L 82 U/L 331 U/L 82 U/L 331 U/L
17–<19 yrs 45 U/L 87 U/L 45 U/L 87 U/L 55 U/L 149 U/L 55 U/L 149 U/L
Amylaseb 0–<15 d 3 U/L 11 U/L 3 U/L 11 U/L 3 U/L 11 U/L 3 U/L 11 U/L
15 d–<13 wks 0 U/L 26 U/L 0 U/L 26 U/L 0 U/L 26 U/L 0 U/L 26 U/L
13 wks–<1 yr 3 U/L 58 U/L 3 U/L 58 U/L 3 U/L 58 U/L 3 U/L 58 U/L
1–<19 yrs 29 U/L 118 U/L 29 U/L 118 U/L 29 U/L 118 U/L 29 U/L 118 U/L
Antistreptolysin-O (ASO)b,c 0–<6 m 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL
6 m–<1 yr 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL
1–<6 yrs 0 IU/mL 147 IU/mL 0 IU/mL 147 IU/mL 0 IU/mL 147 IU/mL 0 IU/mL 147 IU/mL
6–<19 yrs 0 IU/mL 535 IU/mL 0 IU/mL 535 IU/mL 0 IU/mL 535 IU/mL 0 IU/mL 535 IU/mL
Apolipoprotein Bb,c 0–<15 d 0.1 g/L 0.7 g/L 6 mg/dL 67 mg/dL 0.1 g/L 0.7 g/L 6 mg/dL 67 mg/dL
15 d–<1 yr 0.2 g/L 1.3 g/L 17 mg/dL 125 mg/dL 0.2 g/L 1.3 g/L 17 mg/dL 125 mg/dL
1–<6 yrs 0.4 g/L 0.9 g/L 40 mg/dL 94 mg/dL 0.4 g/L 0.9 g/L 40 mg/dL 94 mg/dL
6–<19 yrs 0.3 g/L 0.9 g/L 29 mg/dL 85 mg/dL 0.3 g/L 0.9 g/L 29 mg/dL 85 mg/dL
Aspartate aminotransferase (AST)a 0–<15 d 0 U/L 155 U/L 0 U/L 155 U/L 0 U/L 155 U/L 0 U/L 155 U/L
15 d–<1 yr 0 U/L 63 U/L 0 U/L 63 U/L 0 U/L 63 U/L 0 U/L 63 U/L
1–<7 yrs 0 U/L 41 U/L 0 U/L 41 U/L 0 U/L 41 U/L 0 U/L 41 U/L
7–<12 yrs 0 U/L 33 U/L 0 U/L 33 U/L 0 U/L 33 U/L 0 U/L 33 U/L
12–<19 yrs 0 U/L 23 U/L 0 U/L 23 U/L 0 U/L 32 U/L 0 U/L 32 U/L
Bilirubin, directb 0–<15 d 4.3 mmol/L 9.4 mmol/L 0.3 mg/dL 0.5 mg/dL 4.3 mmol/L 9.4 mmol/L 0.3 mg/dL 0.5 mg/dL
15 d–<1 yr 0.0 mmol/L 3.9 mmol/L 0.0 mg/dL 0.2 mg/dL 0.0 mmol/L 3.9 mmol/L 0.0 mg/dL 0.2 mg/dL
1–<9 yrs 0.0 mmol/L 2.4 mmol/L 0.0 mg/dL 0.1 mg/dL 0.0 mmol/L 2.4 mmol/L 0.0 mg/dL 0.1 mg/dL
9–<13 yrs 0.0 mmol/L 3.7 mmol/L 0.0 mg/dL 0.2 mg/dL 0.0 mmol/L 3.7 mmol/L 0.0 mg/dL 0.2 mg/dL
13–<19 yrs 0.0 mmol/L 5.1 mmol/L 0.0 mg/dL 0.3 mg/dL 1.2 mmol/L 5.4 mmol/L 0.1 mg/dL 0.3 mg/dL
Bilirubin, totala 0–<15 d 0 mmol/L 250 mmol/L 0.0 mg/dL 14.6 mg/dL 0 mmol/L 250 mmol/L 0.0 mg/dL 14.6 mg/dL
15 d–<1 yr 0 mmol/L 10 mmol/L 0.0 mg/dL 0.6 mg/dL 0 mmol/L 10 mmol/L 0.0 mg/dL 0.6 mg/dL
1–<9 yrs 0 mmol/L 5 mmol/L 0.0 mg/dL 0.3 mg/dL 0 mmol/L 5 mmol/L 0.0 mg/dL 0.3 mg/dL
9–<12 yrs 0 mmol/L 8 mmol/L 0.0 mg/dL 0.5 mg/dL 0 mmol/L 8 mmol/L 0.0 mg/dL 0.5 mg/dL
12–<15 yrs 0 mmol/L 10 mmol/L 0.0 mg/dL 0.6 mg/dL 0 mmol/L 10 mmol/L 0.0 mg/dL 0.6 mg/dL
15–<19 yrs 0 mmol/L 12 mmol/L 0.0 mg/dL 0.7 mg/dL 0 mmol/L 12 mmol/L 0.0 mg/dL 0.7 mg/dL
Calciuma,c 0–<1 yr 2.16 mmol/L 2.74 mmol/L 8.6 mg/dL 11.0 mg/dL 2.16 mmol/L 2.74 mmol/L 8.6 mg/dL 11.0 mg/dL
1–<19 yrs 2.31 mmol/L 2.64 mmol/L 9.3 mg/dL 10.6 mg/dL 2.31 mmol/L 2.64 mmol/L 9.3 mg/dL 10.6 mg/dL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

Cholesterola 0–<15 d 1.25 mmol/L 3.24 mmol/L 48 mg/dL 125 mg/dL 1.15 mmol/L 2.83 mmol/L 45 mg/dL 109 mg/dL
15 d–<1 yr 1.70 mmol/L 6.07 mmol/L 66 mg/dL 234 mg/dL 1.70 mmol/L 6.07 mmol/L 66 mg/dL 234 mg/dL
1–<19 yrs 2.91 mmol/L 5.36 mmol/L 112 mg/dL 207 mg/dL 2.91 mmol/L 5.36 mmol/L 112 mg/dL 207 mg/dL
397

(continued)
Table 6. Continued
398

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Complement component 3 (C3)b 0–<15 d 0.57 g/L 1.29 g/L 57 mg/dL 129 mg/dL 0.57 g/L 1.29 g/L 57 mg/dL 129 mg/dL
15 d–<1 yr 0.58 g/L 1.69 g/L 58 mg/dL 169 mg/dL 0.58 g/L 1.69 g/L 58 mg/dL 169 mg/dL
1–<19 yrs 0.90 g/L 1.61 g/L 90 mg/dL 161 mg/dL 0.90 g/L 1.61 g/L 90 mg/dL 161 mg/dL
K. ADELI ET AL.

Complement component 4 (C4)b 0 d–<1 yrs 0.07 g/L 0.31 g/L 7 mg/dL 31 mg/dL 0.07 g/L 0.31 g/L 7 mg/dL 31 mg/dL
1–<19 yrs 0.13 g/L 0.38 g/L 13 mg/dL 38 mg/dL 0.13 g/L 0.38 g/L 13 mg/dL 38 mg/dL
C-Reactive protein high sensitivity (CRP)b,c 0–<15 d 0.6 mg/L 6.1 mg/L 0.6 mg/L 6.1 mg/L 0.6 mg/L 6.1 mg/L 0.6 mg/L 6.1 mg/L
15 d–<15 yrs 0.4 mg/L 1.3 mg/L 0.4 mg/L 1.3 mg/L 0.4 mg/L 1.3 mg/L 0.4 mg/L 1.3 mg/L
15–<19 yrs 0.4 mg/L 2.0 mg/L 0.4 mg/L 2.0 mg/L 0.4 mg/L 2.0 mg/L 0.4 mg/L 2.0 mg/L
Creatinine, enzymaticb,c 0–<15 d 35 mmol/L 86 mmol/L 0 mg/dL 1 mg/dL 35 mmol/L 86 mmol/L 0 mg/dL 1 mg/dL
15 d–<2 yrs 15 mmol/L 38 mmol/L 0 mg/dL 0 mg/dL 15 mmol/L 38 mmol/L 0 mg/dL 0 mg/dL
2–<5 yrs 24 mmol/L 43 mmol/L 0 mg/dL 1 mg/dL 24 mmol/L 43 mmol/L 0 mg/dL 1 mg/dL
5–<12 yrs 33 mmol/L 59 mmol/L 0 mg/dL 1 mg/dL 33 mmol/L 59 mmol/L 0 mg/dL 1 mg/dL
12–<15 yrs 45 mmol/L 77 mmol/L 1 mg/dL 1 mg/dL 45 mmol/L 77 mmol/L 1 mg/dL 1 mg/dL
15–<19 yrs 48 mmol/L 79 mmol/L 1 mg/dL 1 mg/dL 60 mmol/L 100 mmol/L 1 mg/dL 1 mg/dL
Gamma-glutamyl transferase (GGT)b,c 0–<15 d 17 U/L 175 U/L 17 U/L 175 U/L 17 U/L 175 U/L 17 U/L 175 U/L
15 d–<1 yr 5 U/L 101 U/L 5 U/L 101 U/L 5 U/L 101 U/L 5 U/L 101 U/L
1–<11 yrs 4 U/L 12 U/L 4 U/L 12 U/L 4 U/L 12 U/L 4 U/L 12 U/L
11–<19 yrs 4 U/L 16 U/L 4 U/L 16 U/L 4 U/L 16 U/L 4 U/L 16 U/L
Haptoglobina 0–<15 d 0.00 g/L 0.12 g/L 0 mg/dL 12 mg/dL 0.00 g/L 0.12 g/L 0 mg/dL 12 mg/dL
15 d–<1 yr 0.00 g/L 2.38 g/L 0 mg/dL 238 mg/dL 0.00 g/L 2.38 g/L 0 mg/dL 238 mg/dL
1–<12 yrs 0.00 g/L 1.76 g/L 0 mg/dL 176 mg/dL 0.00 g/L 1.76 g/L 0 mg/dL 176 mg/dL
12–<19 yrs 0.00 g/L 1.93 g/L 0 mg/dL 193 mg/dL 0.00 g/L 1.93 g/L 0 mg/dL 193 mg/dL
High-density lipoprotein cholesterol (HDL-C)b 0–<15 d 0.18 mmol/L 1.01 mmol/L 7 mg/dL 39 mg/dL 0.18 mmol/L 1.01 mmol/L 7 mg/dL 39 mg/dL
15 d–<1 yr 0.00 mmol/L 1.95 mmol/L 0 mg/dL 75 mg/dL 0.00 mmol/L 1.95 mmol/L 0 mg/dL 75 mg/dL
1–<4 yrs 0.72 mmol/L 1.68 mmol/L 28 mg/dL 65 mg/dL 0.72 mmol/L 1.68 mmol/L 28 mg/dL 65 mg/dL
4–<13 yrs 0.81 mmol/L 1.99 mmol/L 31 mg/dL 77 mg/dL 0.81 mmol/L 1.99 mmol/L 31 mg/dL 77 mg/dL
13–<19 yrs 0.70 mmol/L 1.96 mmol/L 27 mg/dL 76 mg/dL 0.69 mmol/L 1.85 mmol/L 27 mg/dL 71 mg/dL
Immunoglobulin A (IgA)a 0–<1 yr 0.0 g/L 0.1 g/L 0 mg/dL 10 mg/dL 0.0 g/L 0.1 g/L 0 mg/dL 10 mg/dL
1–<3 yrs 0.0 g/L 0.8 g/L 0 mg/dL 80 mg/dL 0.0 g/L 0.8 g/L 0 mg/dL 80 mg/dL
3–<6 yrs 0.1 g/L 1.4 g/L 10 mg/dL 140 mg/dL 0.1 g/L 1.4 g/L 10 mg/dL 140 mg/dL
6–<14 yrs 0.3 g/L 2.2 g/L 30 mg/dL 220 mg/dL 0.3 g/L 2.2 g/L 30 mg/dL 220 mg/dL
14–<19 yrs 0.4 g/L 2.9 g/L 40 mg/dL 290 mg/dL 0.4 g/L 2.9 g/L 40 mg/dL 290 mg/dL
Immunoglobulin G (IgG)a 0–<15 d 3.2 g/L 12.0 g/L 320 mg/dL 1210 mg/dL 3.2 g/L 12.0 g/L 320 mg/dL 1210 mg/dL
15 d–<1 yr 1.5 g/L 6.3 g/L 150 mg/dL 630 mg/dL 1.5 g/L 6.3 g/L 150 mg/dL 630 mg/dL
1–<4 yrs 3.2 g/L 9.9 g/L 320 mg/dL 990 mg/dL 3.2 g/L 9.9 g/L 320 mg/dL 990 mg/dL
4–<10 yrs 5.0 g/L 11.6 g/L 500 mg/dL 1170 mg/dL 5.0 g/L 11.6 g/L 500 mg/dL 1170 mg/dL
10–<19 yrs 6.0 g/L 13.1 g/L 600 mg/dL 1310 mg/dL 6.0 g/L 13.1 g/L 600 mg/dL 1310 mg/dL
Immunoglobulin M (IgM)a,c 0–<15 d 0.0 g/L 0.3 g/L 0 mg/dL 30 mg/dL 0.0 g/L 0.3 g/L 0 mg/dL 30 mg/dL
15 d–<13 wks 0.1 g/L 0.7 g/L 10 mg/dL 70 mg/dL 0.1 g/L 0.7 g/L 10 mg/dL 70 mg/dL
13 wks–<1 yr 0.1 g/L 0.8 g/L 10 mg/dL 80 mg/dL 0.1 g/L 0.8 g/L 10 mg/dL 80 mg/dL
1–<19 yrs 0.4 g/L 1.8 g/L 50 mg/dL 180 mg/dL 0.4 g/L 1.4 g/L 40 mg/dL 140 mg/dL
Irona 0–<14 yrs 5 25 29 137 5 25 29 137
14–<19 yrs 6 30 33 170 8 31 43 176
Lactate dehydrogenase (LDH)a 0–<15 d 0 U/L 1128 U/L 0 U/L 1128 U/L 0 U/L 1128 U/L 0 U/L 1128 U/L
15 d–<1 yr 0 U/L 424 U/L 0 U/L 424 U/L 0 U/L 424 U/L 0 U/L 424 U/L
1–<10 yrs 0 U/L 305 U/L 0 U/L 305 U/L 0 U/L 305 U/L 0 U/L 305 U/L
10–<15 yrs 0 U/L 260 U/L 0 U/L 260 U/L 0 U/L 270 U/L 0 U/L 270 U/L
15–<19 yrs 0 U/L 240 U/L 0 U/L 240 U/L 0 U/L 240 U/L 0 U/L 240 U/L
(continued)
Table 6. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Phosphatea,c 0–<15 d 1.71 mmol/L 3.15 mmol/L 5.3 mg/dL 9.8 mg/dL 1.71 mmol/L 3.15 mmol/L 5.3 mg/dL 9.8 mg/dL
15 d–<1 yr 1.47 mmol/L 2.54 mmol/L 4.6 mg/dL 7.9 mg/dL 1.47 mmol/L 2.54 mmol/L 4.6 mg/dL 7.9 mg/dL
1–<5 yrs 1.33 mmol/L 2.06 mmol/L 4.1 mg/dL 6.4 mg/dL 1.33 mmol/L 2.06 mmol/L 4.1 mg/dL 6.4 mg/dL
5–<13 yrs 1.28 mmol/L 1.82 mmol/L 4.0 mg/dL 5.6 mg/dL 1.28 mmol/L 1.82 mmol/L 4.0 mg/dL 5.6 mg/dL
13–<16 yrs 1.00 mmol/L 1.70 mmol/L 3.1 mg/dL 5.3 mg/dL 1.11 mmol/L 1.88 mmol/L 3.5 mg/dL 5.8 mg/dL
16–<19 yrs 0.94 mmol/L 1.55 mmol/L 2.9 mg/dL 4.8 mg/dL 0.94 mmol/L 1.55 mmol/L 2.9 mg/dL 4.8 mg/dL
Prealbumina 0–<15 d 0.00 g/L 0.11 g/L 0 mg/dL 11 mg/dL 0.00 g/L 0.11 g/L 0 mg/dL 11 mg/dL
15 d–<1 yr 0.04 g/L 0.24 g/L 4 mg/dL 24 mg/dL 0.04 g/L 0.24 g/L 4 mg/dL 24 mg/dL
1–<5 yrs 0.11 g/L 0.23 g/L 11 mg/dL 23 mg/dL 0.11 g/L 0.23 g/L 11 mg/dL 23 mg/dL
5–<13 yrs 0.13 g/L 0.26 g/L 13 mg/dL 26 mg/dL 0.13 g/L 0.26 g/L 13 mg/dL 26 mg/dL
13–<16 yrs 0.17 g/L 0.31 g/L 17 mg/dL 31 mg/dL 0.17 g/L 0.31 g/L 17 mg/dL 31 mg/dL
16–<19 yrs 0.16 g/L 0.33 g/L 16 mg/dL 33 mg/dL 0.20 g/L 0.35 g/L 20 mg/dL 35 mg/dL
Total proteina 0–<15 d 51 g/L 80 g/L 5.1 g/dL 8.0 g/dL 51 g/L 80 g/L 5.1 g/dL 8.0 g/dL
15 d–<1 yr 43 g/L 69 g/L 4.3 g/dL 6.9 g/dL 43 g/L 69 g/L 4.3 g/dL 6.9 g/dL
1–<6 yrs 59 g/L 73 g/L 5.9 g/dL 7.3 g/dL 59 g/L 73 g/L 5.9 g/dL 7.3 g/dL
6–<9 yrs 62 g/L 75 g/L 6.2 g/dL 7.5 g/dL 62 g/L 75 g/L 6.2 g/dL 7.5 g/dL
9–<19 yrs 63 g/L 78 g/L 6.3 g/dL 7.8 g/dL 63 g/L 78 g/L 6.3 g/dL 7.8 g/dL
Transferrinb 0–<9 wks 1.11 g/L 2.43 g/L 111 mg/dL 243 mg/dL 1.11 g/L 2.43 g/L 111 mg/dL 243 mg/dL
9 wks–<1 yr 1.15 g/L 3.52 g/L 115 mg/dL 352 mg/dL 1.15 g/L 3.52 g/L 115 mg/dL 352 mg/dL
1–<19 yrs 2.38 g/L 3.66 g/L 238 mg/dL 366 mg/dL 2.38 g/L 3.66 g/L 238 mg/dL 366 mg/dL
Triglyceridesb 0–<15 d 1.02 mmol/L 3.25 mmol/L 90 mg/dL 288 mg/dL 1.02 mmol/L 3.25 mmol/L 90 mg/dL 288 mg/dL
15 d–<1 yr 0.65 mmol/L 3.24 mmol/L 58 mg/dL 287 mg/dL 0.65 mmol/L 3.24 mmol/L 58 mg/dL 287 mg/dL
1–<19 yrs 0.54 mmol/L 2.47 mmol/L 48 mg/dL 219 mg/dL 0.54 mmol/L 2.47 mmol/L 48 mg/dL 219 mg/dL
Ureaa 0–<15 d 1.1 mmol/L 7.9 mmol/L 3 mg/dL 22 mg/dL 1.1 mmol/L 7.9 mmol/L 3 mg/dL 22 mg/dL
15 d–<1 yr 1.3 mmol/L 5.8 mmol/L 4 mg/dL 16 mg/dL 1.3 mmol/L 5.8 mmol/L 4 mg/dL 16 mg/dL
1–<10 yrs 3.2 mmol/L 7.6 mmol/L 9 mg/dL 21 mg/dL 3.2 mmol/L 7.6 mmol/L 9 mg/dL 21 mg/dL
10–<19 yrs 2.6 mmol/L 6.5 mmol/L 7 mg/dL 18 mg/dL 2.6 mmol/L 7.2 mmol/L 7 mg/dL 20 mg/dL
Uric acida 0–<15 d 158 mmol/L 748 mmol/L 2.7 mg/dL 12.6 mg/dL 158 mmol/L 748 mmol/L 2.7 mg/dL 12.6 mg/dL
15 d–<1 yr 88 mmol/L 370 mmol/L 1.5 mg/dL 6.2 mg/dL 88 mmol/L 370 mmol/L 1.5 mg/dL 6.2 mg/dL
1–<12 yrs 100 mmol/L 282 mmol/L 1.7 mg/dL 4.7 mg/dL 100 mmol/L 282 mmol/L 1.7 mg/dL 4.7 mg/dL
12–<19 yrs 147 mmol/L 342 mmol/L 2.5 mg/dL 5.7 mg/dL 150 mmol/L 446 mmol/L 2.5 mg/dL 7.5 mg/dL
Reference interval value units are in Standard International units (SI units) and Conventional units (CON units).
Colored partitions indicate sex-specific differences within the age partitions.
a
Refer to the original publication [29] for additional information.
b
Refer to the original publication [32] for additional information.
Approximately 200 patient samples were run on the Roche cobas to transfer reference intervals from the Abbott ARCHITECT.
c
Reference interval did not verify. Use with caution. See original publications [29,32] for more information.
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES
399
Table 7. Pediatric reference intervals for the Roche Modular P – age and sex specific.
400

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Alanine aminotransferase (ALT) 0–<1 yr 8 U/L 31 U/L 8 U/L 31 U/L 8 U/L 31 U/L 8 U/L 31 U/L
1–<13 yrs 11 U/L 25 U/L 11 U/L 25 U/L 11 U/L 25 U/L 11 U/L 25 U/L
13–<19 yrs 11 U/L 22 U/L 11 U/L 22 U/L 11 U/L 24 U/L 11 U/L 24 U/L
K. ADELI ET AL.

Alanine aminotransferase with pyridoxal phosphate (ALT ACT) 0–<1 yrs 7 U/L 36 U/L 7 U/L 36 U/L 7 U/L 36 U/L 7 U/L 36 U/L
1–<13 yrs 12 U/L 28 U/L 12 U/L 28 U/L 12 U/L 28 U/L 12 U/L 28 U/L
13–<19 yrs 10 U/L 25 U/L 10 U/L 25 U/L 12 U/L 27 U/L 12 U/L 27 U/L
Albumin G (bromcresol green) 0–<15 d 33 g/L 45 g/L 3.3 g/dL 4.5 g/dL 33 g/L 45 g/L 3.3 g/dL 4.5 g/dL
15 d–<1 yr 31 g/L 50 g/L 3.1 g/dL 5.0 g/dL 31 g/L 50 g/L 3.1 g/dL 5.0 g/dL
1–<8 yrs 40 g/L 49 g/L 4.0 g/dL 4.9 g/dL 40 g/L 49 g/L 4.0 g/dL 4.9 g/dL
8–<15 yrs 42 g/L 51 g/L 4.2 g/dL 5.1 g/dL 42 g/L 51 g/L 4.2 g/dL 5.1 g/dL
15–<19 yrs 40 g/L 53 g/L 4.0 g/dL 5.3 g/dL 43 g/L 53 g/L 4.3 g/dL 5.3 g/dL
Albumin P (bromcresol purple) 0–<15 d 28 g/L 41 g/L 2.8 g/dL 4.1 g/dL 28 g/L 41 g/L 2.8 g/dL 4.1 g/dL
15 d–<1 yr 24 g/L 47 g/L 2.4 g/dL 4.7 g/dL 24 g/L 47 g/L 2.4 g/dL 4.7 g/dL
1–<8 yrs 35 g/L 46 g/L 3.5 g/dL 4.6 g/dL 35 g/L 46 g/L 3.5 g/dL 4.6 g/dL
8–<15 yrs 37 g/L 48 g/L 3.7 g/dL 4.8 g/dL 37 g/L 48 g/L 3.7 g/dL 4.8 g/dL
15–<19 yrs 35 g/L 50 g/L 3.5 g/dL 5.0 g/dL 38 g/L 51 g/L 3.8 g/dL 5.1 g/dL
Alkaline phosphatase (ALP)a 0–<15 d 89 U/L 260 U/L 89 U/L 260 U/L 89 U/L 260 U/L 89 U/L 260 U/L
15 d–<1 yr 130 U/L 490 U/L 130 U/L 490 U/L 130 U/L 490 U/L 130 U/L 490 U/L
1–<10 yrs 150 U/L 350 U/L 150 U/L 350 U/L 150 U/L 350 U/L 150 U/L 350 U/L
10–<13 yrs 136 U/L 435 U/L 136 U/L 435 U/L 136 U/L 435 U/L 136 U/L 435 U/L
13–<15 yrs 62 U/L 267 U/L 62 U/L 267 U/L 123 U/L 489 U/L 123 U/L 489 U/L
15–<17 yrs 55 U/L 124 U/L 55 U/L 124 U/L 88 U/L 346 U/L 88 U/L 346 U/L
17–<19 yrs 50 U/L 93 U/L 50 U/L 93 U/L 60 U/L 158 U/L 60 U/L 158 U/L
Amylasea 0–<15 d 4 U/L 12 U/L 4 U/L 12 U/L 4 U/L 12 U/L 4 U/L 12 U/L
15 d––<13 wks 0 U/L 25 U/L 0 U/L 25 U/L 0 U/L 25 U/L 0 U/L 25 U/L
13 wks–<1 yr 4 U/L 56 U/L 4 U/L 56 U/L 4 U/L 56 U/L 4 U/L 56 U/L
1–<19 yrs 29 U/L 113 U/L 29 U/L 113 U/L 29 U/L 113 U/L 29 U/L 113 U/L
Antistreptolysin-O (ASO)a 0–<6 m 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL
6 m–<1 yr 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL 0 IU/mL
1–<6 yrs 0 IU/mL 134 IU/mL 0 IU/mL 134 IU/mL 0 IU/mL 134 IU/mL 0 IU/mL 134 IU/mL
6–<19 yrs 0 IU/mL 518 IU/mL 0 IU/mL 518 IU/mL 0 IU/mL 518 IU/mL 0 IU/mL 518 IU/mL
Apolipoprotein B 0–<15 d 0.00 g/L 0.60 g/L 0 mg/dL 60 mg/dL 0.00 g/L 0.60 g/L 0 mg/dL 60 mg/dL
15 d–<1 yr 0.10 g/L 1.20 g/L 10 mg/dL 120 mg/dL 0.10 g/L 1.20 g/L 10 mg/dL 120 mg/dL
1–<6 yrs 0.36 g/L 0.87 g/L 36 mg/dL 87 mg/dL 0.36 g/L 0.87 g/L 36 mg/dL 87 mg/dL
6–<19 yrs 0.26 g/L 0.82 g/L 26 mg/dL 82 mg/dL 0.26 g/L 0.82 g/L 26 mg/dL 82 mg/dL
Aspartate aminotransferase without pyridoxal phosphate (AST) 0–<15 d 33 U/L 154 U/L 33 U/L 154 U/L 33 U/L 154 U/L 33 U/L 154 U/L
15 d–<1 yr 22 U/L 66 U/L 22 U/L 66 U/L 22 U/L 66 U/L 22 U/L 66 U/L
1–<7 yrs 23 U/L 44 U/L 23 U/L 44 U/L 23 U/L 44 U/L 23 U/L 44 U/L
7–<12 yrs 20 U/L 37 U/L 20 U/L 37 U/L 20 U/L 37 U/L 20 U/L 37 U/L
12–<19 yrs 16 U/L 28 U/L 16 U/L 28 U/L 17 U/L 36 U/L 17 U/L 36 U/L
Aspartate aminotransferase with pyridoxal phosphate (AST ACT) 0–<15 d 40 U/L 175 U/L 40 U/L 175 U/L 40 U/L 175 U/L 40 U/L 175 U/L
15 d–<1 yr 28 U/L 77 U/L 28 U/L 77 U/L 28 U/L 77 U/L 28 U/L 77 U/L
1–<7 yrs 29 U/L 53 U/L 29 U/L 53 U/L 29 U/L 53 U/L 29 U/L 53 U/L
7–<12 yrs 26 U/L 45 U/L 26 U/L 45 U/L 26 U/L 45 U/L 26 U/L 45 U/L
12–<19 yrs 21 U/L 34 U/L 21 U/L 34 U/L 22 U/L 44 U/L 22 U/L 44 U/L
Bilirubin, direct 0–<15 d 3.4 mmol/L 7.7 mmol/L 0.2 mg/dL 0.5 mg/dL 3.4 mmol/L 7.7 mmol/L 0.2 mg/dL 0.5 mg/dL
15 d–<1 yr 0.0 mmol/L 3.0 mmol/L 0.0 mg/dL 0.2 mg/dL 0.0 mmol/L 3.0 mmol/L 0.0 mg/dL 0.2 mg/dL
(continued)
Table 7. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
1–<9 yrs 0.0 mmol/L 1.8 mmol/L 0.0 mg/dL 0.1 mg/dL 0.0 mmol/L 1.8 mmol/L 0.0 mg/dL 0.1 mg/dL
9–<13 yrs 0.0 mmol/L 2.9 mmol/L 0.0 mg/dL 0.2 mg/dL 0.0 mmol/L 2.9 mmol/L 0.0 mg/dL 0.2 mg/dL
13–<19 yrs 0.0 mmol/L 4.0 mmol/L 0.0 mg/dL 0.2 mg/dL 0.0 mmol/L 4.3 mmol/L 0.0 mg/dL 0.3 mg/dL
Bilirubin, total 0–<15 d 2.4 mmol/L 247 mmol/L 0.1 mg/dL 14.4 mg/dL 2.4 mmol/L 247 mmol/L 0.1 mg/dL 14.4 mg/dL
15 d–<1 yr 0.0 mmol/L 9.7 mmol/L 0.0 mg/dL 0.6 mg/dL 0.0 mmol/L 9.7 mmol/L 0.0 mg/dL 0.6 mg/dL
1–<9 yrs 0.0 mmol/L 5.4 mmol/L 0.0 mg/dL 0.3 mg/dL 0.0 mmol/L 5.4 mmol/L 0.0 mg/dL 0.3 mg/dL
9–<12 yrs 0.0 mmol/L 7.7 mmol/L 0.0 mg/dL 0.5 mg/dL 0.0 mmol/L 7.7 mmol/L 0.0 mg/dL 0.5 mg/dL
12–<15 yrs 0.0 mmol/L 9.9 mmol/L 0.0 mg/dL 0.6 mg/dL 0.0 mmol/L 9.9 mmol/L 0.0 mg/dL 0.6 mg/dL
15–<19 yrs 1.0 mmol/L 12.0 mmol/L 0.1 mg/dL 0.7 mg/dL 1.0 mmol/L 12.0 mmol/L 0.1 mg/dL 0.7 mg/dL
Cholesterol 0–<15 d 1.29 mmol/L 3.38 mmol/L 50 mg/dL 131 mg/dL 1.19 mmol/L 2.96 mmol/L 46 mg/dL 114 mg/dL
15 d–<1 yr 1.76 mmol/L 6.37 mmol/L 68 mg/dL 246 mg/dL 1.76 mmol/L 6.37 mmol/L 68 mg/dL 246 mg/dL
1–<19 yrs 3.04 mmol/L 5.62 mmol/L 117 mg/dL 217 mg/dL 3.04 mmol/L 5.62 mmol/L 117 mg/dL 217 mg/dL
Complement component 3 (C3) 0–<15 d 0.52 g/L 1.26 g/L 52 mg/dL 126 mg/dL 0.52 g/L 1.26 g/L 52 mg/dL 126 mg/dL
15 d–<1 yrs 0.53 g/L 1.67 g/L 53 mg/dL 167 mg/dL 0.53 g/L 1.67 g/L 53 mg/dL 167 mg/dL
1–<19 yrs 0.86 g/L 1.59 g/L 86 mg/dL 159 mg/dL 0.86 g/L 1.59 g/L 86 mg/dL 159 mg/dL
Complement component 4 (C4) 0–<1 yr 0.07 g/L 0.30 g/L 7 mg/dL 30 mg/dL 0.07 g/L 0.30 g/L 7 mg/dL 30 mg/dL
1–<19 yrs 0.13 g/L 0.37 g/L 13 mg/dL 37 mg/dL 0.13 g/L 0.37 g/L 13 mg/dL 37 mg/dL
C-Reactive protein high sensitivity (CRP)a 0–<15 d 0.4 mg/L 5.0 mg/L 0.4 mg/L 5.0 mg/L 0.4 mg/L 5.0 mg/L 0.4 mg/L 5.0 mg/L
15 d–<15 yrs 0.2 mg/L 0.9 mg/L 0.2 mg/L 0.9 mg/L 0.2 mg/L 0.9 mg/L 0.2 mg/L 0.9 mg/L
15–<19 yrs 0.2 mg/L 1.5 mg/L 0.2 mg/L 1.5 mg/L 0.2 mg/L 1.5 mg/L 0.2 mg/L 1.5 mg/L
Creatinine, enzymatica 0–<15 d 27 mmol/L 79 mmol/L 0.3 mg/dL 0.9 mg/dL 27 mmol/L 79 mmol/L 0.3 mg/dL 0.9 mg/dL
15 d–<2 yrs 8 mmol/L 30 mmol/L 0.1 mg/dL 0.3 mg/dL 8 mmol/L 30 mmol/L 0.1 mg/dL 0.3 mg/dL
2–<5 yrs 16 mmol/L 36 mmol/L 0.2 mg/dL 0.4 mg/dL 16 mmol/L 36 mmol/L 0.2 mg/dL 0.4 mg/dL
5–<12 yrs 25 mmol/L 52 mmol/L 0.3 mg/dL 0.6 mg/dL 25 mmol/L 52 mmol/L 0.3 mg/dL 0.6 mg/dL
12–<15 yrs 38 mmol/L 69 mmol/L 0.4 mg/dL 0.8 mg/dL 38 mmol/L 69 mmol/L 0.4 mg/dL 0.8 mg/dL
15–<19 yrs 41 mmol/L 71 mmol/L 0.5 mg/dL 0.8 mg/dL 53 mmol/L 93 mmol/L 0.6 mg/dL 1.1 mg/dL
Gamma-glutamyl transferase (GGT) 0–<15 d 17 U/L 171 U/L 17 U/L 171 U/L 17 U/L 171 U/L 17 U/L 171 U/L
15 d–<1 yr 5 U/L 99 U/L 5 U/L 99 U/L 5 U/L 99 U/L 5 U/L 99 U/L
1–<11 yrs 3 U/L 11 U/L 3 U/L 11 U/L 3 U/L 11 U/L 3 U/L 11 U/L
11–<19 yrs 4 U/L 15 U/L 4 U/L 15 U/L 4 U/L 15 U/L 4 U/L 15 U/L
Haptoglobin 0–<15 d 0.00 g/L 0.11 g/L 0 mg/dL 11 mg/dL 0.00 g/L 0.11 g/L 0 mg/dL 11 mg/dL
15 d–<1 yr 0.00 g/L 2.09 g/L 0 mg/dL 209 mg/dL 0.00 g/L 2.09 g/L 0 mg/dL 209 mg/dL
1–<12 yrs 0.00 g/L 1.54 g/L 0 mg/dL 154 mg/dL 0.00 g/L 1.54 g/L 0 mg/dL 154 mg/dL
12–<19 yrs 0.00 g/L 1.69 g/L 0 mg/dL 169 mg/dL 0.00 g/L 1.69 g/L 0 mg/dL 169 mg/dL
High-density lipoprotein cholesterol (HDL-C)a 0–<15 d 0.22 mmol/L 1.00 mmol/L 8 mg/dL 39 mg/dL 0.22 mmol/L 1.00 mmol/L 8 mg/dL 39 mg/dL
15 d–<1 yr 0.10 mmol/L 1.89 mmol/L 4 mg/dL 73 mg/dL 0.10 mmol/L 1.89 mmol/L 4 mg/dL 73 mg/dL
1–<4 yrs 0.72 mmol/L 1.63 mmol/L 28 mg/dL 63 mg/dL 0.72 mmol/L 1.63 mmol/L 28 mg/dL 63 mg/dL
4–<13 yrs 0.82 mmol/L 1.92 mmol/L 32 mg/dL 74 mg/dL 0.82 mmol/L 1.92 mmol/L 32 mg/dL 74 mg/dL
13–<19 yrs 0.71 mmol/L 1.90 mmol/L 27 mg/dL 73 mg/dL 0.70 mmol/L 1.79 mmol/L 27 mg/dL 69 mg/dL
Immunoglobulin A (IgA)a 0–<1 yr 0.0 g/L 0.2 g/L 0 mg/dL 16 mg/dL 0.0 g/L 0.2 g/L 0 mg/dL 16 mg/dL
1–<3 yrs 0.0 g/L 0.8 g/L 0 mg/dL 84 mg/dL 0.0 g/L 0.8 g/L 0 mg/dL 84 mg/dL
3–<6 yrs 0.2 g/L 1.5 g/L 16 mg/dL 151 mg/dL 0.2 g/L 1.5 g/L 16 mg/dL 151 mg/dL
6–<14 yrs 0.4 g/L 2.3 g/L 39 mg/dL 230 mg/dL 0.4 g/L 2.3 g/L 39 mg/dL 230 mg/dL
14–<19 yrs 0.4 g/L 3.1 g/L 39 mg/dL 309 mg/dL 0.4 g/L 3.1 g/L 39 mg/dL 309 mg/dL
Immunoglobulin G (IgG)a 0–<15 d 3.3 g/L 13.2 g/L 325 mg/dL 1319 mg/dL 3.3 g/L 13.2 g/L 325 mg/dL 1319 mg/dL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

15 d–<1 yr 1.3 g/L 6.8 g/L 132 mg/dL 675 mg/dL 1.3 g/L 6.8 g/L 132 mg/dL 675 mg/dL
1–<4 yrs 3.3 g/L 10.9 g/L 325 mg/dL 1089 mg/dL 3.3 g/L 10.9 g/L 325 mg/dL 1089 mg/dL
(continued)
401
Table 7. Continued
402

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
4–<10 yrs 5.3 g/L 12.8 g/L 528 mg/dL 1282 mg/dL 5.3 g/L 12.8 g/L 528 mg/dL 1282 mg/dL
10–<19 yrs 6.4 g/L 14.4 g/L 638 mg/dL 1438 mg/dL 6.4 g/L 14.4 g/L 638 mg/dL 1438 mg/dL
Immunoglobulin M (IgM)a 0–<15 d 0.1 g/L 0.4 g/L 7 mg/dL 39 mg/dL 0.1 g/L 0.4 g/L 7 mg/dL 39 mg/dL
K. ADELI ET AL.

15 d–<13 wks 0.1 g/L 0.7 g/L 7 mg/dL 71 mg/dL 0.1 g/L 0.7 g/L 7 mg/dL 71 mg/dL
13 wks–<1 yr 0.2 g/L 0.9 g/L 18 mg/dL 93 mg/dL 0.2 g/L 0.9 g/L 18 mg/dL 93 mg/dL
1–<19 yrs 0.5 g/L 2.0 g/L 50 mg/dL 199 mg/dL 0.4 g/L 1.6 g/L 39 mg/dL 157 mg/dL
Iron 0–<14 yrs 3 mmol/L 24 mmol/L 17 mg/dL 134 mg/dL 3 mmol/L 24 mmol/L 17 mg/dL 134 mg/dL
14–<19 yrs 4 mmol/L 30 mmol/L 22 mg/dL 168 mg/dL 6 mmol/L 31 mmol/L 34 mg/dL 173 mg/dL
Lactate dehydrogenase (LDH) 0–<15 d 303 U/L 1143 U/L 303 U/L 1143 U/L 303 U/L 1143 U/L 303 U/L 1143 U/L
15 d–<1 yr 169 U/L 435 U/L 169 U/L 435 U/L 169 U/L 435 U/L 169 U/L 435 U/L
1–<10 yrs 196 U/L 314 U/L 196 U/L 314 U/L 196 U/L 314 U/L 196 U/L 314 U/L
10–<15 yrs 163 U/L 269 U/L 163 U/L 269 U/L 175 U/L 279 U/L 175 U/L 279 U/L
15–<19 yrs 139 U/L 249 U/L 139 U/L 249 U/L 139 U/L 249 U/L 139 U/L 249 U/L
Phosphatea 0–<15 d 1.82 mmol/L 3.45 mmol/L 5.6 mg/dL 10.7 mg/dL 1.82 mmol/L 3.45 mmol/L 5.6 mg/dL 10.7 mg/dL
15 d–<1 yr 1.55 mmol/L 2.76 mmol/L 4.8 mg/dL 8.5 mg/dL 1.55 mmol/L 2.76 mmol/L 4.8 mg/dL 8.5 mg/dL
1–<5 yrs 1.39 mmol/L 2.21 mmol/L 4.3 mg/dL 6.8 mg/dL 1.39 mmol/L 2.21 mmol/L 4.3 mg/dL 6.8 mg/dL
5–<13 yrs 1.33 mmol/L 1.94 mmol/L 4.1 mg/dL 6.0 mg/dL 1.33 mmol/L 1.94 mmol/L 4.1 mg/dL 6.0 mg/dL
13–<16 yrs 1.02 mmol/L 1.81 mmol/L 3.2 mg/dL 5.6 mg/dL 1.14 mmol/L 2.01 mmol/L 3.5 mg/dL 6.2 mg/dL
16–<19 yrs 0.95 mmol/L 1.63 mmol/L 2.9 mg/dL 5.0 mg/dL 0.95 mmol/L 1.63 mmol/L 2.9 mg/dL 5.0 mg/dL
Total proteina 0–<15 d 55 g/L 83 g/L 5.5 g/dL 8.3 g/dL 55 g/L 83 g/L 5.5 g/dL 8.3 g/dL
15 d–<1 yr 46 g/L 72 g/L 4.6 g/dL 7.2 g/dL 46 g/L 72 g/L 4.6 g/dL 7.2 g/dL
1–<6 yrs 62 g/L 76 g/L 6.2 g/dL 7.6 g/dL 62 g/L 76 g/L 6.2 g/dL 7.6 g/dL
6–<9 yrs 65 g/L 77 g/L 6.5 g/dL 7.7 g/dL 65 g/L 77 g/L 6.5 g/dL 7.7 g/dL
9–<19 yrs 66 g/L 81 g/L 6.6 g/dL 8.1 g/dL 66 g/L 81 g/L 6.6 g/dL 8.1 g/dL
Transferrin 0–<9 wks 1.15 g/L 2.44 g/L 115 mg/dL 244 mg/dL 1.15 g/L 2.44 g/L 115 mg/dL 244 mg/dL
9 wks–<1 yr 1.18 g/L 3.52 g/L 118 mg/dL 352 mg/dL 1.18 g/L 3.52 g/L 118 mg/dL 352 mg/dL
1–<19 yrs 2.40 g/L 3.66 g/L 240 mg/dL 366 mg/dL 2.40 g/L 3.66 g/L 240 mg/dL 366 mg/dL
Triglycerides 0–<15 d 0.98 mmol/L 3.21 mmol/L 87 mg/dL 284 mg/dL 0.98 mmol/L 3.21 mmol/L 87 mg/dL 284 mg/dL
15 d–<1 yr 0.61 mmol/L 3.20 mmol/L 54 mg/dL 283 mg/dL 0.61 mmol/L 3.20 mmol/L 54 mg/dL 283 mg/dL
1–<19 yrs 0.50 mmol/L 2.43 mmol/L 44 mg/dL 215 mg/dL 0.50 mmol/L 2.43 mmol/L 44 mg/dL 215 mg/dL
Urea 0–<15 d 1.0 mmol/L 8.7 mmol/L 3 mg/dL 24 mg/dL 1.0 mmol/L 8.7 mmol/L 3 mg/dL 24 mg/dL
15 d–<1 yr 1.2 mmol/L 6.3 mmol/L 3 mg/dL 18 mg/dL 1.2 mmol/L 6.3 mmol/L 3 mg/dL 18 mg/dL
1–<10 yrs 3.3 mmol/L 8.4 mmol/L 9 mg/dL 24 mg/dL 3.3 mmol/L 8.4 mmol/L 9 mg/dL 24 mg/dL
10–<19 yrs 2.7 mmol/L 7.2 mmol/L 8 mg/dL 20 mg/dL 2.7 mmol/L 7.9 mmol/L 8 mg/dL 22 mg/dL
Uric acida 0–<15 d 165 mmol/L 718 mmol/L 2.8 mg/dL 12.1 mg/dL 165 mmol/L 718 mmol/L 2.8 mg/dL 12.1 mg/dL
15 d–<1 yr 100 mmol/L 364 mmol/L 1.7 mg/dL 6.1 mg/dL 100 mmol/L 364 mmol/L 1.7 mg/dL 6.1 mg/dL
1–<12 yrs 111 mmol/L 282 mmol/L 1.9 mg/dL 4.7 mg/dL 111 mmol/L 282 mmol/L 1.9 mg/dL 4.7 mg/dL
12–<19 yrs 155 mmol/L 338 mmol/L 2.6 mg/dL 5.7 mg/dL 158 mmol/L 435 mmol/L 2.7 mg/dL 7.3 mg/dL
Reference interval value units are in Standard International units (SI units) and Conventional units (CON units).
Colored partitions indicate sex-specific differences within the age partitions.
Refer to the original publications [32] for additional information.
Approximately 200 patient samples were run on the Roche Modular P to transfer reference intervals from the Abbott ARCHITECT.
a
Reference interval did not verify. Please use with caution. See original publication [32] for more information.
Table 8. Pediatric reference intervals for the Siemens Vista – age and sex specific.
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
Alanine aminotransferase with pyridoxal 0–<1 yr NA 41 U/L NA 41 U/L NA 41 U/L NA 41 U/L
phosphate (ALT ACT) 1–<13 yrs NA 32 U/L NA 32 U/L NA 32 U/L NA 32 U/L
13–<19 yrs NA 29 U/L NA 29 U/L NA 31 U/L NA 31 U/L
Albumin P (bromcresol purple) 0–<15 d 30 g/L 43 g/L 3.0 g/dL 4.3 g/dL 30 g/L 43 g/L 3.0 g/dL 4.3 g/dL
15 d–<1 yr 27 g/L 48 g/L 2.7 g/dL 4.8 g/dL 27 g/L 48 g/L 2.7 g/dL 4.8 g/dL
1–<8 yrs 37 g/L 47 g/L 3.7 g/dL 4.7 g/dL 37 g/L 47 g/L 3.7 g/dL 4.7 g/dL
8–<15 yrs 39 g/L 49 g/L 3.9 g/dL 4.9 g/dL 39 g/L 49 g/L 3.9 g/dL 4.9 g/dL
15–<19 yrs 37 g/L 51 g/L 3.7 g/dL 5.1 g/dL 40 g/L 53 g/L 4.0 g/dL 5.3 g/dL
Alkaline phosphatase (ALP) 0–<15 d 82 U/L 249 U/L 82 U/L 249 U/L 82 U/L 249 U/L 82 U/L 249 U/L
15 d–<1yr 122 U/L 473 U/L 122 U/L 473 U/L 122 U/L 473 U/L 122 U/L 473 U/L
1–<10 yrs 142 U/L 336 U/L 142 U/L 336 U/L 142 U/L 336 U/L 142 U/L 336 U/L
10–<13yrs 128 U/L 420 U/L 128 U/L 420 U/L 128 U/L 420 U/L 128 U/L 420 U/L
13–<15 yrs 55 U/L 255 U/L 55 U/L 255 U/L 115 U/L 471 U/L 115 U/L 471 U/L
15–<17 yrs 49 U/L 116 U/L 49 U/L 116 U/L 81 U/L 333 U/L 81 U/L 333 U/L
17–<19 yrs 43 U/L 86 U/L 43 U/L 86 U/L 53 U/L 149 U/L 53 U/L 149 U/L
Apolipoprotein B (Apo B) 0–<15 d NA 0.7 g/L NA 72 mg/dL NA 0.7 g/L NA 72 mg/dL
15 d–<1yr 0.2 g/L 1.3 g/L 18 mg/dL 134 mg/dL 0.2 g/L 1.3 g/L 18 mg/dL 134 mg/dL
1–<6 yrs 0.4 g/L 1.0 g/L 43 mg/dL 100 mg/dL 0.4 g/L 1.0 g/L 43 mg/dL 100 mg/dL
6–<19 yrs 0.3 g/L 0.9 g/L 32 mg/dL 90 mg/dL 0.3 g/L 0.9 g/L 32 mg/dL 90 mg/dL
Aspartate aminotransferase with pyridoxal 0–<15 d NA 185 U/L NA 185 U/L NA 185 U/L NA 185 U/L
phosphate (AST ACT) 15 d–<1 yr NA 73 U/L NA 73 U/L NA 73 U/L NA 73 U/L
1–<7 yrs NA 46 U/L NA 46 U/L NA 46 U/L NA 46 U/L
7–<12 yrs NA 37 U/L NA 37 U/L NA 37 U/L NA 37 U/L
12–<19 yrs NA 25 U/L NA 25 U/L NA 36 U/L NA 36 U/L
Amylase 0–<15 d NA 10 U/L NA 10 U/L NA 10 U/L NA 10 U/L
15 d–<13 wks NA 21 U/L NA 21 U/L NA 21 U/L NA 21 U/L
13 wks–<1 yr NA 47 U/L NA 47 U/L NA 47 U/L NA 47 U/L
1–<19 yrs NA 94 U/L NA 94 U/L NA 94 U/L NA 94 U/L
Bilirubin, direct 0–<15 d NA 8 mmol/L NA 0.5 mg/dL NA 8 mmol/L NA 0.5 mg/dL
15 d–<1yr NA 3 mmol/L NA 0.2 mg/dL NA 3 mmol/L NA 0.2 mg/dL
1–<9 yrs NA 1 mmol/L NA 0.1 mg/dL NA 1 mmol/L NA 0.1 mg/dL
9–<13yrs NA 3 mmol/L NA 0.2 mg/dL NA 3 mmol/L NA 0.2 mg/dL
13–<19 yrs NA 4 mmol/L NA 0.2 mg/dL NA 4 mmol/L NA 0.2 mg/dL
Bilirubin, totala 0–<15 d NA 239 mmol/L NA 14.0 mg/dL NA 239 mmol/L NA 14.0 mg/dL
15 d–<1 yr NA 9 mmol/L NA 0.5 mg/dL NA 9 mmol/L NA 0.5 mg/dL
1–<9yrs NA 5 mmol/L NA 0.3 mg/dL NA 5 mmol/L NA 0.3 mg/dL
9–<12 yrs NA 7 mmol/L NA 0.4 mg/dL NA 7 mmol/L NA 0.4 mg/dL
12–<15 yrs NA 10 mmol/L NA 0.6 mg/dL NA 10 mmol/L NA 0.6 mg/dL
15–<19 yrs NA 12 mmol/L NA 0.7 mg/dL NA 12 mmol/L NA 0.7 mg/dL
Calciuma 0–<1 yr 2.13 mmol/L 2.67 mmol/L 8.5 mg/dL 10.7 mg/dL 2.13 mmol/L 2.67 mmol/L 8.5 mg/dL 10.7 mg/dL
1–<19yrs 2.27 mmol/L 2.58 mmol/L 9.1 mg/dL 10.3 mg/dL 2.27 mmol/L 2.58 mmol/L 9.1 mg/dL 10.3 mg/dL
(continued)
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES
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 404

Table 8. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
K. ADELI ET AL.

Cholesterola 0–<15 d 1.08 mmol/L 3.09 mmol/L 42 mg/dL 119 mg/dL 0.98 mmol/L 2.69 mmol/L 38 mg/dL 104 mg/dL
15 d–<1 yr 1.54 mmol/L 5.97 mmol/L 59 mg/dL 231 mg/dL 1.54 mmol/L 5.97 mmol/L 59 mg/dL 231 mg/dL
1–<19 yrs 2.77 mmol/L 5.24 mmol/L 107 mg/dL 202 mg/dL 2.77 mmol/L 5.24 mmol/L 107 mg/dL 202 mg/dL
Complement component 3 (C3) 0–<15 d 0.54 g/L 1.26 g/L 54 mg/dL 126 mg/dL 0.54 g/L 1.26 g/L 54 mg/dL 126 mg/dL
15 d–<1 yr 0.55 g/L 1.66 g/L 55 mg/dL 166 mg/dL 0.55 g/L 1.66 g/L 55 mg/dL 166 mg/dL
1–<19 yrs 0.87 g/L 1.58 g/L 87 mg/dL 158 mg/dL 0.87 g/L 1.58 g/L 87 mg/dL 158 mg/dL
Complement component 4 (C4)a 0–<1 yr 0.09 g/L 0.30 g/L 9 mg/dL 30 mg/dL 0.09 g/L 0.30 g/L 9 mg/dL 30 mg/dL
1–<19 yrs 0.14 g/L 0.36 g/L 14 mg/dL 36 mg/dL 0.14 g/L 0.36 g/L 14 mg/dL 36 mg/dL
Creatinine, enzymatic 0–<15 d 27.2 mmol/L 77.6 mmol/L 0.31 mg/dL 0.88 mg/dL 27.0 mmol/L 77.6 mmol/L 0.31 mg/dL 0.88 mg/dL
15 d–<2 yrs 8.4 mmol/L 30.7 mmol/L 0.10 mg/dL 0.35 mg/dL 8.4 mmol/L 30.7 mmol/L 0.10 mg/dL 0.35 mg/dL
2–<5 yrs 16.9 mmol/L 36.0 mmol/L 0.19 mg/dL 0.41 mg/dL 16.9 mmol/L 36.0 mmol/L 0.19 mg/dL 0.41 mg/dL
5–<12 yrs 25.9 mmol/L 50.9 mmol/L 0.29 mg/dL 0.58 mg/dL 25.9 mmol/L 50.9 mmol/L 0.29 mg/dL 0.58 mg/dL
12–<15 yrs 37.9 mmol/L 68.3 mmol/L 0.43 mg/dL 0.77 mg/dL 37.9 mmol/L 68.3 mmol/L 0.43 mg/dL 0.77 mg/dL
15–<19 yrs 41.2 mmol/L 70.5 mmol/L 0.47 mg/dL 0.80 mg/dL 52.4 mmol/L 90.8 mmol/L 0.59 mg/dL 1.03 mg/dL
Haptoglobin 0–<15 d NA 0.18 g/L NA 18 mg/dL NA 0.18 g/L NA 18 mg/dL
15 d–<1 yr NA 2.27 g/L NA 227 mg/dL NA 2.27 g/L NA 227 mg/dL
1–<12 yrs NA 1.69 g/L NA 169 mg/dL NA 1.69 g/L NA 169 mg/dL
12–<19 yrs NA 1.85 g/L NA 185 mg/dL NA 1.85 g/L NA 185 mg/dL
Immunoglobulin A (IgA) 0–<1 yr NA 0.30 g/L NA 30 mg/dL NA 0.30 g/L NA 30 mg/dL
1–<3 yrs NA 1.00 g/L NA 100 mg/dL NA 1.00 g/L NA 100 mg/dL
3–<6 yrs 0.30 g/L 1.60 g/L 30 mg/dL 160 mg/dL 0.30 g/L 1.60 g/L 30 mg/dL 160 mg/dL
6–<14 yrs 0.50 g/L 2.40 g/L 50 mg/dL 240 mg/dL 0.50 g/L 2.40 g/L 50 mg/dL 240 mg/dL
14–<19 yrs 0.60 g/L 3.10 g/L 60 mg/dL 310 mg/dL 0.60 g/L 3.10 g/L 60 mg/dL 310 mg/dL
Immunoglobulin G (IgG) 0–<15 d 3.2 g/L 13.7 g/L 320 mg/dL 1370 mg/dL 3.2 g/L 13.7 g/L 320 mg/dL 1370 mg/dL
15 d–<1 yr 1.2 g/L 6.9 g/L 120 mg/dL 690 mg/dL 1.2 g/L 6.9 g/L 120 mg/dL 690 mg/dL
1–<4 yrs 3.2 g/L 11.2 g/L 320 mg/dL 1120 mg/dL 3.2 g/L 11.2 g/L 320 mg/dL 1120 mg/dL
4–<10 yrs 5.4 g/L 13.3 g/L 540 mg/dL 1330 mg/dL 5.4 g/L 13.3 g/L 540 mg/dL 1330 mg/dL
10–<19 yrs 6.5 g/L 15.0 g/L 650 mg/dL 1500 mg/dL 6.5 g/L 15.0 g/L 650 mg/dL 1500 mg/dL
Immunoglobulin M (IgM)a 0–<15 d 0.07 g/L 0.35 g/L 7 mg/dL 35 mg/dL 0.07 g/L 0.35 g/L 7 mg/dL 35 mg/dL
15 d–<13 wks 0.14 g/L 0.68 g/L 14 mg/dL 68 mg/dL 0.14 g/L 0.68 g/L 14 mg/dL 68 mg/dL
13 wks–<1 yr 0.18 g/L 0.82 g/L 18 mg/dL 82 mg/dL 0.18 g/L 0.82 g/L 18 mg/dL 82 mg/dL
1–<19 yrs 0.47 g/L 1.75 g/L 47 mg/dL 175 mg/dL 0.39 g/L 1.42 g/L 39 mg/dL 142 mg/dL
Iron 0 –<14 yrs 5 mmol/L 25 mmol/L 28 mg/dL 140 mg/dL 5 mmol/L 25 mmol/L 28 mg/dL 140 mg/dL
14–<19 yrs 5 mmol/L 31 mmol/L 28 mg/dL 173 mg/dL 7 mmol/L 31 mmol/L 39 mg/dL 173 mg/dL
Lactate dehydrogenase (LDH) 0–<15 d NA 1255 U/L NA 1255 U/L NA 1255 U/L NA 1255 U/L
15 d–<1 yr NA 470 U/L NA 470 U/L NA 470 U/L NA 470 U/L
1–<10 yrs NA 337 U/L NA 337 U/L NA 337 U/L NA 337 U/L
10–<15 yrs NA 287 U/L NA 287 U/L NA 298 U/L NA 298 U/L
15–<19 yrs NA 265 U/L NA 265 U/L NA 265 U/L NA 265 U/L
Lipase 0–<19 yrs NA 194 U/L NA 194 U/L NA 194 U/L NA 194 U/L
Phosphatea 0–<15 d 1.72 mmol/L 3.22 mmol/L 5.3 mg/dL 10.0 mg/dL 1.72 mmol/L 3.22 mmol/L 5.3 mg/dL 10.0 mg/dL
15 d–<1 yr 1.48 mmol/L 2.58 mmol/L 4.6 mg/dL 8.0 mg/dL 1.48 mmol/L 2.58 mmol/L 4.6 mg/dL 8.0 mg/dL
(continued)
Table 8. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age LL UL LL UL LL UL LL UL
1–<5 yrs 1.33 mmol/L 2.09 mmol/L 4.1 mg/dL 6.5 mg/dL 1.33 mmol/L 2.09 mmol/L 4.1 mg/dL 6.5 mg/dL
5–<13 yrs 1.28 mmol/L 1.83 mmol/L 4.0 mg/dL 5.7 mg/dL 1.28 mmol/L 1.83 mmol/L 4.0 mg/dL 5.7 mg/dL
13–<16 yrs 0.99 mmol/L 1.71 mmol/L 3.1 mg/dL 5.3 mg/dL 1.10 mmol/L 1.90 mmol/L 3.4 mg/dL 5.9 mg/dL
16–<19 yrs 0.92 mmol/L 1.55 mmol/L 2.9 mg/dL 4.8 mg/dL 0.92 mmol/L 1.55 mmol/L 2.9 mg/dL 4.8 mg/dL
Prealbumina 0–<15 d NA 0.10 g/L NA 10 mg/dL NA 0.10 g/L NA 10 mg/dL
15 d–<1 yr 0.01 g/L 0.24 g/L 1 mg/dL 24 mg/dL 0.01 g/L 0.24 g/L 1 mg/dL 24 mg/dL
1–<5 yrs 0.10 g/L 0.23 g/L 10 mg/dL 23 mg/dL 0.10 g/L 0.23 g/L 10 mg/dL 23 mg/dL
5–<13 yrs 0.12 g/L 0.26 g/L 12 mg/dL 26 mg/dL 0.12 g/L 0.26 g/L 12 mg/dL 26 mg/dL
13–<16 yrs 0.17 g/L 0.32 g/L 17 mg/dL 32 mg/dL 0.17 g/L 0.32 g/L 17 mg/dL 32 mg/dL
16–<19 yrs 0.16 g/L 0.35 g/L 16 mg/dL 35 mg/dL 0.19 g/L 0.37 g/L 19 mg/dL 37 mg/dL
Total protein 0–<15 d 54 g/L 86 g/L 5.4 g/dL 8.6 g/dL 54 g/L 86 g/L 5.4 g/dL 8.6 g/dL
15 d–<1 yr 45 g/L 73 g/L 4.5 g/dL 7.3 g/dL 45 g/L 73 g/L 4.5 g/dL 7.3 g/dL
1–<6 yrs 63 g/L 78 g/L 6.3 g/dL 7.8 g/dL 63 g/L 78 g/L 6.3 g/dL 7.8 g/dL
6–<9 yrs 66 g/L 80 g/L 6.6 g/dL 8.0 g/dL 66 g/L 80 g/L 6.6 g/dL 8.0 g/dL
9–<19 yrs 67 g/L 84 g/L 6.7 g/dL 8.4 g/dL 67 g/L 84 g/L 6.7 g/dL 8.4 g/dL
Transferrin 0–<9 wks 0.97 g/L 2.29 g/L 97 mg/dL 229 mg/dL 0.97 g/L 2.29 g/L 97 mg/dL 229 mg/dL
9 wks–<1 yr 1.01 g/L 3.39 g/L 101 mg/dL 339 mg/dL 1.01 g/L 3.39 g/L 101 mg/dL 339 mg/dL
1–<19 yrs 2.25 g/L 3.54 g/L 225 mg/dL 354 mg/dL 2.25 g/L 3.54 g/L 225 mg/dL 354 mg/dL
Triglyceridesa 0–<15 d 0.99 mmol/L 3.12 mmol/L 88 mg/dL 276 mg/dL 0.99 mmol/L 3.12 mmol/L 88 mg/dL 276 mg/dL
15 d–<1 yr 0.64 mmol/L 3.11 mmol/L 57 mg/dL 275 mg/dL 0.64 mmol/L 3.11 mmol/L 57 mg/dL 275 mg/dL
1–<19 yrs 0.53 mmol/L 2.38 mmol/L 47 mg/dL 210 mg/dL 0.53 mmol/L 2.38 mmol/L 47 mg/dL 210 mg/dL
Ureaa 0–<15 d 1.0 mmol/L 8.3 mmol/L 3 mg/dL 23 mg/dL 1.0 mmol/L 8.3 mmol/L 3 mg/dL 23 mg/dL
15 d–<1 yr 1.2 mmol/L 6.0 mmol/L 3 mg/dL 17 mg/dL 1.2 mmol/L 6.0 mmol/L 3 mg/dL 17 mg/dL
1–<10 yrs 3.2 mmol/L 8.0 mmol/L 9 mg/dL 22 mg/dL 3.2 mmol/L 8.0 mmol/L 9 mg/dL 22 mg/dL
10–<19 yrs 2.6 mmol/L 6.9 mmol/L 7 mg/dL 19 mg/dL 2.6 mmol/L 7.6 mmol/L 7 mg/dL 21 mg/dL
Uric acid 0–<15 d 132 mmol/L 654 mmol/L 2.2 mg/dL 11.0 mg/dL 132 mmol/L 654 mmol/L 2.2 mg/dL 11.0 mg/dL
15 d–<1 yr 71 mmol/L 320 mmol/L 1.2 mg/dL 5.4 mg/dL 71 mmol/L 320 mmol/L 1.2 mg/dL 5.4 mg/dL
1–<12 yrs 81 mmol/L 242 mmol/L 1.4 mg/dL 4.1 mg/dL 81 mmol/L 242 mmol/L 1.4 mg/dL 4.1 mg/dL
12–<19 yrs 123 mmol/L 295 mmol/L 2.1 mg/dL 5.0 mg/dL 125 mmol/L 388 mmol/L 2.1 mg/dL 6.5 mg/dL
Reference interval value units are in Standard International units (SI units) and Conventional units (CON units).
Colored partitions indicate sex-specific differences within the age partitions.
Refer to the original publication [29] for additional information.
Approximately 200 patient samples were run on the Siemens Vista to transfer reference intervals from the Abbott ARCHITECT.
a
Reference interval did not verify. Use with caution. See original publication [29] for more information.
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES
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Table 9. Pediatric reference intervals for markers of metabolic disease, steroid hormones, and vitamins a and E (HPLC, UPLC, LC-MS/MS).
406

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Alaninea 0–<1 wk 76 175 mmol/L 427 mmol/L 175 nmol/mL 427 nmol/mL 76 175 mmol/L 427 mmol/L 175 nmol/mL 427 nmol/mL
1 wk–<19 yrs 426 208 mmol/L 588 mmol/L 208 nmol/mL 588 nmol/mL 426 208 mmol/L 588 mmol/L 208 nmol/mL 588 nmol/mL
Alloisoleucinea 0–<12 yrs 535 0 mmol/L <2 mmol/L 0 nmol/mL <2 nmol/mL 535 0 mmol/L <2 mmol/L 0 nmol/mL <2 nmol/mL
K. ADELI ET AL.

12–<19 yrs 64 NA <2 mmol/L NA <2 nmol/mL 58 <2 mmol/L 3 mmol/L <2 nmol/mL 3 nmol/mL
Androstenedioneb 0–<14 d 27 0.00 nmol/L 2.54 nmol/L 0 ng/dL 73 ng/dL 27 0.00 nmol/L 2.54 nmol/L 0 ng/dL 73 ng/dL
14 d–<1 yr 68 0.09 nmol/L 5.70 nmol/L 3 ng/dL 163 ng/dL 68 0.09 nmol/L 5.70 nmol/L 3 ng/dL 163 ng/dL
1–<6 yrs 58 0.09 nmol/L 0.57 nmol/L 3 ng/dL 16 ng/dL 58 0.09 nmol/L 0.57 nmol/L 3 ng/dL 16 ng/dL
6–<10 yrs 46 0.20 nmol/L 0.92 nmol/L 6 ng/dL 26 ng/dL 46 0.20 nmol/L 0.92 nmol/L 6 ng/dL 26 ng/dL
10–<12 yrs 24 0.00 nmol/L 2.54 nmol/L 0 ng/dL 73 ng/dL 24 0.00 nmol/L 2.54 nmol/L 0 ng/dL 73 ng/dL
12–<15 yrs 17 0.74 nmol/L 6.01 nmol/L 21 ng/dL 172 ng/dL 16 0.51 nmol/L 2.01 nmol/L 15 ng/dL 58 ng/dL
15–<19 yrs 37 0.48 nmol/L 6.45 nmol/L 14 ng/dL 185 ng/dL 34 0.87 nmol/L 3.55 nmol/L 25 ng/dL 102 ng/dL
a-Aminoadipic acida 0–<1 yr 243 <2 mmol/L 3 mmol/L <2 nmol/mL 3 nmol/mL 243 <2 mmol/L 3 mmol/L <2 nmol/mL 3 nmol/mL
1–<19 yrs 277 NA <2 mmol/L NA <2 nmol/mL 277 NA <2 mmol/L NA <2 nmol/mL
a-Amino-n-butyric acida 0–<1 wk 88 7 mmol/L 42 mmol/L 7 nmol/mL 42 nmol/mL 88 7 mmol/L 42 mmol/L 7 nmol/mL 42 nmol/mL
1–<2 wks 42 8 mmol/L 42 mmol/L 8 nmol/mL 42 nmol/mL 42 8 mmol/L 42 mmol/L 8 nmol/mL 42 nmol/mL
2 wks–19 yrs 376 8 mmol/L 30 mmol/L 8 nmol/mL 30 nmol/mL 376 8 mmol/L 30 mmol/L 8 nmol/mL 30 nmol/mL
b-Alaninea 0–<13 yrs 419 3 mmol/L 27 mmol/L 3 nmol/mL 27 nmol/mL 417 3 mmol/L 27 mmol/L 3 nmol/mL 27 nmol/mL
13–<19yrs 43 1 mmol/L 8 mmol/L 1 nmol/mL 8 nmol/mL 50 5 mmol/L 20 mmol/L 5 nmol/mL 20 nmol/mL
b-Aminobutyric acida 0–<1 yr 235 <2 mmol/L 19 mmol/L <2 nmol/mL 19 nmol/mL 2535 <2 mmol/L 19 mmol/L <2 nmol/mL 19 nmol/mL
1–<19 yrs 277 NA <2 mmol/L NA <2 nmol/mL 277 NA <2 mmol/L NA <2 nmol/mL
Anserinea 0–<1 yr 536 <2 mmol/L 5 mmol/L <2 nmol/mL 5 nmol/mL 536 <2 mmol/L 5 mmol/L <2 nmol/mL 5 nmol/mL
1–<19 yrs 277 NA <2 lmol/L NA <2 nmol/mL 277 NA <2 mmol/L NA <2 nmol/mL
Argininea 0–<1 m 152 2 mmol/L 118 mmol/L 2 nmol/mL 118 nmol/mL 152 2 mmol/L 118 mmol/L 2 nmol/mL 118 nmol/mL
1 m–<1 yr 77 47 mmol/L 138 mmol/L 47 nmol/mL 138 nmol/mL 77 47 mmol/L 138 mmol/L 47 nmol/mL 138 nmol/mL
1–<19 yrs 284 66 mmol/L 150 mmol/L 66 nmol/mL 150 nmol/mL 284 66 mmol/L 150 mmol/L 66 nmol/mL 150 nmol/mL
Asparaginea 0–<19 yrs 493 38 mmol/L 91 mmol/L 38 nmol/mL 91 nmol/mL 493 38 mmol/L 91 mmol/L 38 nmol/mL 91 nmol/mL
Aspartic acida 0–<2 wks 128 19 mmol/L 121 mmol/L 19 nmol/mL 121 nmol/mL 128 19 mmol/L 121 mmol/L 19 nmol/mL 121 nmol/mL
2 wks–<19 yrs 362 20 mmol/L 42 mmol/L 20 nmol/mL 42 nmol/mL 362 20 mmol/L 42 mmol/L 20 nmol/mL 42 nmol/mL
C2a 0–<1 wk 60 8.2 mmol/L 58.1 mmol/L 8.22 nmol/mL 58.13 nmol/mL 60 8.2 mmol/L 58.1 mmol/L 8.22 nmol/mL 58.13 nmol/mL
1–<2 wks 66 3.4 mmol/L 27.3 mmol/L 3.36 nmol/mL 27.29 nmol/mL 66 3.4 mmol/L 27.3 mmol/L 3.36 nmol/mL 27.29 nmol/mL
2 wks–<1 yr 92 11.3 mmol/L 27.9 mmol/L 11.32 nmol/mL 27.88 nmol/mL 92 11.3 mmol/L 27.9 mmol/L 11.32 nmol/mL 27.88 nmol/mL
1–<19yrs 278 7.0 mmol/L 20.9 mmol/L 7.04 nmol/mL 20.92 nmol/mL 278 7.0 mmol/L 20.9 mmol/L 7.04 nmol/mL 20.92 nmol/mL
C3a 0–<2 wks 123 0.10 mmol/L 0.42 mmol/L 0.10 nmol/mL 0.42 nmol/mL 123 0.10 mmol/L 0.42 mmol/L 0.10 nmol/mL 0.42 nmol/mL
2 wks–<12 yrs 243 0.16 mmol/L 0.70 mmol/L 0.16 nmol/mL 0.70 nmol/mL 243 0.16 mmol/L 0.70 mmol/L 0.16 nmol/mL 0.70 nmol/mL
12–<19 yrs 55 0.18 mmol/L 0.46 mmol/L 0.18 nmol/mL 0.46 nmol/mL 55 0.18 mmol/L 0.46 mmol/L 0.18 nmol/mL 0.46 nmol/mL
C3-DCa 0–<1 yr 225 0.02 mmol/L 0.10 mmol/L 0.02 nmol/mL 0.10 nmol/mL 225 0.02 mmol/L 0.10 mmol/L 0.02 nmol/mL 0.10 nmol/mL
1–<7 yrs 88 0.01 mmol/L 0.06 mmol/L 0.01 nmol/mL 0.06 nmol/mL 88 0.01 mmol/L 0.06 mmol/L 0.01 nmol/mL 0.06 nmol/mL
7–<19 yrs 192 0.02 mmol/L 0.09 mmol/L 0.02 nmol/mL 0.09 nmol/mL 192 0.02 mmol/L 0.09 mmol/L 0.02 nmol/mL 0.09 nmol/mL
C4a 0–<19 yrs 506 0.1 mmol/L 0.4 mmol/L 0.10 nmol/mL 0.40 nmol/mL 506 0.1 mmol/L 0.4 mmol/L 0.10 nmol/mL 0.40 nmol/mL
C4-DCa 0–<19 yrs 488 0.04 mmol/L 0.10 mmol/L 0.04 nmol/mL 0.10 nmol/mL 488 0.04 mmol/L 0.10 mmol/L 0.04 nmol/mL 0.10 nmol/mL
C5:1a 0–<1 wk 62 0.01 mmol/L 0.05 mmol/L 0.01 nmol/mL 0.05 nmol/mL 62 0.01 mmol/L 0.05 mmol/L 0.01 nmol/mL 0.05 nmol/mL
1–<2 wks 51 0.01 mmol/L 0.02 mmol/L 0.01 nmol/mL 0.02 nmol/mL 51 0.01 mmol/L 0.02 mmol/L 0.01 nmol/mL 0.02 nmol/mL
2 wks–<1 yr 97 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL 97 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL
1–<19yrs 281 0.01 mmol/L 0.03 mmol/L 0.01 nmol/mL 0.03 nmol/mL 281 0.01 mmol/L 0.03 mmol/L 0.01 nmol/mL 0.03 nmol/mL
C5a 0–<1 wk 62 0.06 mmol/L 0.32 mmol/L 0.06 nmol/mL 0.32 nmol/mL 62 0.06 mmol/L 0.32 mmol/L 0.06 nmol/mL 0.32 nmol/mL
1–<2 wks 62 0.04 mmol/L 0.32 mmol/L 0.04 nmol/mL 0.32 nmol/mL 62 0.04 mmol/L 0.32 mmol/L 0.04 nmol/mL 0.32 nmol/mL
2 wks–<19 yrs 382 0.05 mmol/L 0.23 mmol/L 0.05 nmol/mL 0.23 nmol/mL 382 0.05 mmol/L 0.23 mmol/L 0.05 nmol/mL 0.23 nmol/mL
C5-DCa 0–<2 wks 129 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL 129 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL
2 wks–<7 yrs 176 0.01 mmol/L 0.04 mmol/L 0.01 nmol/mL 0.04 nmol/mL 176 0.01 mmol/L 0.04 mmol/L 0.01 nmol/mL 0.04 nmol/mL
7–<12 yrs 68 0.02 mmol/L 0.05 mmol/L 0.02 nmol/mL 0.05 nmol/mL 68 0.02 mmol/L 0.05 mmol/L 0.02 nmol/mL 0.05 nmol/mL
(continued)
Table 9. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
12–<19 yrs 117 0.02 mmol/L 0.07 mmol/L 0.02 nmol/mL 0.07 nmol/mL 117 0.02 mmol/L 0.07 mmol/L 0.02 nmol/mL 0.07 nmol/mL
C5-OHa 0–<1 wk 63 0.02 mmol/L 0.12 mmol/L 0.02 nmol/mL 0.12 nmol/mL 63 0.02 mmol/L 0.12 mmol/L 0.02 nmol/mL 0.12 nmol/mL
1–<2 wks 62 0.02 mmol/L 0.06 mmol/L 0.02 nmol/mL 0.06 nmol/mL 62 0.02 mmol/L 0.06 mmol/L 0.02 nmol/mL 0.06 nmol/mL
2 wks–<19 yrs 359 0.02 mmol/L 0.06 mmol/L 0.02 nmol/mL 0.06 nmol/mL 359 0.02 mmol/L 0.06 mmol/L 0.02 nmol/mL 0.06 nmol/mL
C6a 0–<2 wks 124 0.02 mmol/L 0.13 mmol/L 0.02 nmol/mL 0.13 nmol/mL 124 0.02 mmol/L 0.13 mmol/L 0.02 nmol/mL 0.13 nmol/mL
2 wks–<19 yrs 378 0.01 mmol/L 0.07 mmol/L 0.01 nmol/mL 0.07 nmol/mL 378 0.01 mmol/L 0.07 mmol/L 0.01 nmol/mL 0.07 nmol/mL
C6-DCa 0–<2 wks 116 0.07 mmol/L 0.24 mmol/L 0.07 nmol/mL 0.24 nmol/mL 116 0.07 mmol/L 0.24 mmol/L 0.07 nmol/mL 0.24 nmol/mL
2 wks–<1 yr 98 0.04 mmol/L 0.17 mmol/L 0.04 nmol/mL 0.17 nmol/mL 98 0.04 mmol/L 0.17 mmol/L 0.04 nmol/mL 0.17 nmol/mL
1–<19 yrs 275 0.05 mmol/L 0.14 mmol/L 0.05 nmol/mL 0.14 nmol/mL 275 0.05 mmol/L 0.14 mmol/L 0.05 nmol/mL 0.14 nmol/mL
C8:1a 0–<19 yrs 494 0.05 mmol/L 0.34 mmol/L 0.05 nmol/mL 0.34 nmol/mL 494 0.05 mmol/L 0.34 mmol/L 0.05 nmol/mL 0.34 nmol/mL
C8a 0–<1 wk 61 0.04 mmol/L 0.18 mmol/L 0.04 nmol/mL 0.18 nmol/mL 61 0.04 mmol/L 0.18 mmol/L 0.04 nmol/mL 0.18 nmol/mL
1–<2 wks 63 0.04 mmol/L 0.33 mmol/L 0.04 nmol/mL 0.33 nmol/mL 63 0.04 mmol/L 0.33 mmol/L 0.04 nmol/mL 0.33 nmol/mL
2 wks–<1 yr 99 0.02 mmol/L 0.14 mmol/L 0.02 nmol/mL 0.14 nmol/mL 99 0.02 mmol/L 0.14 mmol/L 0.02 nmol/mL 0.14 nmol/mL
1–<7 yrs 87 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL 87 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL
7–<19yrs 196 0.02 mmol/L 0.16 mmol/L 0.02 nmol/mL 0.16 nmol/mL 196 0.02 mmol/L 0.16 mmol/L 0.02 nmol/mL 0.16 nmol/mL
C10:1a 0–<1 yr 228 0.05 mmol/L 0.26 mmol/L 0.05 nmol/mL 0.26 nmol/mL 228 0.05 mmol/L 0.26 mmol/L 0.05 nmol/mL 0.26 nmol/mL
1–<7 yrs 78 0.03 mmol/L 0.14 mmol/L 0.03 nmol/mL 0.14 nmol/mL 78 0.03 mmol/L 0.14 mmol/L 0.03 nmol/mL 0.14 nmol/mL
7–<19 yrs 193 0.04 mmol/L 0.30 mmol/L 0.04 nmol/mL 0.30 nmol/mL 193 0.04 mmol/L 0.30 mmol/L 0.04 nmol/mL 0.30 nmol/mL
C10a 0–<2 wks 102 0.08 mmol/L 0.38 mmol/L 0.08 nmol/mL 0.38 nmol/mL 102 0.08 mmol/L 0.38 mmol/L 0.08 nmol/mL 0.38 nmol/mL
2 wks–<1 yr 98 0.03 mmol/L 0.27 mmol/L 0.03 nmol/mL 0.27 nmol/mL 98 0.03 mmol/L 0.27 mmol/L 0.03 nmol/mL 0.27 nmol/mL
1–<7 yrs 87 0.02 mmol/L 0.19 mmol/L 0.02 nmol/mL 0.19 nmol/mL 87 0.02 mmol/L 0.19 mmol/L 0.02 nmol/mL 0.19 nmol/mL
7–<19 yrs 196 0.03 mmol/L 0.35 mmol/L 0.03 nmol/mL 0.35 nmol/mL 196 0.03 mmol/L 0.35 mmol/L 0.03 nmol/mL 0.35 nmol/mL
C12:1a 0–<2 wks 130 0.01 mmol/L 0.29 mmol/L 0.01 nmol/mL 0.29 nmol/mL 130 0.01 mmol/L 0.29 mmol/L 0.01 nmol/mL 0.29 nmol/mL
2 wks–<19 yrs 384 0.01 mmol/L 0.11 mmol/L 0.01 nmol/mL 0.11 nmol/mL 384 0.01 mmol/L 0.11 mmol/L 0.01 nmol/mL 0.11 nmol/mL
C12a 0–<2 wks 127 0.01 mmol/L 0.26 mmol/L 0.01 nmol/mL 0.26 nmol/mL 127 0.01 mmol/L 0.26 mmol/L 0.01 nmol/mL 0.26 nmol/mL
2 wks–<1 yr 100 0.02 mmol/L 0.11 mmol/L 0.02 nmol/mL 0.11 nmol/mL 100 0.02 mmol/L 0.11 mmol/L 0.02 nmol/mL 0.11 nmol/mL
1–<19 yrs 279 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL 279 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL
C12-OHa 0–<2 wks 129 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL 129 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL
2 wks–<19 yrs 370 0.01 mmol/L 0.04 mmol/L 0.01 nmol/mL 0.04 nmol/mL 370 0.01 mmol/L 0.04 mmol/L 0.01 nmol/mL 0.04 nmol/mL
C14:2a 0–<1 yr 226 0.02 mmol/L 0.09 mmol/L 0.02 nmol/mL 0.09 nmol/mL 226 0.02 mmol/L 0.09 mmol/L 0.02 nmol/mL 0.09 nmol/mL
1–<7 yrs 87 0.01 mmol/L 0.06 mmol/L 0.01 nmol/mL 0.06 nmol/mL 87 0.01 mmol/L 0.06 mmol/L 0.01 nmol/mL 0.06 nmol/mL
7–<12 yrs 73 0.01 mmol/L 0.07 mmol/L 0.01 nmol/mL 0.07 nmol/mL 73 0.01 mmol/L 0.07 mmol/L 0.01 nmol/mL 0.07 nmol/mL
12–<19 yrs 117 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL 117 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL
C14:1a 0–<2 wks 130 0.02 mmol/L 0.39 mmol/L 0.02 nmol/mL 0.39 nmol/mL 130 0.02 mmol/L 0.39 mmol/L 0.02 nmol/mL 0.39 nmol/mL
2 wks–<12 yrs 259 0.01 mmol/L 0.12 mmol/L 0.01 nmol/mL 0.12 nmol/mL 259 0.01 mmol/L 0.12 mmol/L 0.01 nmol/mL 0.12 nmol/mL
12–<19 yrs 120 0.02 mmol/L 0.22 mmol/L 0.02 nmol/mL 0.22 nmol/mL 120 0.02 mmol/L 0.22 mmol/L 0.02 nmol/mL 0.22 nmol/mL
C14a 0–<2 wks 127 0.02 mmol/L 0.22 mmol/L 0.02 nmol/mL 0.22 nmol/mL 127 0.02 mmol/L 0.22 mmol/L 0.02 nmol/mL 0.22 nmol/mL
2 wks–<1 yr 90 0.02 mmol/L 0.07 mmol/L 0.02 nmol/mL 0.07 nmol/mL 90 0.02 mmol/L 0.07 mmol/L 0.02 nmol/mL 0.07 nmol/mL
1–<19 yrs 273 0.01 mmol/L 0.05 mmol/L 0.01 nmol/mL 0.05 nmol/mL 273 0.01 mmol/L 0.05 mmol/L 0.01 nmol/mL 0.05 nmol/mL
C14:1-OHa 0–<2 wks 130 0.01 mmol/L 0.08 mmol/L 0.01 nmol/mL 0.08 nmol/mL 130 0.01 mmol/L 0.08 mmol/L 0.01 nmol/mL 0.08 nmol/mL
2 wks–<19 yrs 378 0.01 mmol/L 0.03 mmol/L 0.01 nmol/mL 0.03 nmol/mL 378 0.01 mmol/L 0.03 mmol/L 0.01 nmol/mL 0.03 nmol/mL
C14-OHa 0–<1 wk 63 0.01 mmol/L 0.07 mmol/L 0.01 nmol/mL 0.07 nmol/mL 63 0.01 mmol/L 0.07 mmol/L 0.01 nmol/mL 0.07 nmol/mL
1–<2 wks 58 0.01 mmol/L 0.06 mmol/L 0.01 nmol/mL 0.06 nmol/mL 58 0.01 mmol/L 0.06 mmol/L 0.01 nmol/mL 0.06 nmol/mL
2 wks–<1 yr 96 0.01 mmol/L 0.02 mmol/L 0.01 nmol/mL 0.02 nmol/mL 96 0.01 mmol/L 0.02 mmol/L 0.01 nmol/mL 0.02 nmol/mL
1–<7 yrs 83 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL 83 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL
7–<19 yrs 168 0.01 mmol/L 0.02 mmol/L 0.01 nmol/mL 0.02 nmol/mL 168 0.01 mmol/L 0.02 mmol/L 0.01 nmol/mL 0.02 nmol/mL
C16:1a 0–<1 wk 63 0.01 mmol/L 0.23 mmol/L 0.01 nmol/mL 0.23 nmol/mL 63 0.01 mmol/L 0.23 mmol/L 0.01 nmol/mL 0.23 nmol/mL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

1–<2 wks 66 0.01 mmol/L 0.21 mmol/L 0.01 nmol/mL 0.21 nmol/mL 66 0.01 mmol/L 0.21 mmol/L 0.01 nmol/mL 0.21 nmol/mL
2 wks–<12 yrs 254 0.01 mmol/L 0.04 mmol/L 0.01 nmol/mL 0.04 nmol/mL 254 0.01 mmol/L 0.04 mmol/L 0.01 nmol/mL 0.04 nmol/mL
12–<19 yrs 119 0.01 mmol/L 0.06 mmol/L 0.01 nmol/mL 0.06 nmol/mL 119 0.01 mmol/L 0.06 mmol/L 0.01 nmol/mL 0.06 nmol/mL
(continued)
407
Table 9. Continued
408

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
C16a 0–<2 wks 128 0.04 mmol/L 0.60 mmol/L 0.04 nmol/mL 0.60 nmol/mL 128 0.04 mmol/L 0.60 mmol/L 0.04 nmol/mL 0.60 nmol/mL
2 wks–<1 yr 98 0.04 mmol/L 0.14 mmol/L 0.04 nmol/mL 0.14 nmol/mL 98 0.04 mmol/L 0.14 mmol/L 0.04 nmol/mL 0.14 nmol/mL
1–<19 yrs 278 0.03 mmol/L 0.11 mmol/L 0.03 nmol/mL 0.11 nmol/mL 278 0.03 mmol/L 0.11 mmol/L 0.03 nmol/mL 0.11 nmol/mL
K. ADELI ET AL.

C16:1-OHa 0–<2 wks 123 0.00 mmol/L 0.04 mmol/L 0.00 nmol/mL 0.04 nmol/mL 123 0.00 mmol/L 0.04 mmol/L 0.00 nmol/mL 0.04 nmol/mL
2 wks–<19 yrs 372 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL 372 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL
C16-OHa 0–<2 wks 109 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL 109 0.01 mmol/L 0.09 mmol/L 0.01 nmol/mL 0.09 nmol/mL
2 wks–<19 yrs 329 0.00 mmol/L 0.01 mmol/L 0.00 nmol/mL 0.01 nmol/mL 329 0.00 mmol/L 0.01 mmol/L 0.00 nmol/mL 0.01 nmol/mL
C18:2a 0–<19 yrs 507 0.02 mmol/L 0.11 mmol/L 0.02 nmol/mL 0.11 nmol/mL 507 0.02 mmol/L 0.11 mmol/L 0.02 nmol/mL 0.11 nmol/mL
C18:1a 0–<2 wks 126 0.03 mmol/L 0.25 mmol/L 0.03 nmol/mL 0.25 nmol/mL 126 0.03 mmol/L 0.25 mmol/L 0.03 nmol/mL 0.25 nmol/mL
2 wks–<19 yrs 354 0.04 mmol/L 0.14 mmol/L 0.04 nmol/mL 0.14 nmol/mL 354 0.04 mmol/L 0.14 mmol/L 0.04 nmol/mL 0.14 nmol/mL
C18a 0–<2 wks 125 0.01 mmol/L 0.11 mmol/L 0.01 nmol/mL 0.11 nmol/mL 125 0.01 mmol/L 0.11 mmol/L 0.01 nmol/mL 0.11 nmol/mL
2 wks–<19 yrs 374 0.02 mmol/L 0.07 mmol/L 0.02 nmol/mL 0.07 nmol/mL 374 0.02 mmol/L 0.07 mmol/L 0.02 nmol/mL 0.07 nmol/mL
C18:2-OHa 0–<1 wk 62 0.00 mmol/L 0.04 mmol/L 0.00 nmol/mL 0.04 nmol/mL 62 0.00 mmol/L 0.04 mmol/L 0.00 nmol/mL 0.04 nmol/mL
1 wk–<1 yr 124 0.01 mmol/L 0.02 mmol/L 0.01 nmol/mL 0.02 nmol/mL 124 0.01 mmol/L 0.02 mmol/L 0.01 nmol/mL 0.02 nmol/mL
1–<19 yrs 246 0.00 mmol/L 0.01 mmol/L 0.00 nmol/mL 0.01 nmol/mL 246 0.00 mmol/L 0.01 mmol/L 0.00 nmol/mL 0.01 nmol/mL
C18:1-OHa 0–<2 wks 116 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL 116 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL
2 wks–<19 yrs 372 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL 372 0.00 mmol/L 0.02 mmol/L 0.00 nmol/mL 0.02 nmol/mL
Carnosinea 0–<1 m 149 1 mmol/L 19 mmol/L 1 nmol/mL 19 nmol/mL 149 1 mmol/L 19 mmol/L 1 nmol/mL 19 nmol/mL
1 m–<19 yrs 372 2 mmol/L 7 mmol/L 2 nmol/mL 7 nmol/mL 372 2 mmol/L 7 mmol/L 2 nmol/mL 7 nmol/mL
Citrullinea 0–<1 yr 233 9 mmol/L 44 mmol/L 9 nmol/mL 44 nmol/mL 233 9 mmol/L 44 mmol/L 9 nmol/mL 44 nmol/mL
1–<13 yrs 182 16 mmol/L 41 mmol/L 16 nmol/mL 41 nmol/mL 182 16 mmol/L 41 mmol/L 16 nmol/mL 41 nmol/mL
13–<19 yrs 107 15 mmol/L 36 mmol/L 15 nmol/mL 36 nmol/mL 107 15 mmol/L 36 mmol/L 15 nmol/mL 36 nmol/mL
Corticosteroneb 0–<1 m 33 0.14 nmol/L 20.00 nmol/L 4.844 ng/dL 692.042 ng/dL 33 0.14 nmol/L 20.00 nmol/L 4.844 ng/dL 692.042 ng/dL
1 m–<1 yr 48 0.28 nmol/L 15.40 nmol/L 9.689 ng/dL 532.872 ng/dL 48 0.28 nmol/L 15.40 nmol/L 9.689 ng/dL 532.872 ng/dL
1–<4 yrs 30 0.62 nmol/L 3.72 nmol/L 21.453 ng/dL 128.720 ng/dL 30 0.62 nmol/L 3.72 nmol/L 21.453 ng/dL 128.720 ng/dL
4–<6 yrs 20 0.95 nmol/L 4.11 nmol/L 32.872 ng/dL 142.215 ng/dL 20 0.95 nmol/L 4.11 nmol/L 32.872 ng/dL 142.215 ng/dL
6–<15 yrs 96 0.44 nmol/L 9.19 nmol/L 15.225 ng/dL 317.993 ng/dL 96 0.44 nmol/L 9.19 nmol/L 15.225 ng/dL 317.993 ng/dL
15–<19 yrs 63 0.85 nmol/L 15.24 nmol/L 29.412 ng/dL 527.336 ng/dL 63 0.85 nmol/L 15.24 nmol/L 29.412 ng/dL 527.336 ng/dL
Cortisolb 0–<2 yrs 108 5 nmol/L 529 nmol/L 0.2 mg/dL 19.2 mg/dL 108 5 nmol/L 529 nmol/L 0.2 mg/dL 19.2 mg/dL
2–<7 yrs 55 32 nmol/L 269 nmol/L 1.2 mg/dL 9.8 mg/dL 55 32 nmol/L 269 nmol/L 1.2 mg/dL 9.8 mg/dL
7–<15 yrs 96 52 nmol/L 358 nmol/L 1.9 mg/dL 13.0 mg/dL 96 52 nmol/L 358 nmol/L 1.9 mg/dL 13.0 mg/dL
15–<19 yrs 69 81 nmol/L 510 nmol/L 2.9 mg/dL 18.5 mg/dL 69 81 nmol/L 510 nmol/L 2.9 mg/dL 18.5 mg/dL
Cystathioninea 0–<1 yr 306 <2 mmol/L 9 mmol/L <2 nmol/mL 9 nmol/mL 306 <2 mmol/L 9 mmol/L <2 nmol/mL 9 nmol/mL
1–<19 yrs 300 NA <2 mmol/L NA <2 nmol/mL 300 NA <2 mmol/L NA <2 nmol/mL
Cystinea 0–<6 d 62 16 mmol/L 51 mmol/L 16 nmol/mL 51 nmol/mL 64 16 mmol/L 53 mmol/L 16 nmol/mL 53 nmol/mL
6 d–<2 wks 67 7 mmol/L 57 mmol/L 7 nmol/mL 57 nmol/mL 67 7 mmol/L 57 mmol/L 7 nmol/mL 57 nmol/mL
2 wk–<8 yrs 200 3 mmol/L 20 mmol/L 3 nmol/mL 20 nmol/mL 200 3 mmol/L 20 mmol/L 3 nmol/mL 20 nmol/mL
8–<19yrs 181 4 mmol/L 28 mmol/L 4 nmol/mL 28 nmol/mL 181 4 mmol/L 28 mmol/L 4 nmol/mL 28 nmol/mL
11-Deoxycortisolb 0–<1 yr 89 0.00 nmol/L 5.30 nmol/L 0.000 ng/dL 0.153 ng/dL 89 0.00 nmol/L 5.30 nmol/L 0.000 ng/dL 0.153 ng/dL
1–<2 yrs 14 0.10 nmol/L 0.88 nmol/L 0.003 ng/dL 0.025 ng/dL 14 0.10 nmol/L 0.88 nmol/L 0.003 ng/dL 0.025 ng/dL
2–<7 yrs 49 0.07 nmol/L 1.07 nmol/L 0.002 ng/dL 0.031 ng/dL 49 0.07 nmol/L 1.07 nmol/L 0.002 ng/dL 0.031 ng/dL
7–<12 yrs 59 0.09 nmol/L 2.27 nmol/L 0.003 ng/dL 0.066 ng/dL 59 0.09 nmol/L 2.27 nmol/L 0.003 ng/dL 0.066 ng/dL
12–<19 yrs 100 0.00 nmol/L 2.28 nmol/L 0.000 ng/dL 0.066 ng/dL 100 0.00 nmol/L 2.28 nmol/L 0.000 ng/dL 0.066 ng/dL
Eth/asa/Sarca 0–<2 wks 129 23 mmol/L 110 mmol/L 23 nmol/mL 110 nmol/mL 129 23 mmol/L 110 mmol/L 23 nmol/mL 110 nmol/mL
2 wks–<1 yr 89 9 mmol/L 27 mmol/L 9 nmol/mL 27 nmol/mL 89 9 mmol/L 27 mmol/L 9 nmol/mL 27 nmol/mL
1–<19 yrs 288 8 mmol/L 18 mmol/L 8 nmol/mL 18 nmol/mL 288 8 mmol/L 18 mmol/L 8 nmol/mL 18 nmol/mL
Glutamic acida 0–<2 wks 138 91 mmol/L 401 mmol/L 91 nmol/mL 401 nmol/mL 138 91 mmol/L 401 mmol/L 91 nmol/mL 401 nmol/mL
2 wks–<1 yr 93 74 mmol/L 266 mmol/L 74 nmol/mL 266 nmol/mL 93 74 mmol/L 266 mmol/L 74 nmol/mL 266 nmol/mL
1–<9 yrs 280 52 mmol/L 137 mmol/L 52 nmol/mL 137 nmol/mL 280 52 mmol/L 137 mmol/L 52 nmol/mL 137 nmol/mL
(continued)
Table 9. Continued
Female reference interval Male reference interval
SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Glutaminea 0–<1 wk 80 451 mmol/L 1113 mmol/L 451 nmol/mL 1113 nmol/mL 80 451 mmol/L 1113 mmol/L 451 nmol/mL 1113 nmol/mL
1 wk–<1 yr 124 332 mmol/L 789 mmol/L 332 nmol/mL 789 nmol/mL 124 332 mmol/L 789 mmol/L 332 nmol/mL 789 nmol/mL
1–<9 yrs 119 417 mmol/L 678 mmol/L 417 nmol/mL 678 nmol/mL 119 417 mmol/L 678 mmol/L 417 nmol/mL 678 nmol/mL
9–<19 yrs 164 467 mmol/L 755 mmol/L 467 nmol/mL 755 nmol/mL 164 467 mmol/L 755 mmol/L 467 nmol/mL 755 nmol/mL
Glycinea 0–<2 wks 134 299 mmol/L 782 mmol/L 299 nmol/mL 782 nmol/mL 134 299 mmol/L 782 mmol/L 299 nmol/mL 782 nmol/mL
2 wks–<13 yrs 266 196 mmol/L 398 mmol/L 196 nmol/mL 398 nmol/mL 266 196 mmol/L 398 mmol/L 196 nmol/mL 398 nmol/mL
13–<19 yrs 104 218 mmol/L 407 mmol/L 218 nmol/mL 407 nmol/mL 104 218 mmol/L 407 mmol/L 218 nmol/mL 407 nmol/mL
Histidinea 0–<2 wks 133 45 mmol/L 168 mmol/L 45 nmol/mL 168 nmol/mL 133 45 mmol/L 168 mmol/L 45 nmol/mL 168 nmol/mL
2 wks–<19 yrs 365 65 mmol/L 113 mmol/L 65 nmol/mL 113 nmol/mL 365 65 mmol/L 113 mmol/L 65 nmol/mL 113 nmol/mL
Isoleucinea 0–<2 wks 142 25 mmol/L 129 mmol/L 25 nmol/mL 129 nmol/mL 142 25 mmol/L 129 mmol/L 25 nmol/mL 129 nmol/mL
2 wks–<1 yr 92 30 mmol/L 113 mmol/L 30 nmol/mL 113 nmol/mL 92 30 mmol/L 113 mmol/L 30 nmol/mL 113 nmol/mL
1 yr–<12 yrs 158 43 mmol/L 129 mmol/L 43 nmol/mL 129 nmol/mL 158 43 mmol/L 129 mmol/L 43 nmol/mL 129 nmol/mL
12–<19 yrs 53 32 mmol/L 68 mmol/L 32 nmol/mL 68 nmol/mL 50 53 mmol/L 127 mmol/L 53 nmol/mL 127 nmol/mL
Leucinea 0–<1 wk 90 46 mmol/L 165 mmol/L 46 nmol/mL 165 nmol/mL 90 46 mmol/L 165 mmol/L 46 nmol/mL 165 nmol/mL
1 wk–<1 yr 139 55 mmol/L 188 mmol/L 55 nmol/mL 188 nmol/mL 139 55 mmol/L 188 mmol/L 55 nmol/mL 188 nmol/mL
1–<11 yrs 152 85 mmol/L 226 mmol/L 85 nmol/mL 226 nmol/mL 152 85 mmol/L 226 mmol/L 85 nmol/mL 226 nmol/mL
11–<19 yrs 64 84 mmol/L 152 mmol/L 84 nmol/mL 152 nmol/mL 59 103 mmol/L 227 mmol/L 103 nmol/mL 227 nmol/mL
Lysinea 0–<2 wks 134 90 mmol/L 319 mmol/L 90 nmol/mL 319 nmol/mL 134 90 mmol/L 319 mmol/L 90 nmol/mL 319 nmol/mL
2 wks–<19 yrs 373 102 mmol/L 259 mmol/L 102 nmol/mL 259 nmol/mL 373 102 mmol/L 259 mmol/L 102 nmol/mL 259 nmol/mL
1-Methylhistidinea 0–<1wk 88 0 mmol/L 20 mmol/L 0 nmol/mL 20 nmol/mL 88 0 mmol/L 20 mmol/L 0 nmol/mL 20 nmol/mL
1–<2 wks 42 0 mmol/L 19 mmol/L 0 nmol/mL 19 nmol/mL 42 0 mmol/L 19 mmol/L 0 nmol/mL 19 nmol/mL
2 wks–<19 yrs 384 1 mmol/L 30 mmol/L 1 nmol/mL 30 nmol/mL 384 1 mmol/L 30 mmol/L 1 nmol/mL 30 nmol/mL
3-Methylhistidinea 1–<1 wk 91 6 mmol/L 21 mmol/L 6 nmol/mL 21 nmol/mL 91 6 mmol/L 21 mmol/L 6 nmol/mL 21 nmol/mL
1 wk–<1 yr 142 4 mmol/L 18 mmol/L 4 nmol/mL 18 nmol/mL 142 4 mmol/L 18 mmol/L 4 nmol/mL 18 nmol/mL
1–<4 yrs 55 3 mmol/L 23 mmol/L 3 nmol/mL 23 nmol/mL 55 3 mmol/L 23 mmol/L 3 nmol/mL 23 nmol/mL
4–<19 yrs 220 4 mmol/L 12 mmol/L 4 nmol/mL 12 nmol/mL 220 4 mmol/L 12 mmol/L 4 nmol/mL 12 nmol/mL
Methioninea 0–<19 yrs 519 13 mmol/L 44 mmol/L 13 nmol/mL 44 nmol/mL 519 13 mmol/L 44 mmol/L 13 nmol/mL 44 nmol/mL
Ornithinea 0–<2 wks 142 82 mmol/L 365 mmol/L 82 nmol/mL 365 nmol/mL 142 82 mmol/L 365 mmol/L 82 nmol/mL 365 nmol/mL
2 wks–<1 yr 87 40 mmol/L 132 mmol/L 40 nmol/mL 132 nmol/mL 87 40 mmol/L 132 mmol/L 40 nmol/mL 132 nmol/mL
1–<13 yrs 183 34 mmol/L 94 mmol/L 34 nmol/mL 94 nmol/mL 183 34 mmol/L 94 mmol/L 34 nmol/mL 94 nmol/mL
13–<19 yrs 56 30 mmol/L 108 mmol/L 30 nmol/mL 108 nmol/mL 51 46 mmol/L 114 mmol/L 46 nmol/mL 114 nmol/mL
17-OH-Progesteroneb 0–<14 d 27 0.00 nmol/L 4.83 nmol/L 0 ng/dL 160 ng/dL 27 0.00 nmol/L 4.83 nmol/L 0 ng/dL 160 ng/dL
14 d–<1 yr 61 0.06 nmol/L 3.39 nmol/L 2 ng/dL 112 ng/dL 61 0.06 nmol/L 3.39 nmol/L 2 ng/dL 112 ng/dL
1–<12 yrs 118 0.09 nmol/L 1.06 nmol/L 3 ng/dL 35 ng/dL 118 0.09 nmol/L 1.06 nmol/L 3 ng/dL 35 ng/dL
12–<14 yrs 23 0.00 nmol/L 1.95 nmol/L 0 ng/dL 64 ng/dL 23 0.00 nmol/L 1.95 nmol/L 0 ng/dL 64 ng/dL
14–<16 yrs 22 0.00 nmol/L 4.15 nmol/L 0 ng/dL 137 ng/dL 22 0.00 nmol/L 4.15 nmol/L 0 ng/dL 137 ng/dL
16–<19 yrs 56 0.02 nmol/L 3.90 nmol/L 1 ng/dL 129 ng/dL 56 0.02 nmol/L 3.90 nmol/L 1 ng/dL 129 ng/dL
21-OH-Progesteroneb 0–<1 yr 36 0.07 nmol/L 0.76 nmol/L 2 ng/dL 25 ng/dL 36 0.07 nmol/L 0.76 nmol/L 2 ng/dL 25 ng/dL
1–<2 yrs 13 0.03 nmol/L 0.25 nmol/L 1 ng/dL 8 ng/dL 13 0.03 nmol/L 0.25 nmol/L 1 ng/dL 8 ng/dL
2–<12 yrs 104 0.00 nmol/L 0.15 nmol/L 0 ng/dL 5 ng/dL 104 0.00 nmol/L 0.15 nmol/L 0 ng/dL 5 ng/dL
12–<19 yrs 102 0.00 nmol/L 0.24 nmol/L 0 ng/dL 8 ng/dL 102 0.00 nmol/L 0.24 nmol/L 0 ng/dL 8 ng/dL
Phenylalaninea 0–<2 wks 141 49 mmol/L 107 mmol/L 49 nmol/mL 107 nmol/mL 141 49 mmol/L 107 mmol/L 49 nmol/mL 107 nmol/mL
2 wks–<1 yr 88 52 mmol/L 116 mmol/L 52 nmol/mL 116 nmol/mL 88 52 mmol/L 116 mmol/L 52 nmol/mL 116 nmol/mL
1–<19 yrs 268 55 mmol/L 101 mmol/L 55 nmol/mL 101 nmol/mL 268 55 mmol/L 101 mmol/L 55 nmol/mL 101 nmol/mL
Phosphoserinea 0–<19 yrs 536 NA <3 mmol/L NA <3 nmol/mL 536 NA <3 mmol/L NA <3 nmol/mL
Progesteroneb 0–<12 yrs 92 0.00 nmol/L 0.71 nmol/L 0.00 ng/dL 0.71 ng/dL 98 0.00 nmol/L 0.81 nmol/L 0.00 ng/dL 0.81 ng/dL
12–<19 yrs 47 0.11 nmol/L 6.98 nmol/L 0.11 ng/dL 6.98 ng/dL 55 0.10 nmol/L 0.96 nmol/L 0.10 ng/dL 0.96 ng/dL
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES

Prolinea 0–<1 yr 221 127 mmol/L 292 mmol/L 127 nmol/mL 292 nmol/mL 221 127 mmol/L 292 mmol/L 127 nmol/mL 292 nmol/mL
1–<13 yrs 182 118 mmol/L 372 mmol/L 118 nmol/mL 372 nmol/mL 182 118 mmol/L 372 mmol/L 118 nmol/mL 372 nmol/mL
13–<19 yrs 103 116 mmol/L 360 mmol/L 116 nmol/mL 360 nmol/mL 103 116 mmol/L 360 mmol/L 116 nmol/mL 360 nmol/mL
(continued)
409
Table 9. Continued
410

Female reference interval Male reference interval

SI units CON units SI units CON units
Analyte Age N LL UL LL UL N LL UL LL UL
Sarcosinea 0–<19 yrs 536 NA <4 mmol/mL NA <4 nmol/L 536 NA <4 mmol/L NA <4 nmol/L
Serinea 0–<2 wks 132 199 mmol/L 843 mmol/L 199 nmol/mL 843 nmol/mL 132 199 mmol/L 843 mmol/L 199 nmol/mL 843 nmol/mL
2 wks–<19 yrs 377 112 mmol/L 216 mmol/L 112 nmol/mL 216 nmol/mL 377 112 mmol/L 216 mmol/L 112 nmol/mL 216 nmol/mL
K. ADELI ET AL.

Taurinea 0–<2 wks 112 87 mmol/L 375 mmol/L 87 nmol/mL 375 nmol/mL 112 87 mmol/L 375 mmol/L 87 nmol/mL 375 nmol/mL
2 wks–<19 yrs 385 55 mmol/L 204 mmol/L 55 nmol/mL 204 nmol/mL 385 55 mmol/L 204 mmol/L 55 nmol/mL 204 nmol/mL
Testosteroneb 0–<15 d 13 0.06 nmol/L 0.43 nmol/L 1.7 ng/dL 13.4 ng/dL 18 0.25 nmol/L 6.36 nmol/L 7.2 ng/dL 183.3 ng/dL
15 d–<1 yr 28 0.02 nmol/L 0.22 nmol/L 0.6 ng/dL 6.3 ng/dL 34 0.05 nmol/L 8.90 nmol/L 1.4 ng/dL 256.5 ng/dL
1–<13 yrs 138 0.06 nmol/L 1.12 nmol/L 1.7 ng/dL 32.3 ng/dL 138 0.06 nmol/L 1.12 nmol/L 1.7 ng/dL 32.3 ng/dL
13–<16 yrs 17 0.50 nmol/L 1.36 nmol/L 14.4 ng/dL 39.2 ng/dL 18 0.97 nmol/L 15.70 nmol/L 28.0 ng/dL 452.5 ng/dL
16–<19 yrs 31 0.11 nmol/L 2.31 nmol/L 3.2 ng/dL 66.6 ng/dL 30 0.86 nmol/L 23.40 nmol/L 27.7 ng/dL 674.4 ng/dL
Threoninea 0–<1 yr 229 81 mmol/L 313 mmol/L 81 nmol/mL 313 nmol/mL 229 81 mmol/L 313 mmol/L 81 nmol/mL 313 nmol/mL
1–<19 yrs 291 72 mmol/L 185 mmol/L 72 nmol/mL 185 nmol/mL 291 72 mmol/L 185 mmol/L 72 nmol/mL 185 nmol/mL
Tyrosinea 0–<2 wks 136 27 mmol/L 187 mmol/L 27 nmol/mL 187 nmol/mL 136 27 mmol/L 187 mmol/L 27 nmol/mL 187 nmol/mL
2 wks–<1 yr 90 34 mmol/L 151 mmol/L 34 nmol/mL 151 nmol/mL 90 34 mmol/L 151 mmol/L 34 nmol/mL 151 nmol/mL
1–<13 yrs 180 45 mmol/L 126 mmol/L 45 nmol/mL 126 nmol/mL 180 45 mmol/L 126 mmol/L 45 nmol/mL 126 nmol/mL
13–<19yrs 104 34 mmol/L 88 mmol/L 34 nmol/mL 88 nmol/mL 104 34 mmol/L 88 mmol/L 34 nmol/mL 88 nmol/mL
Valinea 0–<2 wks 141 87 mmol/L 326 mmol/L 87 nmol/mL 326 nmol/mL 141 87 mmol/L 326 mmol/L 87 nmol/mL 326 nmol/mL
2 wks–<13 yrs 270 128 mmol/L 361 mmol/L 128 nmol/mL 361 nmol/mL 270 128 mmol/L 361 mmol/L 128 nmol/mL 361 nmol/mL
13–<19 yrs 51 155 mmol/L 259 mmol/L 155 nmol/mL 259 nmol/mL 46 166 mmol/L 301 mmol/L 166 nmol/mL 301 nmol/mL
Vitamin Ac 0–<1 yr 86 0 mmol/L 2 mmol/L 8.0 mg/dL 53.6 mg/dL 86 0 mmol/L 2 mmol/L 8.0 mg/dL 53.6 mg/dL
1–<11 yrs 100 1 mmol/L 2 mmol/L 27.5 mg/dL 44.4 mg/dL 100 1 mmol/L 2 mmol/L 27.5 mg/dL 44.4 mg/dL
11–<16 yrs 71 1 mmol/L 2 mmol/L 24.9 mg/dL 55.0 mg/dL 71 1 mmol/L 2 mmol/L 24.9 mg/dL 55.0 mg/dL
16–<19 yrs 50 1 mmol/L 3 mmol/L 28.7 mg/dL 75.1 mg/dL 50 1 mmol/L 3 mmol/L 28.7 mg/dL 75.1 mg/dL
Vitamin Ec 0–<1 yr 85 5.0 mmol/L 50.0 mmol/L 0.2 mg/dL 2.1 mg/dL 85 5.0 mmol/L 50.0 mmol/L 0.2 mg/dL 2.1 mg/dL
1–<19 yrs 245 14.5 mmol/L 33.0 mmol/L 0.6 mg/dL 1.4 mg/dL 245 14.5 mmol/L 33.0 mmol/L 0.6 mg/dL 1.4 mg/dL
E:C ratioc (vitamin E– 1–<19 yrs 82 3.7 mmol/L : 6.7 mmol/L : 0.0040 mg/dL : 0.0072 mg/dL : 82 3.7 mmol/L : 6.7 mmol/L : 0.0040 mg/dL : 0.0072 mg/dL :
total cholesterol) mmol/L mmol/L mg/dL mg/dL mmol/L mmol/L mg/dL mg/dL
E:T ratioc (vitamin E– 1–<19 yrs 83 8.5 mmol/L : 44.5 mmol/L : 0.0040 mg/dL : 0.0208 mg/dL : 83 8.5 mmol/L : 44.5 mmol/L : 0.0040 mg/dL : 0.0208 mg/dL :
triglyceride) mmol/L mmol/L mg/dL mg/dL mmol/L mmol/L mg/dL mg/dL
Reference interval value units are in Standard International units (SI units) and Conventional units (CON units).
Colored partitions indicate sex-specific differences within the age partitions.
a
Refer to the original publication [16] for additional information.
b
Refer to the original publication [13] for additional information.
c
Refer to the original publication [15] for additional information.

lipids throughout the circulation; their breakdown prod-
ucts (i.e. remnant lipoproteins), which have been impli-
cated in cardiovascular disease risk (reviewed in [52]); as
well as gut peptides (e.g. glucagon-like peptide 1 (GLP-
1) and GLP-2), which are secreted following nutrient
ingestion and have been recently implicated in regulat-
ing lipid metabolism (reviewed in [53,54]). Similar to
using the oral glucose tolerance test to determine
impaired glucose tolerance and increased risk of type 2
diabetes, the “oral fat tolerance test” may be a helpful
tool to determine impaired lipid tolerance and
increased risk for cardiovascular events.
6.4. External quality assurance program
To ensure continual relevance of CALIPER reference
intervals in clinical practice, now and in the future, it is
imperative to monitor instrument-specific reagent for-
mulations and method calibrations in each clinical
laboratory. Accordingly, a CALIPER Quality Assurance
Program is essential to maintain the accuracy of the
CALIPER reference interval database in the face of
changing methodologies, reagent formulations, and
calibration biases. CALIPER will be developing and insti-
tuting an external quality assurance (EQA) program that
will be anchored to CALIPER. This will be done in collab-
oration with CEQAL (www.ceqal.com), a world-leading
reference method laboratory specialized in the delivery
of accuracy assessment solutions for improving the
quality of testing in healthcare. CALIPER’s goal is not
only to provide laboratories with appropriate reference
intervals but also to encourage harmonization of pedi-
atric reference intervals across all clinical laboratories,
particularly those using the same instrumentation/
reagents.
6.5. National and global knowledge translation
CALIPER plans to continue its KT campaign to imple-
ment pediatric reference intervals into medical labora-
tories and hospitals across Canada and globally. In
addition to continual updates to the online database
and mobile device application (app), CALIPER plans to
support laboratories in Canada and around the world
that wish to implement CALIPER reference intervals in
clinical practice. A national KT campaign has already
begun in collaboration with senior clinicians and
laboratory directors in Canadian hospitals. This cam-
paign will aid in implementing CALIPER reference
intervals to achieve Canada-wide harmonization of
laboratory test interpretation. Implementation of
CALIPER reference intervals will lead to harmonized
and evidence-based clinical decision making, will
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 411
reduce diagnostic errors, and will improve the quality
of pediatric healthcare in Canada.
7. Pediatric reference interval tables – the
CALIPER database
A compendium of CALIPER reference value data is
reported here, providing a single resource for clinical
laboratories and clinical programs to access the com-
plete CALIPER database published to-date. Data are
included for laboratory markers measured on all major
clinical chemistry platforms for routine application and
implementation in clinical practice (Tables 1–9).
Acknowledgements
The CALIPER program would like to thank thousands of fami-
lies and children who made the study possible by participat-
ing and volunteering to donate blood samples. We also
thank hundreds of CALIPER project coordinators, volunteers,
clinical chemistry fellows and faculty, as well as industry part-
ners and collaborators across Canada, for their tremendous
contributions to the success of the CALIPER study.
Disclosure statement
The authors have no conflict of interest to declare.
Funding
The CALIPER study has been supported by operating grants
from the Canadian Institutes of Health Research (CIHR), and
Sanford Jackson Endowment Funds at the Hospital for Sick
Children Foundation, as well as grant and material support
from Abbott, Beckman, Ortho, Roche, and Siemens
Diagnostics.
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