Insulin reference intervals in Brazilian adolescents by direct and indirect approaches: validation of a data mining method from laboratory data

To determine reference intervals (RI) for fasting blood insulin (FBI) in Brazilian adolescents, 12 to 17 years old, by direct and indirect approaches, and to validate indirectly determined RI. Two databases were used for RI determination. Database 1 (DB1), used to obtain RI through a posteriori dire...

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Bibliographic Details
Published in:Jornal de pediatria 2024-09, Vol.100 (5), p.512-518
Main Authors: Freire, Monica D.C., Dias, Paulo R.T.P., Souza, Thiago S.P., Hirose, Caio K., Araujo, Paula B.M.C., Neves, Mario F.T.
Format: Article
Language:English
Subjects:
Adolescent
Brazil
Child
Data mining
Data Mining - methods
Databases, Factual
Fasting - blood
Female
Humans
Insulin
Insulin - blood
Male
PEDIATRICS
Reference interval
Reference Values
Retrospective Studies
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Summary:To determine reference intervals (RI) for fasting blood insulin (FBI) in Brazilian adolescents, 12 to 17 years old, by direct and indirect approaches, and to validate indirectly determined RI. Two databases were used for RI determination. Database 1 (DB1), used to obtain RI through a posteriori direct method, consisted of prospectively selected healthy individuals. Database 2 (DB2) was retrospectively mined from an outpatient laboratory information system (LIS) used for the indirect method (Bhattacharya method). From DB1, 29345 individuals were enrolled (57.65 % female) and seven age ranges and sex partitions were statistically determined according to mean FBI values: females: 12 and 13 years-old, 14 years-old, 15 years-old, 16 and 17 years-old; and males: 12, 13 and 14 years-old, 15 years-old, 16 and 17 years-old. From DB2, 5465 adolescents (67.5 % female) were selected and grouped according to DB1 partitions. The mean FBI level was significantly higher in DB2, on all groups. The RI upper limit (URL) determined by Bhattacharya method was slightly lower than the 90 % CI URL directly obtained on DB1, except for group female 12 and 13 years old. High agreement rates for diagnosing elevated FBI in all groups on DB1 validated indirect RI presented. The present study demonstrates that Bhattacharya indirect method to determine FBI RI in adolescents can overcome some of the difficulties and challenges of the direct approach.
ISSN:0021-7557
1678-4782
1678-4782
DOI:10.1016/j.jped.2024.03.009