{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:41:59Z","timestamp":1777444919607,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Urine metanephrines are used to screen for phaeochromocytoma or paraganglioma (PPGL). Current reference intervals (RI) derived in healthy individuals are not age or sex-stratified, and lower than in hypertensive patients, leading to high false positive rates. This study aims to determine age and sex-stratified RI from a contingent screening population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with 24-h deconjugated urine metanephrines from 3\/6\/2010 to 27\/8\/2022 were included (2936 males, 5285 females), initially by liquid chromatography-electrochemical detection (LC-ECD) then liquid chromatography-tandem mass spectrometry (LC-MS\/MS). Bhattacharya analysis was used after log transformation to determine age and sex-stratified RI for metanephrine excretion, normetanephrine excretion, metanephrine\/creatinine and normetanephrine\/creatinine ratios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Normetanephrine excretion increases with age (RI: males: 18\u2013&lt;30\u00a0years: &lt;3.4\u00a0\u00b5mol\/24\u00a0h, 30\u2013&lt;40\u00a0years: &lt;3.7\u00a0\u00b5mol\/24\u00a0h, 40+ years: &lt;5.3\u00a0\u00b5mol\/24\u00a0h; females: 18\u2013&lt;30\u00a0years: &lt;2.7\u00a0\u00b5mol\/24\u00a0h, 30\u2013&lt;40\u00a0years: &lt;3.1\u00a0\u00b5mol\/24\u00a0h, 40+ years: &lt;3.7\u00a0\u00b5mol\/24\u00a0h), while metanephrine excretion was consistent across adulthood (RI: males: 18+ years: &lt;1.8\u00a0\u00b5mol\/24\u00a0h; females: 18+ years: &lt;1.2\u00a0\u00b5mol\/24\u00a0h). However, normetanephrine\/creatinine and metanephrine\/creatinine increase steadily with age after early adulthood, likely due to a decrease in muscle mass, with females having higher normetanephrine\/creatinine and metanephrine\/creatinine ratios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Age and sex-stratified RI were derived for metanephrine excretion, normetanephrine excretion, metanephrine\/creatinine and normetanephrine\/creatinine ratios. This is expected to reduce false positives while flagging most PPGL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00045632231204505","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T02:04:45Z","timestamp":1694743485000},"page":"173-181","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reference intervals for deconjugated urine metanephrines by Bhattacharya analysis"],"prefix":"10.1177","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9408-6129","authenticated-orcid":false,"given":"Bobby","family":"Li","sequence":"first","affiliation":[{"name":"Specialist Biochemistry, Canterbury Health Laboratories, Te Whatu Ora \u2013 Health New Zealand Waitaha Canterbury, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"King","sequence":"additional","affiliation":[{"name":"Specialist Biochemistry, Canterbury Health Laboratories, Te Whatu Ora \u2013 Health New Zealand Waitaha Canterbury, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiaan","family":"Sies","sequence":"additional","affiliation":[{"name":"Specialist Biochemistry, Canterbury Health Laboratories, Te Whatu Ora \u2013 Health New Zealand Waitaha Canterbury, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Thompson","sequence":"additional","affiliation":[{"name":"Specialist Biochemistry, Canterbury Health Laboratories, Te Whatu Ora \u2013 Health New Zealand Waitaha Canterbury, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Florkowski","sequence":"additional","affiliation":[{"name":"Specialist Biochemistry, Canterbury Health Laboratories, Te Whatu Ora \u2013 Health New Zealand Waitaha Canterbury, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"bibr1-00045632231204505","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199101000-00004"},{"key":"bibr2-00045632231204505","doi-asserted-by":"publisher","DOI":"10.14744\/SEMB.2020.18794"},{"key":"bibr3-00045632231204505","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2018.12.019"},{"key":"bibr4-00045632231204505","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2020.01.005"},{"key":"bibr5-00045632231204505","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqab006"},{"issue":"3","key":"bibr6-00045632231204505","first-page":"S39","volume":"38","author":"Lam L","year":"2017","journal-title":"Clin Biochem Rev"},{"key":"bibr7-00045632231204505","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2008.10.022"},{"key":"bibr8-00045632231204505","unstructured":"CLSI. Defining, establishing, and verifying reference intervals in the clinical laboratory; approved guideline\u2014Third edition. CLSI document C28-A3c. Clinical and Laboratory Standards Institute, 2008."},{"key":"bibr9-00045632231204505","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11818"},{"key":"bibr10-00045632231204505","unstructured":"LabPLUS. Creatinine - urine. Updated November 21, 2022. http:\/\/testguide.adhb.govt.nz\/EGuide\/?elv=1&name=Creatininedurine&pn=2788&mn=1130&sd=3&ts=18ad387b7cd. (Accessed September 27, 2023)."},{"key":"bibr11-00045632231204505","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2020.12.009"},{"key":"bibr12-00045632231204505","unstructured":"Chesher D. Bellview. Published March 30, 2017. Updated December 16, 2021. https:\/\/sourceforge.net\/projects\/bellview\/https:\/\/sourceforge.net\/projects\/bellview\/. (Accessed September 7, 2022)."},{"key":"bibr13-00045632231204505","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2017.36"},{"key":"bibr14-00045632231204505","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-19-0809"}],"container-title":["Annals of Clinical Biochemistry: International Journal of Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00045632231204505","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00045632231204505","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00045632231204505","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:25:22Z","timestamp":1777379122000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00045632231204505"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,2]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1177\/00045632231204505"],"URL":"https:\/\/doi.org\/10.1177\/00045632231204505","relation":{},"ISSN":["0004-5632","1758-1001"],"issn-type":[{"value":"0004-5632","type":"print"},{"value":"1758-1001","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,2]]}}}