{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:11:36Z","timestamp":1791317496255,"version":"4.3.1"},"reference-count":32,"publisher":"Walter de Gruyter GmbH","issue":"9","license":[{"start":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T00:00:00Z","timestamp":1656892800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_cclm-2022-0293_abs_001\">\n                  <jats:title>Objectvies<\/jats:title>\n                  <jats:p>This study is aimed at establishing reference intervals (RIs) of 40 chemistry and immunochemistry analytes for Ghanaian adults based on internationally harmonized protocol by IFCC Committee on Reference Intervals and Decision Limits (C-RIDL).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2022-0293_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 501 healthy volunteers aged\u00a0\u226518 years were recruited from the northern and southern regions of Ghana. Blood samples were analyzed with Beckman-Coulter AU480 and Centaur-XP\/Siemen auto-analyzers. Sources of variations of reference values (RVs) were evaluated by multiple regression analysis (MRA). The need for partitioning RVs by sex and age was guided by the SD ratio (SDR). The RI for each analyte was derived using parametric method with application of the latent abnormal values exclusion (LAVE) method.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2022-0293_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Using SDR\u22650.4 as threshold, RVs were partitioned by sex for most enzymes, creatinine, uric acid (UA), bilirubin, immunoglobulin-M. MRA revealed age and body mass index (BMI) as major source of variations of many analytes. LAVE lowered the upper limits of RIs for alanine\/aspartate aminotransferase, \u03b3-glutamyl transaminase and lipids. Exclusion of individuals with BMI\u226530 further lowered the RIs for lipids and CRP. After standardization based on value-assigned serum panel provided by C-RIDL, Ghanaian RIs were found higher for creatine kinase, amylase, and lower for albumin and urea compared to other collaborating countries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2022-0293_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The LAVE effect on many clinical chemistry RIs supports the need for the secondary exclusion for reliable derivation of RIs. The differences in Ghanaian RIs compared to other countries underscore the importance of\u00a0country specific-RIs for improved clinical decision making.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/cclm-2022-0293","type":"journal-article","created":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T05:38:11Z","timestamp":1656913091000},"page":"1426-1439","source":"Crossref","is-referenced-by-count":21,"title":["Derivation of sex and age-specific reference intervals for clinical chemistry analytes in healthy Ghanaian adults"],"prefix":"10.1515","volume":"60","author":[{"given":"Serwaa Akoto","family":"Bawua","sequence":"first","affiliation":[{"name":"Department of Biological, Environmental & Occupational Health Sciences , University of Ghana School of Public Health , Accra , Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6039-4537","authenticated-orcid":false,"given":"Kiyoshi","family":"Ichihara","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Department of Clinical Laboratory Sciences , Yamaguchi University Graduate School of Medicine , Ube , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary","family":"Keatley","sequence":"additional","affiliation":[{"name":"Medlab Ghana Ltd., Roman Ridge , Accra , Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Arko-Mensah","sequence":"additional","affiliation":[{"name":"Department of Biological, Environmental & Occupational Health Sciences , University of Ghana School of Public Health , Accra , Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick F.","family":"Ayeh-Kumi","sequence":"additional","affiliation":[{"name":"Department of Microbiology , University of Ghana Medical School, College of Health Sciences, University of Ghana , Korle-Bu , Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Erasmus","sequence":"additional","affiliation":[{"name":"University of Stellenbosch, Division of Chemical Pathology , Tygerberg , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Fobil","sequence":"additional","affiliation":[{"name":"Department of Biological, Environmental & Occupational Health Sciences , University of Ghana School of Public Health , Accra , Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,7,4]]},"reference":[{"key":"2023033112140919663_j_cclm-2022-0293_ref_001","doi-asserted-by":"crossref","unstructured":"Concordet, D, Geffr\u00e9, A, Braun, J-P, Trumel, C. 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