Consideration for Setting Reference Range for Adrenocorticotropic Hormone Test according to Blood Collection Time

채혈 시간에 따른 부신피질 자극 호르몬 검사의 참고치 설정에 관한 고찰

  • Ji-Hye Park (Department of Nuclear Medicine, Asan Medical Center) ;
  • Jin-Ju Choi (Department of Nuclear Medicine, Asan Medical Center) ;
  • Soo-Yeon Lim (Department of Nuclear Medicine, Asan Medical Center) ;
  • Seon-Hee Yoo (Department of Nuclear Medicine, Asan Medical Center) ;
  • Sun-Ho Lee (Department of Nuclear Medicine, Asan Medical Center)
  • 박지혜 (서울아산병원 핵의학과) ;
  • 최진주 (서울아산병원 핵의학과) ;
  • 임수연 (서울아산병원 핵의학과) ;
  • 유선희 (서울아산병원 핵의학과) ;
  • 이선호 (서울아산병원 핵의학과)
  • Published : 2023.05.20

Abstract

Purpose The reference range described in Adrenocorticotropic Hormone reagent used in our laboratory is 10-60 pg/mL at 8 a.m. to 10 a.m., and 6-30 pg/mL at 8 p.m. to 10 p.m. However, in the case of outpatients, blood is mainly collected between 10 a.m. and 6 p.m., accounting for 57.8% of the total. Therefore, This study is intended to help make a more accurate diagnosis by reevaluating the reference range provided by the manufacturer of the Adrenocorticotropic Hormone reagent and setting split-timed reference range. Materials and Methods The patients collected blood before 10 a.m. were group A (68 people), and the patients collected blood after 10 a.m. were set to group B (80 people). A T-test was performed between groups to test their significance. And it was confirmed whether it was necessary to set the gender classification as a subgroup. The method of setting the reference range was calculated by the Bayesian's method and the Hoffmann's method. Results The reference range of Group A was 8.6 to 60.6 pg/mL by the Bayesian's method, and the Hoffmann's method was 3.6 to 61.3 pg/mL. The reference range of Group B was 6.9 to 50.5 pg/mL when applying the Bayesian's method, and the Hoffmann method's was 2.3 to 48.9 pg/mL. Conclusion This study was concluded that it was necessary to set the split-timed reference range. Through this study, the later the blood collection time, the lower the level of Adrenocorticotropic Hormone, indicating that blood collection time is important for patients with clinical significance. If a large number of subjects are selected and supplemented in the future, it is believed that systematic and accurate reference range can be set.

Keywords

References

  1. 고창순, 서일택. 임상 핵의학 검사 기술학. 2nd ed. 서울. 고려의학; 1933. p.234-37 
  2. 신선영, 이현주, 민경선, 이호영. 전혈에서 시간과 온도에 따른 Adrenocorticotropic Hormone의 안정성 평가. 핵의학 기술. 2009;13(1):116-9 
  3. 김외정, 윤필영, 신영균, 유선희, 조시만. 통계적 분석을 통한 Insulin의 정상 참고치 설정. 핵의학기술. 2010;14(1):143-6 
  4. Seon-Ah Cha, Sung-Dae Moon. Blood Tests for the Diagnosis of Adrenal Diseases. Korean J Med. 2018;93(6):532-7 https://doi.org/10.3904/kjm.2018.93.6.532