Objectives: To determine the 99th percentile upper reference limit (URL) of high-sensitivity cardiac troponin I (hs-cTnI) in a healthy population in Xinjiang, China, and investigate the impact of ethnicity, sex, and age on this limit.
Design and methods: From September 2018 to March 2022, 5,090 Han and Uyghur adults aged 20-79 years were recruited. After questionnaire screening, 2,970 participants with physical and/or laboratory normality were enrolled. Participants recruited between September 2018 and October 2021 (2,109/2,970) were evaluated by ARCHITECTi2000 to determine the 99th percentile URL of hs-cTnI. The results were then validated in 861/2,970 participants recruited from November 2021 to March 2022. A criterion of ≤ 10% of test results falling outside the original determined value was used to determine whether the newly established reference intervals were valid.
Results: The hs-cTnI concentration was higher among Uyghurs than among Han participants (p < 0.001). The 99th percentile URLs were 17.52 ng/L for all participants, 18.96 ng/L for Uyghur, and 16.93 ng/L for Han. Hs-cTnI concentration was also correlated with sex and age. In the Han and Uyghur groups, male participants had a higher hs-cTnI concentration than female participants (p < 0.001); the 99th percentile URLs of hs-cTnI among male and female participants were 17.80 vs. 13.67 ng/L and 19.47 vs. 16.52 ng/L, respectively. Stratified by age, hs-cTnI concentrations were higher in participants aged > 60 years than in those of other age categories (p < 0.001), in both the Han and Uyghur groups. Finally, <2% of these test results exceeded the newly established reference, validating the results.
Conclusions: This study established the 99th percentile URLs of hs-cTnI in the Xinjiang. Ethnicity and sex influence the value and should be considered.
Keywords: 99th percentile URL; Ethnicity-specific; High-sensitivity cardiac troponin I; Sex-specific.
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