Summary
According to the literature, the mean values of immunoreactive serum trypsin (IRT) (RIA-gnost Hoechst) in controls vary considerably between 150 and 283 ng/ml. The reasons for these variations are unknown. The purpose of the present investigation was to study the variations of IRT in relation to age in adults. We studied 124 hospital controls, who were without evidence of pancreatic disease or renal insufficiency and who varied in age between 17 and 84 years. Utilizing the kit of Hoechst, IRT was determined in fasting serum specimens. The mean (±SD) in patients over 60 years was 469.6±197.4 ng/ml, in contrast to 309.1±118.9 ng/ml (30–59 years) and 209.7±80.7 (<30 years). Of cases over 60 years 36.5% had elevated IRT levels above 500 ng/ml. In 25 cases over 60 years no correlation was found between IRT levels and creatinine clearance and in eight of ten cases of this group with high IRT (>500 ng/ml) the serum pancreatic isoamylase levels were normal. The data indicate that in the diagnosis of pancreatic disease the higher reference ranges in the elderly people have to be taken into account. The age-related higher reference ranges seem not to be due to subclinical renal disease nor to clinically evident pancreatic disease.
Zusammenfassung
Die nach Literatur im Normalkollektiv mittels Radioimmunassay (RIA-gnost Hoechst) ermittelten Mittelwerte von Serum-Trypsin (IRT) zeigen aus ungeklärten Gründen große Unterschiede mit Extremwerten zwischen 150 bis 283 ng/ml. Zweck dieser Studie war es, die Normalwerte in Abhängigkeit vom Alter abzukären. Als Kontrollen dienten 124 pankreasgesunde Spitalfälle unterschiedlichen Alters ohne Niereninsuffizienz, nämlich 21 F unter 30 J, 40 F zwischen 30–59 J und 63 F über 60 Jahre. Die Bestimmung erfolgte mittels RIA-gnost Hoechst im Nüchternserum. Die Mittelwerte bei Patienten über 60 J lagen mit 469,6 ng/ml (±SD; 197.4) wesentlich höher als in den beiden jüngeren Altersklassen (309.1 ± 118.9 ng/ml (30–59 J) resp. 209.7 ± 80.7 ng/ml (<30 J). 36.5% der Fälle über 60 J wiesen erhöhte IRT-Spiegel (> 500 ng/ml) auf. In 25 Fällen über 60 J fand sich keine Korrelation zwischen Kreatinin-Clearance und IRT-Spiegel und die Serumwerte von Pankreas-Isoamylase lagen bei 8 von 10 dieser Fälle mit hohen IRT-Spiegeln (> 500 ng/ml) im Normbereich. Diese Resultate zeigen, daß für die Diagnose einer Pankreatopathie im Alter die wesentlich höheren Normwerte von IRT zu berücksichtigen sind. Die altersabhängig erhöhten IRT-Spiegel scheinen weder Folge einer subklinischen Niereninsuffizienz noch einer klinisch faßbaren Pankreaserkrankung zu sein.
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The RIA-gnost Trypsin was kindly supplied by Hoechst Pharma, Frankfurt/M, and the Isoamylase Test by Pharmacia, Uppsala
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Ammann, R.W., Pei, P., Satz, N. et al. Variations with age of immunoreactive serum trypsin: Higher reference ranges in “Healthy” elderly people. Klin Wochenschr 60, 243–246 (1982). https://doi.org/10.1007/BF01728343
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DOI: https://doi.org/10.1007/BF01728343
Key words
- Trypsin radioimmunassay
- High levels in ‘healthy’ elderly people
- Age-related normal values
- Creatinine clearance