Table 1.
Levels Defining High-Risk Quintile for Markers of Physiologic Dysregulation
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Levels defined as high risk |
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| Markers | Assay method | Lower DL | CV (%) | Low | High |
| Cardiovascular/metabolic | |||||
| Systolic blood pressure (mm Hg) | ≥147 | ||||
| Diastolic blood pressure (mm Hg) | ≤60 | ≥87 | |||
| Total cholesterol (mmol/L) | Cholesterol oxidase | 0.13 | 1.4 | ≤3.99 | ≥6.45 |
| HDL cholesterol (mmol/L) | Direct surfactant/dextran sulfate | 0.13 | 3.1 | ≤0.96 | |
| Triglycerides (mmol/L) | GPO method | 0.11 | 1.6 | ≥1.76 | |
| Glycosylated hemoglobin (%) | HPLC (Tosoh HCL-723) | 1.0 | 1.1 | ≥6.6 | |
| Fasting glucose (mmol/L) | Glucose oxidase | 0.17 | 1.7 | ≤4.77 | ≥7.88 |
| Body–mass index | ≤20.6 | ≥29.2 | |||
| Waist–hip ratio | ≥0.94 | ||||
| Resting pulse rate (beats/min) | ≥79 | ||||
| Inflammation | |||||
| White blood cell count (x 109/L) | Direct current | 0.02 | 2.3 | ≥7.4 | |
| Neutrophils (%) | Calculated from WBC, EO, BASO, LYMPH, MONO | 3.3 | ≥66.5 | ||
| Interleukin-6 (pg/mL) | ELISA (R&D Systems) | 0.7 | 12.1 | ≥4.31 | |
| C-reactive protein (nmol/L) | Immunoturbidimetry (Roche Cobas Integra 800) | 0.68 | 2.5 | ≥2.67 | |
| Fibrinogen (μmol/L) | Coagulation method (Sysmex CA-1500; reagent: Dade Behring Co.) | 2.35 | 2.5 | ≥11.34 | |
| Soluble ICAM-1 (ng/mL) | ELISA (R&D Systems) | 0.35 | 16.9 | ≥321.3 | |
| Soluble E-selectin (ng/mL) | ELISA (R&D Systems) | 0.1 | 14.3 | ≥55.6 | |
| sIL-6R (ng/mL) | ELISA (R&D Systems) | 0.008 | 10.5 | ≥52.44 | |
| Other markers | |||||
| DHEA-S (μmol/L) | ECLIA (Roche Hitachi Elecsys 2010) | 0.003 | 4.2 | ≤1.18 | |
| Cortisol (mol/mol creatinine) | a | ≥8.52 | |||
| Epinephrine (mol/mol creatinine) | a | ≤1.04 | ≥4.40 | ||
| Norepinephrine (mol/mol creatinine) | a | ≥23.5 | |||
| IGF-1 (nmol/L) | ELISA (Diagnostic System Laboratories) | 2.95 | 7.7 | ≤12.58 | |
| Creatinine clearance (mL/sec) | b | ≤0.8 | |||
| Albumin (g/L) | Bromcresol green (BCG) | 10 | 1.8 | ≤42 | |
| Homocysteine (μmol/L) | FPIA (Abbott IMx) | 0.068 | 41.4 | ≥14.57 | |
Conversion to traditional units: To convert HDL and total cholesterol to mg/dL, divide by 0.0259; triglycerides to mg/dL, divide by 0.0113; glucose to mg/dL, divide by 0.0555; white blood cell count to 103/μL, multiply by 1.0; C-reactive protein to mg/dL, divide by 9.524; fibrinogen to mg/dL, divide by 0.0294; DHEA-S to μg/dL, divide by 0.027; cortisol to μg per g creatinine, divide by 0.312; epinephrine to μg per g creatinine, divide by 0.617; norepinephrine to μg per g creatinine, divide by 0.669; IGF-1 to ng/mL, divide by 0.131; creatinine clearance to mL/min, multiply by 60; albumin to g/dL, divide by 10; homocysteine to mg/L, divide by 7.397.
Assays of urinary cortisol (DL=11.04 nmol/L [4 μg/L]; CV=8.6), epinephrine (DL=10.9 nmol/L (2 μg/L); CV=4.1), and norepinephrine (DL=11.8 nmol/L [2 μg/L]; CV=3.8) were done by HPLC. Urinary creatinine was assayed using the alkaline picrate method (DL=884 μmol/L [10 mg/dL]; CV=1.0).
Estimated based on serum creatinine (SCr), sex, age, and weight using the Cockcroft-Gault Formula.21 SCr was assayed using the alkaline picrate method (DL=0.1 mg/dL; CV=3.3%).
DL, detection limit; CV, coefficient of variation; HDL, high-density lipoprotein; GPO, glycerophosphate oxidase; HPLC, high-pressure liquid chromatography; WBC, white blood cells; EO, eosinophils; BASO, basophils; LYMPH, lymphocytes; MONO, monocytes; ELISA, enzyme-linked immunosorbent assay; ICAM-1, intercellular adhesion molecule-1; sIL6-R, soluble interleukin-6 receptor; DHEA-S, dehydroepiandrosterone sulfate; ECLIA, electrochemiluminescence immunoassay; IGF-1, insulinlike growth factor-1; FPIA, fluorescence polarization immunoassay.