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000282577 0247_ $$2doi$$a10.1093/clinchem/hvaf120
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000282577 037__ $$aDZNE-2025-01337
000282577 041__ $$aEnglish
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000282577 1001_ $$0P:(DE-2719)9002026$$aHalbgebauer, Steffen$$b0$$eFirst author
000282577 245__ $$aAge-Specific Control and Alzheimer Disease Reference Curves and z-Scores for Glial Fibrillary Acidic Protein in Blood.
000282577 260__ $$aWashington, DC$$bAmerican Association for Clinical Chemistry$$c2025
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000282577 520__ $$aSerum glial fibrillary acidic protein (GFAP) is a biomarker for astrocytic injury and astrogliosis. Concentrations are elevated in numerous neurological disorders, including a pronounced increase in Alzheimer disease (AD). However, GFAP levels in the serum also increase with age. Consequently, the integration of GFAP levels into clinical routine and their interpretation demands age-adjusted reference values.Serum from 1273 subjects (952 noninflammatory and nonneurodegenerative neurological controls and 321 subjects with AD) was analyzed for GFAP using the microfluidic Ella system. Age-dependent serum GFAP reference values were estimated by additive quantile regression analysis and visualized with percentiles and z-scores.AD exhibited elevated serum GFAP levels in comparison to control patients (P < 0.0001). This remained the case when the newly generated age-corrected z-scores were applied (P < 0.0001). In the control cohort, a nonlinear elevation of serum GFAP with increasing age was observed (Spearman correlation coefficient 0.62, 95% CI 0.58-0.66, P < 0.0001). In contrast, the AD cohort exhibited a more linear increase (0.16, 95% CI 0.05-0.26, P = 0.004). Age-dependent cut-offs for serum GFAP were determined for different AD age groups. The calculated areas under the curve (AUCs; 0.97) demonstrated excellent diagnostic test performance in the early-onset age group. This effect was less marked in the elderly subjects (AUC 0.72).Our novel GFAP z-scores enable the integration and interpretation of serum GFAP levels in clinical practice, moving from the group to individual level. They support both intra- and interindividual interpretation of single GFAP levels in neurological diseases with astrocytic pathology, including an accurate discrimination of AD.
000282577 536__ $$0G:(DE-HGF)POF4-353$$a353 - Clinical and Health Care Research (POF4-353)$$cPOF4-353$$fPOF IV$$x0
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000282577 650_7 $$2NLM Chemicals$$aGlial Fibrillary Acidic Protein
000282577 650_7 $$2NLM Chemicals$$aBiomarkers
000282577 650_7 $$2NLM Chemicals$$aGFAP protein, human
000282577 650_2 $$2MeSH$$aHumans
000282577 650_2 $$2MeSH$$aAlzheimer Disease: blood
000282577 650_2 $$2MeSH$$aAlzheimer Disease: diagnosis
000282577 650_2 $$2MeSH$$aGlial Fibrillary Acidic Protein: blood
000282577 650_2 $$2MeSH$$aAged
000282577 650_2 $$2MeSH$$aMale
000282577 650_2 $$2MeSH$$aFemale
000282577 650_2 $$2MeSH$$aMiddle Aged
000282577 650_2 $$2MeSH$$aReference Values
000282577 650_2 $$2MeSH$$aBiomarkers: blood
000282577 650_2 $$2MeSH$$aAged, 80 and over
000282577 650_2 $$2MeSH$$aAge Factors
000282577 650_2 $$2MeSH$$aAdult
000282577 650_2 $$2MeSH$$aCase-Control Studies
000282577 7001_ $$aFazeli, Badrieh$$b1
000282577 7001_ $$0P:(DE-2719)9001084$$aKlose, Veronika$$b2
000282577 7001_ $$aNagel, Gabriele$$b3
000282577 7001_ $$0P:(DE-2719)9002269$$aRosenbohm, Angela$$b4
000282577 7001_ $$0P:(DE-2719)9002270$$aRothenbacher, Dietrich$$b5
000282577 7001_ $$aBachhuber, Franziska$$b6
000282577 7001_ $$0P:(DE-2719)9001441$$aJesse, Sarah$$b7$$udzne
000282577 7001_ $$aOtto, Markus$$b8
000282577 7001_ $$0P:(DE-2719)9003425$$aLandwehrmeyer, Georg Bernhard$$b9$$udzne
000282577 7001_ $$00000-0001-9731-4169$$aAbdelhak, Ahmed$$b10
000282577 7001_ $$00000-0002-0344-9749$$aPetzold, Axel$$b11
000282577 7001_ $$0P:(DE-2719)2812633$$aLudolph, Albert C$$b12$$udzne
000282577 7001_ $$0P:(DE-2719)9002007$$aTumani, Hayrettin$$b13$$udzne
000282577 773__ $$0PERI:(DE-600)1468161-4$$a10.1093/clinchem/hvaf120$$gVol. 71, no. 12, p. 1234 - 1242$$n12$$p1234 - 1242$$tClinical chemistry$$v71$$x0009-9147$$y2025
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