Quality Requirements
Biological Variation in Patients with Disease
Dr. Carmen Ricos and her colleagues have generously allowed us to post a new database on Biologic Variation within subjects with disease. The previous databases have relied on data from healthy patients. See how the variation changes when you examine patients with different disease states.
Within-subject biological variation in disease
June 2009
We are pleased to present a new published data set from Dr. Carmen Ricos and her colleagues. This set of biologic variation data is unique in that it represents the biologic variation not from healthy individuals, but from patients with various diseases.
The original paper appeared as Carmen Ricos, Natalia Iglesias, Jose-Vicente Garcia-Lario, Margarita Simon, Fernando Cava, Amparo Hernandez, Carmen Perich, Joanna Minchinela, Virtudes Alvarez, Maria-Vicenta Domenench, Carlos-Victor Jimenez, Carmen Biosca, and Raquel Tena, Within-subject biological variation in disease: collated data and clinical consquences, Ann Clin Biochem 2007:44:343-352
- ?-Fetoprotein through AST
- Bicarbonate through Cystatin C
- FT4 through NTx/creatinine ratio, 2h
- PBG, first morning through Protein, total
- SCC through Urea
- See the Desirable Specifications for Total Error, Imprecision, and Bias, derived from Biologic Variation
A note on abbreviations:
Matrix: specimen type S: Serum P: Plasma B: Whole Blood U: Urine |
Column 3 CVI: within-subject biological variation in healthy patients |
Column 4 CVI: within-subject biological variation in patients with disease |
n: number of subjects studies |
d: period of time covered in days | s: number of samples obotained for each subject | Disease: name of the disease in study | Ref: Reference number (see list below |
Analytes A
Analyte | Matrix | CVI (%) Healthy (median) |
CVI (%) Disease |
n | d | s | Disease | Reference | Mean | Units |
?-Fetoprotein | S | 12 | 12 | 30 | 180 | 3 | Colon neoplasm | 10 | 2.86 | ug/L |
?-Fetoprotein | S | 35 | 40 | 180 | 3-10 | Hepatic disease, no cirrhosis | 10 | 4.07 | ug/mL | |
?-Fetoprotein | S | 38 | 85 | 180 | 3-10 | Hepatocellular carcinoma | 10 | 3.97 | ug/L | |
?-Fetoprotein | S | 40 | 45 | 108 | 3-8 | Cirrhosis | 10 | 3.83 | ug/L | |
Alanine aminopeptidase | S | 4.1 | 4.3 | 20 | 28 | 7 | Chronic liver disease | 29 | 1.39 | ukat/L |
ALT | S | 24 | 11 | 20 | 28 | 7 | Chronic liver disease | 29 | 2.04 | ukat/L |
ALT | S | 13 | 27 | 56 | 8 | Type I- DM | 27 | 0.52 | ukat/L | |
ALT | S | 25 | 9 | 2 | 11 | Impaired renal function | 23 | 0.21 | ukat/L | |
Albumin | S | 3.1 | 2.8 | 16 | 56 | 8 | Type I-DM | 27 | 44 | g/L |
Albumin | S | 2.9 | 8 | 21 | 8 | Chronic renal failure | 28 | 41 | g/L | |
Albumin | S | 3.3 | 20 | 28 | 7 | Chronic liver disease | 29 | 39 | g/L | |
Albumin | S | 4.3 | 9 | 2 | 11 | Impaired renal function | 23 | 39.1 | g/L | |
Albumin | S | 6.7 | 20 | 4 | 19 | Acute myocardial infarction | 22 | 37.1 | g/L | |
Albumin, first morning | U | 36 | 42 | 47 | 21 | 3 | Type I-DM | 39 | 350 | mg/L |
Albumin, first morning | U | 61 | 16 | 21-28 | 10 | Diabetic subjects | 33 | 14 | mg/L | |
Albumin/creatinine ratio | U | NA | 39 | 16 | 21-28 | 10 | Diabetic subjects | 33 | 1.25 | mg/mmol |
ALP | S | 6.4 | 6.4 | 8 | 84 | 8 | Chronic renal failure | 28 | 3.21 | ukat/L |
ALP | S | 6.6 | 20 | 28 | 7 | Chronic liver disease | 29 | 7.5 | ukat/L | |
ALP | S | 12.4 | 15 | 72 | 5 | Paget disease | 17 | 9.8 | ukat/L | |
ALP bone isoform | S | 6.2 | 4.9 | 15 | 72 | 5 | Paget disease | 17 | 136 | ug/L |
Amino-terminal proBNP | P | NA | 8.6 | 37 | 1 | 6 | Stable chronic heart failure | 20 | 570 | ng/L |
Amino-terminal proBNP | P | 20 | 37 | 5 | 5 | Stable chronic heart failure | 20 | 570 | ng/L | |
Amino-terminal proBNP | P | 35 | 37 | 42 | 15 | Stable chronic heart failure | 20 | 570 | ng/L | |
Amylase | S | 12 | 8.2 | 17 | 21 | 8 | Chronic renal failure | 28 | 110 | U/L |
Amylase | S | 8.4 | 20 | 28 | 7 | Chronic liver disease | 29 | 8.7 | U/L | |
Amylase | S | 11.1 | 27 | 56 | 8 | Type I- DM | 27 | 4.58 | U/L | |
Amylase (total) first morning | U | NA | 35 | 47 | 21 | 3 | Type I- DM | 39 | 4.58 | ukat/L |
Amylase (pancreatic) first morning | U | NA | 38 | 47 | 21 | 3 | Type I- DM | 39 | 2.90 | ukat/L |
Amylase | Saliva | NA | 51 | 47 | 21 | 3 | Type I- DM | 39 | 1.60 | ukat/L |
Apo-A1 | S | 6.5 | 7.1 | 143 | 70 | 3 | Lipid disorders | 36 | 1.50 | g/L |
Apo-B | S | 6.9 | 6.4 | 143 | 70 | 3 | Lipid disorders | 36 | 1.71 | g/L |
AST | S | 12 | 10.6 | 20 | 28 | 7 | Chronic liver disease | 29 | 1.76 | ukat/L |
AST | S | 12.3 | 37 | 56 | 8 | Type I- DM | 27 | 0.48 | ukat/L |
Analytes B-C
Analyte | Matrix | CVI (%) Healthy (median) |
CVI (%) Disease |
n | d | s | Disease | Reference | Mean | Units |
Bicarbonate | S | 4.8 | 7.9 | 20 | 4 | 19.5 | Acute myocardial infarction | 22 | 19.5 | mmol/L |
BNP | P | NA | 8.2 | 37 | 1 | 6 | Stable chronic heart failure | 20 | 135 | ng/L |
BNP | P | 24 | 37 | 5 | s | Stable chronic heart failure | 20 | 135 | ng/L | |
BNP | P | 40 | 37 | 42 | 15 | Stable chronic heart failure | 20 | 135 | ng/L | |
CA 125 | S | 29 | 21.8 | 12 | 120 | 4 | Non small cell lung carcinoma | 43 | NA | NA |
CA 125 | S | 36.0 | 24 | 1095 | 5 | Resected lung neoplasm (not oat cell) | 36 | 10.6 | U/L | |
CA 125 | S | 46.2 | 41 | 1095 | 7 | Resected ovarian neoplasm | 35 | 8.8 | U/L | |
CA 15.3 | S | 6.2 | 7.0 | 50 | 30 | 3 | Radically resected breast cancer | 24 | 16 | U/mL |
CA 15.3 | S | 11.2 | 33 | 2010 | 11 | Breast cancer (resected) | 32 | NA | NA | |
CA 15.3 | S | 16.7 | 170 | 90 | NA | Breast cancer | 25 | 16.2 | U/mL | |
CA 19.9 | S | 16 | 24.5 | 41 | 1095 | 7 | Resected ovarian neoplasm | 35 | 8.8 | U/L |
CA 19.9 | s | 24.5 | 24 | 1095 | 7 | Resected lung neoplams (not oat cell) | 35 | 13.2 | U/L | |
Calcium | S | 1.9 | 1.3 | 8 | 84 | 8 | Chronic renal failure | 28 | 2.34 | mmol/L |
Calcium | S | 1.6 | 14 | 56 | 8 | Hyptertension | 30 | 2.34 | mmol/L | |
Calcium | S | 2.8 | 9 | 84 | 11 | Chronic renal failure | 28 | 2.23 | mmol/L | |
Calcium | S | 4.8 | 20 | 4 | 19.5 | Acute Myocardial infarction | 22 | 2.25 | mmol/L | |
Calcium | S | 6.7 | 9 | 2 | 11 | Impaired renal function | 23 | 2.4 | mmol/L | |
Calcium/creatinine ratio, 2h | U | NA | 33 | 46 | 2 | 2 | Inpatients Metabolic bone disease | 45 | 0.31 | mmol/mmol |
Calcium/creatinine ratio, 2h | U | 39 | 20 | 30-90 | 2 | Outpatients Osteoporosis (only) | 45 | 0.48 | mmol/mmol | |
Calcium/creatinine ratio, 2h. | U | 41 | 20 | 2 | 2 | Inpatients Osteoporosis (only) | 45 | 0.31 | mmol/mmol | |
Calcium/creatinine ratio, 2h | U | 44 | 46 | 30-90 | 2 | Outpatients Metabolic bone disease | 45 | 0.39 | mmol/mmol | |
CEA | S | 13 | 9.8 | 92 | 30 | 3 | Radically resected breast cancer | 24 | NA | NA |
CEA | S | 10.6 | 12 | 120 | 4 | Non small cell lung carcinoma | 43 | NA | NA | |
CEA | S | 12.4 | 31 | 900 | 3 to 7 | Colon neoplasm | 21 | 1,80 | ug/L | |
CEA | S | 16.2 | 420 | 90 | >3 | Radically resected breast cancer | 24 | NA | NA | |
CEA | S | 19.1 | 32 | 901 | 4 to 7 | Breast cancer (no evidence of disease) | 21 | 1.40 | ug/L | |
CEA | S | 23.6 | 24 | 1095 | 5 | Resected lung neoplasm (not oat cell) | 35 | 1.77 | mg/L | |
CEA | S | 26.9 | 170 | 90 | NA | Breast cancer (operated) | 25 | 1.60 | ug/L | |
CEA | S | 27.0 | 33 | 2010 | 11 | Breast cancer | 32 | NA | NA | |
CEA | S | 44.9 | 33 | 1095 | 7 | Resected colorectal neoplasm | 35 | 1.99 | mg/L | |
Chloride | S | 1.2 | 1.1 | 14 | 56 | 8 | Hypertension | 30 | 105 | mmol/L |
Chloride | S | 1.1 | 9 | 2 | 11 | Impaired renal function | 23 | 104 | mmol/L | |
Chloride | S | 1.8 | 41 | 90 | 8 | Renal post-transplantation | 18 | 108.6 | mmol/L | |
Chloride | S | 1.8 | 8 | 21 | 8 | Chronic renal failure | 28 | 110 | mmol/L | |
Chloride | S | 1.9 | 27 | 56 | 8 | Type I- DM | 27 | 100 | mmol/L | |
Chloride | S | 2.2 | 20 | 4 | 20 | Acute myocardial infarction | 22 | 102.7 | mmol/L | |
Chloride | S | 3.2 | 10 | 28 | 7 | Chronic liver disease | 29 | 103 | mmol/L | |
Cholesterol | S | 6.0 | 4.7 | 35 | 28 | 4 | Mild hypercholesterolemia | 41 | 6.0 | mmol/L |
Cholesterol | S | 5.0 | 128 | 70 | 3 | Lipid disorders | 35 | 6.1 | mmol/L | |
Cholesterol | S | 5.2 | 20 | 28 | 7 | Chronic liver disease | 29 | 5.0 | mmmol/L | |
Cholesterol | S | 7.0 | 14 | 56 | 8 | Hyptertension | 30 | 6.0 | mmol/L | |
Cholesterol | S | 7.2 | 27 | 56 | 8 | Type I- DM | 27 | 5.6 | mmol/L | |
Cholinesterase | S | 7.0 | 7.1 | 20 | 28 | 7 | Chronic liver disease | 29 | 103 | ukat/L |
Creatine kinase | S | 23 | 43 | 9 | 2 | 11 | Impaired renal function | 23 | 75.2 | U/L |
Creatinine | S | 4.3 | 5.3 | 17 | 21 | 8 | Chronic renal failure | 28 | 483 | umol/L |
Creatinine | S | 5.9 | 27 | 56 | 8 | Type I- DM | 27 | 73 | umol/L | |
Creatinine | S | 6.4 | 9 | 2 | 11 | Impaired renal function | 23 | 190 | umol/L | |
Creatinine | S | 6.5 | 11 | 56 | 8 | Type I- DM | 27 | 64 | umol/L | |
Creatinine | S | 11.5 | 41 | 90 | 8 | Renal post-transplantation | 18 | 148 | umol/L | |
Creatinine | S | 13.0 | 54 | 540 | 9 | Children chronic kidney disease | 40 | 52 | umol/L | |
Creatinine | S | 13.4 | 20 | 4 | 19.5 | Acute myocardial infarction | 22 | 85 | umol/L | |
Creatinine, first morning | U | NA | 34 | 47 | 21 | 3 | Type I- DM | 39 | 10.1 | mmol/L |
CTx | S | 9.6 | 12.4 | 15 | 365 | 5 | Paget | 17 | 5976 | pmol/L |
CTX/creatinine ratio, 2h | U | NA | 24 | 15 | 365 | 5 | Paget | 17 | 484 | ug/mmol |
Cyfra 21.1 | S | 22 | 21.8 | 12 | 120 | 4 | Non small cell lung carcinoma | 43 | NA | NA |
Cystatin C | S | NA | 12 | 54 | 540 | 9 | Children chronic kidney disease | 40 | 2.81 | mg/L |
alpha-ALA/creatinine ratio | U | 20 | 20 | 15 | 70 | 10 | Acute intermittent porphyria | 16 | 6.9 | umol/mmol |
alpha-ALA/creatinine ratio | U | 20 | 15 | 720 | 15 | Acute intermittent porphyria | 16 | 6.7 | umol/mmol |
Analytes F through N
Analyte | Matrix | CVI (%) Healthy (median) |
CVI (%) Disease |
n | d | s | Disease | Reference | Mean | Units |
FT4 | S | 7.6 | 5.7 | 12 | 0.33 | 5 | Primary hypothyroidism | 19 | NA | NA |
FT3 | S | 7.9 | 8.7 | 12 | 0.33 | 5 | Primary hypothyroidism | 19 | NA | NA |
GGT | S | 14 | 4.7 | 20 | 28 | 7 | Chronic liver disease | 29 | 6.8 | ukat/L |
GGT | S | 9.9 | 27 | 56 | 8 | Type I- DM | 27 | 0.37 | ukat/L | |
Glucose | S | 5.7 | 27.4 | 9 | 2 | 11 | Impaired renal function | 23 | 5.1 | mmol/L |
HDL Cholesterol | S | 7.1 | 7.1 | 128 | 70 | 3 | Lipid disorders | 36 | 1.36 | mmol/L |
HDL Cholesterol | S | 7.7 | 27 | 56 | 8 | Type I- DM | 27 | 1.53 | mmol/L | |
HDL Cholesterol | S | 8.7 | 14 | 56 | 8 | Hyptertension | 30 | 1.07 | mmol/L | |
HDL Cholesterol | S | 9.5 | 17 | 21 | 8 | Chronic renal failure | 28 | 1.00 | mmol/L | |
Hemoglobin | B | 2.8 | 2.3 | 14 | 56 | 8 | Hypertension | 30 | 9.8 | mmol/L |
Hemoglobin | B | 2.9 | 27 | 56 | 8 | Type I- DM | 27 | 10.1 | mmol/L | |
Hemoglobin | B | 4.2 | 20 | 28 | 7 | Chronic liver disease | 29 | 8.9 | mmol/L | |
Hemoglobin A1c | B | 1.9 | 4.3 | 47 | 720-1260 | 4-7 | Type II- DM | 42 | 6.5 | % |
Hemoglobin A1c | B | 8.8 | 214 | 365 | 4 | Type I- DM | 34 | 11.7 | % | |
Hydroxyproline/creatinine ratio, 2h | U | 26 | 33.8 | 20 | 30-90 | 2 | Osteoporosis (only) | 45 | 30 | umol/mmol |
Hydroxyproline/creatinine ratio, 2h | U | 40.6 | 46 | 30-90 | 2 | Metabolic bone disease | 45 | 37 | umol/mmol | |
Hydroxyproline/creatinine ratio, second | U | 13 | 18.7 | 15 | 365 | 5 | Paget's disease | 17 | 200 | nmol/mg |
LDL- Cholesterol | S | 8.3 | 6.6 | 35 | 28 | 4 | Mild hypercholesterolemia | 41 | 4.30 | mmol/L |
LDL- Cholesterol | S | 7.8 | 128 | 70 | 3 | Lipid disorders | 36 | 4.12 | mmol/L | |
LDL- Cholesterol | S | 9.5 | 85 | 365 | 4 | Coronoary artery disease | 37 | NA | NA | |
Lipoprotein (a) | S | 8.5 | 26.2 | 12 | 360 | 4 | Type I- DM | 26 | 25 | mg/dL |
Lipoprotein (a) | S | 23.3 | 24 | 360 | 4 | Type I- DM | 26 | >40 | mg/dL | |
Lipoprotein (a) | S | 42.3 | 13 | 360 | 4 | Type I- DM | 26 | 15 | mg/dL | |
Lipoprotein (a) | S | 42.3 | 21 | 360 | 4 | Type I- DM | 26 | <10 | mg/dL | |
MCA | S | 10.1 | 14.9 | 33 | 2010 | 11 | Resected breast cancer | 32 | NA | NA |
NAG, first morning | U | NA | 58 | 47 | 21 | 3 | Type I- DM | 39 | 48 | nkat/L |
NTx/creatinine ratio, 2h | U | 17 | 15.8 | 15 | 365 | 5 | Paget | 17 | 248 | nmol |
Analytes P
Analyte | Matrix | CVI (%) Healthy (median) |
CVI (%) Disease |
n | d | s | Disease | Reference | Mean | Units |
PBG, first morning | U | 15 | 18.0 | 15 | 70 | 10 | Acute intermittent porphyria | 16 | 5.0 | umol/mmol |
PBG, first morning | U | 25.0 | 15 | 720 | 15 | Acute intermittent porphyria | 16 | 5.0 | umol/mmol | |
Potassium | S | 4.8 | 4.5 | 14 | 56 | 8 | Hyptertension | 30 | 4.36 | mmol/L |
Potassium | S | 4.8 | 16 | 56 | 8 | Type I- DM | 27 | 4.65 | mmol/L | |
Potassium | S | 5.1 | 17 | 21 | 8 | Chronic renal failure | 28 | 4.98 | mmol/L | |
Potassium | S | 7.0 | 11 | 56 | 8 | Type I- DM | 27 | 4.81 | mmol/L | |
Potassium | S | 7.1 | 41 | 90 | 8 | Renal post-transplantation | 18 | 4.46 | mmol/L | |
Potassium | S | 7.7 | 20 | 28 | 7 | Chronic liver disease | 29 | 4.50 | mmol/L | |
Potassium | S | 12.4 | 20 | 4 | 19.5 | Acute myocardial infarction | 22 | 3.68 | mmol/L | |
Potassium | S | 13.3 | 9 | 2 | 11 | Impaired renal function | 23 | 4.5 | mmol/L | |
Procollagen (Type I N-terminal) | S | 6.8 | 10.0 | 15 | 72 | 5 | Paget | 17 | 176 | ug/L |
PAP | S | NA | 34 | 15 | 4 | 8 | Prostate cancer | 36 | 6.7 | U/L |
PAP | S | 34 | 15 | 4 | 8 | Prostate cancer | 38 | 0.8 | U/L | |
PAP | S | 34 | 15 | 4 | 8 | Prostate cancer | 38 | 0.3 | U/L | |
PSA (total) | S | 18.1 | 14 | 5 | 4 | 8 | Prostate cancer | 38 | 40.3 | ug/L |
PSA (total) | S | 14 | 5 | 4 | 8 | Prostate cancer | 38 | 10.8 | ug/L | |
PSA (total) | S | 14 | 5 | 4 | 8 | Prostate cancer | 38 | 3.2 | ug/L | |
PSA (total) | S | 20 | 890 | 90-960 | 2-10 | Prostate cancer | 15 | 0.1-20 | ug/L | |
Protein, total | S | 2.7 | 3.3 | 17 | 21 | 8 | Chronic renal failure | 28 | 74 | g/L |
Protein, total | S | 4.1 | 27 | 56 | 8 | Type I- DM | 27 | 73 | g/L | |
Protein, total | S | 4.2 | 20 | 28 | 7 | Chronic liver failure | 29 | 78 | g/L |
Analytes S through Z
Analyte | Matrix | CVI (%) Healthy (median) |
CVI (%) Disease |
n | d | s | Disease | Reference | Mean | Units |
SCC | S | 39 | 39 | 24 | 1095 | 5 | Lung neoplasm (not oat cell) | 35 | 1.01 | mg/L |
Sodium | S | 0.7 | 0.6 | 14 | 56 | 8 | Hypertension | 30 | 143 | mmol/L |
Sodium | S | 0.7 | 17 | 21 | 8 | Chronic renal failure | 28 | 142 | mmol/L | |
Sodium | S | 0.8 | 27 | 56 | 8 | Type I- DM | 27 | 140 | mmol/L | |
Sodium | S | 0.8 | 9 | 2 | 11 | Impaired renal function | 23 | 142 | mmol/L | |
Sodium | S | 0.9 | 20 | 28 | 7 | Chronic liver disease | 29 | 140 | mmol/L | |
Sodium | S | 1.0 | 8 | 21 | 11 | Chronic renal failure | 28 | 143.4 | mmol/L | |
Sodium | S | 1.1 | 41 | 90 | 8 | Renal post-transplantation | 18 | 141 | mmol/L | |
Sodium | S | 1.5 | 20 | 4 | 19.5 | Acute myocardial infarction | 22 | 139.8 | mmol/L | |
Sweat chloride | Sweat | 15 | 7.3 | 20 | 35 | 5 | Cystic fibrosis | 44 | 120 | mmol/L |
T3 | S | 8.7 | 8.4 | 13 | 56 | 8 | Pregnancy | 31 | 2.96 | nmol/L |
T3 | S | 8.7 | 12 | 0.33 | 5 | Primary hypothyroidism | 19 | NA | NA | |
T4 | S | 4.9 | 4.9 | 12 | 0.33 | 5 | Primary hypothyroidism | 19 | NA | NA |
T4 | S | 7.3 | 13 | 56 | 8 | Pregnancy | 31 | 108 | nmol/L | |
TSH | S | 29 | 29 | 24 | 1095 | 5 | Lung neoplasm (not oat cell) | 35 | 61 | U/L |
TPA | S | 36 | 36 | 24 | 1095 | 5 | Lung neoplasm (not oat cell) | 35 | 47 | U/L |
TPS | S | 36 | 36 | 24 | 1095 | 5 | Lung neoplasm (not oat cell) | 35 | 47 | U/L |
Triglycerides | S | 20.9 | 7.7 | 11 | 56 | 8 | Type I- DM | 27 | 2.4 | mmol/L |
Triglycerides | S | 15.4 | 17 | 21 | 8 | Chronic renal failure | 28 | 3.59 | mmol/L | |
Triglycerides | S | 17.8 | 128 | 70 | 3 | Lipid disorders | 35 | 1.46 | mmol/L | |
Triglycerides | S | 19.6 | 35 | 28 | 4 | Mild hypercholesterolemia | 41 | 1.41 | mmol/L | |
Triglycerides | S | 20.0 | 16 | 56 | 8 | Type I- DM | 27 | 1.88 | mmol/L | |
Triglycerides | S | 21.8 | 14 | 56 | 8 | Hypertension | 30 | 2.88 | mmol/L | |
Urate | S | 8.6 | 10.1 | 17 | 21 | 8 | Chronic renal failure | 28 | 477 | umol/L |
Urate | S | 10.3 | 27 | 56 | 8 | Type I- DM | 27 | 276 | umol/L | |
Urate | S | 13.2 | 41 | 90 | 8 | Renal post-transplantation | 18 | 415 | umol/L | |
Urea | S | 12.3 | 6.5 | 9 | 2 | 11 | Impaired renal function | 23 | 13.2 | mmol/L |
Urea | S | 11.7 | 17 | 21 | 8 | Chronic renal failure | 28 | 21 | mmol/L | |
Urea | S | 13.0 | 16 | 56 | 8 | Type I-DM | 27 | 5.9 | mmol/L | |
Urea | S | 15.3 | 41 | 90 | 8 | Renal post-transplantation | 18 | NA | NA | |
Urea | S | 15.6 | 11 | 56 | 8 | Type I- DM | 27 | 5.26 | mmol/L | |
Urea | S | 18.3 | 20 | 4 | 20 | Acute myocardial infarction | 22 | 5.31 | mmol/L |
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