Determination of reference ranges of plasma glycosaminoglycans in a tertiary care centre


  • Humayun Mumtaz
  • Muhammad Aamir
  • Usama Bin Khalid
  • Shakeel Ahmad
  • Shahrukh Shah


Glycosaminoglycans; reference range; malignancy; ELISA


Objective: To determine reference ranges of plasma glycosaminoglycans (GAGs) in a population presenting at a tertiary care centre of Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi from January 2020 to December 2020.Methodology: An observational cross-sectional study which involved one hundred and twenty (120) disease-free healthy population was selected by non-probability consecutive sampling at a 90% confidence interval with a 5% margin of error. Plasma glycosaminoglycans were assayed by manual ELISA technique. The study population was stratified according to gender. Normality of data was assessed by Kolmogorov-Smirnov test. Dixon range test was employed to find outliers. After removing the outliers, mean ±, SD was calculated for plasma GAG levels (mg/L). Sex-specific reference values were determined Results: In our study, the total male population was 62 (51.7%), while the female was 58 (48.3%) in the disease-free population (n=120). The overall GAG levels were calculated as 24.12±7.9 mg/l in blood samples against the reference range of 11.48-36.76 mg/l. In males, GAG levels were found as 24.67±6.65 against a reference range of 11.67-37.7 mg/l, while in females, it was 22.22±5.36 against the reference interval of 11.71-32.73 mg/l.Conclusion: The reference range for plasma GAG was found 11.48-36.76 mg/l in our study population. GAG levels differ significantly among males and females with reference ranges of 11.67-37.7 mg/l and 11.71-32.73 mg/l, respectively.


1.Pomin VH. Keratan sulfate: an up-to- date review. Int J Biol Macromol. 2015 Jan;72:282–9.
2.Pomin VH. A Dilemma in the Glycosaminoglycan-Based Therapy: Synthetic or Naturally Unique Molecules? Med Res Rev. 2015 Nov;35(6):1195–219. 3.Rabenstein DL. Heparin and heparan sulfate: structure and function. Nat Prod Rep. 2002 Jun;19(3):312–31.
4.Gatto F, Volpi N, Nilsson H, Nookaew I, Maruzzo M, Roma A, et al. Glycosaminoglycan Profiling in Patients’ Plasma and Urine Predicts the Occurrence of Metastatic Clear Cell Renal Cell Carcinoma. Cell Rep. 2016 May 24;15(8): 1822–36.
5.Gandhi NS, Mancera RL. The structure of glycosaminoglycans and their
interactions with proteins. Chem Biol Drug Des. 2008 Dec;72(6):455–82.
6.Afratis N, Gialeli C, Nikitovic D, Tsegenidis T, Karousou E, Theocharis AD, et al. Glycosaminoglycans: key players in cancer cell biology and treatment. FEBS J. 2012 Apr;279(7):1177–97.
7.Sarica K, Türkölmez K, Soygür T, Ozer G, Yaman MO, Baltaci S, et al. Evaluation of urinary glycosaminoglycan excretion in patients with renal cell carcinoma. Eur Urol. 1997;31(1):54–7.
8.Gatto F, Blum KA, Hosseini SS, Ghanaat M, Kashan M, Maccari F, et al. Plasma Glycosaminoglycans as Diagnostic and Prognostic Biomarkers in Surgically Treated Renal Cell Carcinoma. Eur Urol Oncol. 2018 Oct;1(5):364–77.
9.Ahmad Z, Azad N, Yaqoob N, Husain A, Ahsan A, Khan A, et al. Frequency of primary solid malignant neoplasms in both sexes, as seen in our practice. J Ayub Med Coll. 2007 Jan 1;19(1):53–5.
10.L i n d a h l U , H ö ö k M . Glycosaminoglycans and their binding to biological macromolecules. Annu Rev Biochem. 1978;47:385–417. 11.Muramatsu T, Muramatsu H. Glycosaminoglycan-binding cytokines as tumor markers. Proteomics. 2008 Aug; 8(16):3350–9.
12.Khan SA, Mason RW, Giugliani R, Orii K, Fukao T, Suzuki Y, Yamaguchi S, Kobayashi H, Orii T, Tomatsu S. Glycosaminoglycans analysis in blood and urine of patients with mucopolysaccharidosis. Mol Genet Metab. 2018 Sep;125(1-2):44-52. doi: 10.1016/ j.ymgme.2018.04.011.
13.Tomatsu S, Fujii T, Fukushi M, Oguma T, Shimada T, Maeda M, Kida K, Shibata Y, Futatsumori H, Montaño AM, Mason RW, Yamaguchi S, Suzuki Y, Orii T. Newborn screening and diagnosis of mucopolysaccharidoses. Mol Genet Metab. 2013 Sep-Oct;110(1-2):42-53. doi: 10.1016/j.ymgme.2013.06.007.




How to Cite

Mumtaz, H., Aamir, M., Khalid, U. B., Ahmad, S., & Shah, S. (2021). Determination of reference ranges of plasma glycosaminoglycans in a tertiary care centre. International Journal of Natural Medicine and Health Sciences, 1(1), 9–13. Retrieved from