首页|Continuous age-and sex-specific reference ranges of liver enzymes in Chinese children and application in pediatric non-alcoholic fatty liver disease

Continuous age-and sex-specific reference ranges of liver enzymes in Chinese children and application in pediatric non-alcoholic fatty liver disease

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Background Alanine aminotransferase(ALT)is widely used to screen patients with hepatic diseases.However,the current reference ranges(＜50 U/L)were developed by laboratories and have not been validated in populations with a large number of healthy individuals.Methods This study collected venous blood and anthropometric data from a total of 13,287 healthy children aged 3 months to 18 years who underwent routine physical examinations in the Department of Pediatric Healthcare.We applied the least mean square algorithm to establish age-and sex-related reference percentiles of serum levels of transaminases.For valida-tion,we recruited 4276 children and adolescents with obesity/overweight who underwent evaluation and metabolic tests in the hospital.Using receiver operating characteristic curves,we determined age-and sex-specific upper limit percentiles of liver enzymes for fatty liver diseases.Results This study revealed a significant correlation between serum transaminase levels and age and sex(P＜0.01).These transaminase levels exhibited age-and sex-specific patterns.Among individuals in the non-alcoholic fatty liver disease(NAFLD)cohort,elevated ALT levels displayed a positive association with clinical markers of disease severity,including homeostatic model assessment of insulin resistance,waist-hip ratio,and serum uric acid levels(P＜0.01).According to the receiver operating characteristic curves,ALT levels at the 92.58th percentile for boys and the 92.07th percentile for girls yielded the highest accuracy and specificity.Conclusions This study provides age-and sex-specific reference ranges for ALT,aspartate aminotransferase,and y-glutamyltransferase in Chinese children and adolescents,making it the largest population study to date.Furthermore,the study establishes a precise upper limit for ALT levels,facilitating their use in NAFLD screening.

Alanine aminotransferaseChildhoodFatty liver diseases

Zhao-Yuan Wu、Si-Wei Chi、Liu-Jian Ouyang、Xiao-Qin Xu、Jing-Nan Chen、Bing-Han Jin、Rahim Ullah、Xue-Lian Zhou、Ke Huang、Guan-Ping Dong、Zhe-Ming Li、Ying Shen、Jie Shao、Yan Ni、Jun-Fen Fu、Qiang Shu、Wei Wu

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Department of Endocrinology,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,3333 Binsheng Road,Hangzhou 310051,China

Department of Data and Information,Children's Hospital,Zhejiang University School of Medicine,Hangzhou,China

Department of Child Health Care,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou,China

Department of Thoracic & Cardiovascular Surgery,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,National Children's Regional Medical Center,3333 Binsheng Road,Hangzhou 310051,China

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National Key Research and Development Program of ChinaNational Key Research and Development Program of ChinaNational Natural Science Foundation of ChinaNational Natural Science Foundation of ChinaZhejiang Provincial Key Disciplines of Medicine(Innovation Discipline)

2021YFC27019012016YFC1305301823708638157075911-CX24

2024

10.1007/s12519-023-00789-5

世界儿科杂志(英文版)

世界儿科杂志(英文版)

CSTPCD
ISSN：
年,卷(期)：2024.20(9)