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

作　　者：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 

机构地区：[1]Department of Endocrinology,Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,3333 Binsheng Road,Hangzhou,310051,China [2]Department of Data and Information,Children’s Hospital,Zhejiang University School of Medicine,Hangzhou,China [3]Department of Child Health Care,Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou,China [4]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

出　　处：《World Journal of Pediatrics》2024年第9期949-956,共8页世界儿科杂志（英文版）

基　　金：supported by grants from the National Key Research and Development Program of China(Nos.2021YFC2701901 and 2016YFC1305301);National Natural Science Foundation of China(Nos.82370863 and 81570759);Zhejiang Provincial Key Disciplines of Medicine(Innovation Discipline,11-CX24).

摘　　要：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 validation,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,andγ-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.

关 键 词：Alanine aminotransferase CHILDHOOD Fatty liver diseases 

分 类 号：R725.7[医药卫生—儿科]