New pediatric percentiles of liver enzyme serum levels (alanine aminotransferase, aspartate aminotransferase, -glutamyltransferase): Effects of age, sex, body mass index, and pubertal stage
New pediatric percentiles of liver enzyme serum levels (alanine aminotransferase, aspartate aminotransferase, -glutamyltransferase): Effects of age, sex, body mass index, and pubertal stage
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DOI：
10.1002/hep.29542
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发表时间：
2018-10-01
期刊：
影响因子：
13.5
通讯作者：
Flemming, Gunter
中科院分区：
文献类型：
--
作者：
Bussler, Sarah;Vogel, Mandy;Flemming, Gunter
本研究旨在阐明性别、年龄、体重指数（BMI）和青春期对儿童和青少年血清转氨酶水平的影响，并为丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和谷氨酰转移酶（GGT）提供新的年龄和性别相关的指标。收集了4,126例患者的静脉血和人体测量数据。排除了服用潜在肝毒性药物、在血样采集时有潜在疾病证据且BMI不正常（BMI 90 th）的参与者病例。所得数据（N = 3，131例病例）用于计算ALT、AST和GGT比值。采用Cole型LMS法建立年龄和性别相关的参考区间。血清转氨酶水平遵循年龄特异性模式，并与青春期的开始有关。这一现象在女孩中比在男孩中更为明显。两种性别的ALT水平均呈相似的形态。多变量回归证实青春期和BMI-SDS（= 2.21）对ALT有显著影响。令人惊讶的是，AST血清水平受年龄（= -1.42）和BMI-SDS（= -0.15）的负面影响。GGT评分显示出显著的性别特异性差异，与年龄呈正相关（= 0.37），与BMI-SDS显著相关（= 1.16）。结论：使用现代分析和统计方法计算11个月至16.0岁儿童的ALT、AST和GGT血清水平的当前参考值。本研究通过揭示年龄、性别、BMI和青春期对所有三个参数的血清浓度的影响，扩展了目前关于转氨酶的知识，并且是迄今为止发表的最大样本量的参数之一。（肝脏病学2017）。
The present study aims to clarify the effects of sex, age, body mass index (BMI), and puberty on transaminase serum levels in children and adolescents and to provide new age- and sex-related percentiles for alanine aminotransferase (ALT), aspartate aminotransferase (AST), and -glutamyltransferase (GGT). Venous blood and anthropometric data were collected from 4,126 cases. Excluded were cases of participants with potential hepatotoxic medication, with evidence of potential illness at the time of blood sampling and non-normal BMI (BMI 90th). The resulting data (N = 3,131 cases) were used for the calculations of ALT, AST, and GGT percentiles. Age- and sex-related reference intervals were established by using an LMS method of Cole-type method. Serum levels of transaminases follow age-specific patterns and relate to the onset of puberty. This observation is more pronounced in girls than in boys. ALT percentiles showed similar-shaped patterns in both sexes. Multivariate regression confirmed significant effects of puberty and BMI-SDS ( = 2.21) on ALT. Surprisingly, AST serum levels were negatively influenced by age ( = -1.42) and BMI-SDS ( = -0.15). GGT percentiles revealed significant sex-specific differences, correlated positively with age ( = 0.37) and showed significant association with BMI-SDS ( = 1.16). Conclusion: Current reference values of ALT, AST, and GGT serum levels were calculated for children between 11 months and 16.0 years, using modern analytical and statistical methods. This study extends the current knowledge about transaminases by revealing influences of age, sex, BMI, and puberty on serum concentrations of all three parameters and has for these parameters one of the largest sample sizes published so far. (Hepatology 2017).