Open AccessEstablishment of age‐ and sex‐specific reference intervals for serum liver function tests in pediatric population aged 1–<18 years: A prospective study
Author(s) -
Zhu Xuetong,
Wang Kaijin,
Zhou Qi,
Xu Jiancheng
Publication year - 2021
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.23708
Subject(s) - bilirubin , medicine , albumin , population , liver function , prospective cohort study , liver function tests , reference values , alkaline phosphatase , gastroenterology , physiology , endocrinology , biology , biochemistry , enzyme , environmental health
Background The diagnosis, treatment, and prognosis of pediatric diseases rely on the accurate establishment of the reference interval (RI). This study aimed to establish pediatric RIs for liver function tests and evaluated the correlation of the analytes. Methods Pediatric population (aged 1–<18 years) was prospectively recruited in Jilin Province, China. Analytes detected by Ortho VITORS 5600 automatic biochemical analyzer. All strata were divided using the regression tree and Harris and Boyd's method. The dynamic changes of RI were evaluated by the lambda‐mu‐sigma method. Results Reference individuals were comprised of 6,322 children and adolescents. Age and sex differences were present in all analytes except serum total protein. The serum albumin, total protein, γ‐glutamyl transferase, total bilirubin, and unconjugated bilirubin levels increased with age while serum aspartate aminotransferase was opposite. The serum alanine aminotransferase level reached a trough at the age of 5 and later steadily in males but slowly decreased in females. The serum alkaline phosphatase level dropped rapidly after reaching a peak at 9 years old in females and 12 years old in males. RIs were divided into 11 partitions at most and 5 partitions at least. The strongest correlation between analytes was total bilirubin and unconjugated bilirubin ( r = 0.788), followed by total bilirubin and albumin ( r = 0.511). Conclusions Analytes show unique dynamic changes in pediatric population. The correlations among liver function tests can inform future studies of particular variables. Age‐ and sex‐special pediatric RIs should be established to help an accurate diagnosis of disease.