Common reference intervals for aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) in serum: results from an IFCC multicenter study
Date
2010-11
Authors
Ceruotti, Ferruccio
Henny, Joseph
Queralto, Josep
Ziyu, Shen
Chen, Baorong
Boyd, James C.
Panteghini, Mauro
Journal Title
Journal ISSN
Volume Title
Publisher
Walter de Gruyter
Abstract
Background: Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) measurements are important for the assessment of liver damage. The aim of this study was to define the reference intervals (RIs) for these enzymes in adults, paying attention to standardization of the methods used and careful selection of the reference population.
Methods: AST, ALT and GGT were measured with commercial analytical systems standardized to the IFCC-recommended reference measurement systems. Three centers (two in Italy and one in China) measured their own freshly collected samples; one of these centers also measured frozen samples from the Nordic Countries RI Project and from a Turkish center. RIs were generated using non-parametric techniques from the results of 765 individuals (411 females and 354 males, 18-85 years old) selected on the basis of the results of other laboratory tests and a specific questionnaire.
Results: AST results from the four regions (Milan, Beijing, Bursa and Nordic Countries) were statistically different, but these differences were too small to be clinically relevant. Likewise, differences between the upper reference limits for genders was only 1.7 U/L (0.03 mu kat/L), allowing a single RI of 11-34 U/L (0.18-0.57 mu kat/L) to be defined. Inter-regional differences were not statistically significant for ALT, but partitioning was required due to significant gender differences. RIs for ALT were 8-41 U/L (0.13-0.68 mu kat/L) for females and 9-59 U/L (0.15-0.99 mu kat/L) for males, respectively. The upper reference limits for GGT from the Nordic Country population were higher than those from the other three regions and results from this group were excluded from final calculations. The GGT RIs were 6-40 U/L (0.11-0.66 mu kat/L) for females and 12-68 U/L (0.20-1.13 mu kat/L) for males, respectively.
Conclusions: For AST and ALT, the implementation of common RIs appears to be possible, because no differences between regions were observed. However, a common RI for GGT that is applicable worldwide appears unlikely due to differences among populations. Clin Chem Lab Med 2010;48:1593-601.
Description
Keywords
Alanine aminotransferase, Aspartate aminotransferase, Gamma-glutamyl transferase, Reference intervals, Catalytic-activity concentrations, 6 Asian cities, International-federation, Reference limits, Healthy-subjects, Reference values, Enzymes, 37-degrees-c, Part, Standardization, Medical laboratory technology
Citation
Ceruotti, F. vd. (2010). "Common reference intervals for aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) in serum: results from an IFCC multicenter study". Clinical Chemistry and Laboratory Medicine, 48(11), 1593-1601.