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Establishment of age- and sex-specific reference intervals for serum liver function tests in pediatric population

Xuetong Zhu1, Kaijin Wang1, Qi Zhou2

  • 1Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, China.

Journal of Clinical Laboratory Analysis
|January 22, 2021
PubMed

Insights

Establishing accurate pediatric reference intervals (RIs) for liver function tests is crucial for diagnosing childhood diseases. This study determined age- and sex-specific RIs and analyzed analyte correlations in children.

Area of Science:

  • Clinical Chemistry
  • Pediatric Medicine
  • Biochemistry

Background:

  • Accurate reference intervals (RIs) are essential for diagnosing, treating, and determining the prognosis of pediatric diseases.
  • Establishing pediatric-specific RIs for liver function tests is critical for accurate clinical assessment in children.

Purpose of the Study:

  • To establish pediatric reference intervals (RIs) for key liver function tests.
  • To evaluate the dynamic changes and correlations among these liver function analytes in a pediatric population.

Main Methods:

  • Prospective recruitment of 6,322 children and adolescents (aged 1-18 years) in Jilin Province, China.
  • Analysis of liver function tests using an Ortho VITROS 5600 automatic biochemical analyzer.
  • Stratification by age and sex using regression tree and Harris and Boyd's methods; dynamic RI changes assessed by the lambda-mu-sigma method.

Main Results:

  • Significant age and sex differences observed in most liver function analytes, except serum total protein.
  • Specific trends identified: albumin, total protein, GGT, and bilirubin increased with age; AST decreased.
  • Strongest correlations found between total bilirubin and unconjugated bilirubin (r=0.788), and total bilirubin and albumin (r=0.511).

Conclusions:

  • Liver function test analytes exhibit unique age-dependent dynamic changes in the pediatric population.
  • Established age- and sex-specific pediatric RIs are necessary for accurate disease diagnosis.
  • Identified analyte correlations can guide future research and clinical interpretations.
Abstract

Keywords:
adolescentalkaline phosphatasechildrenliver functionreference interval

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