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Infant liver biochemistry is different than current laboratory accepted norms
Kaija-Leena Kolho1, Tapio Lahtiharju2, Laura Merras-Salmio3
1Department of Pediatric Gastroenterology, Children's Hospital, University of Helsinki, P.O. Box 281, FI-00029, Helsinki, Finland. kaija-leena.kolho@helsinki.fi.
European Journal of Pediatrics
|October 9, 2023
Summary
Healthy infants show higher liver biochemistry values in their first year. Breastfeeding is associated with elevated levels, suggesting a need for infant-specific reference ranges for alanine aminotransferase (ALT) and other liver enzymes.
Area of Science:
- Pediatric Biochemistry
- Neonatal Health
- Clinical Chemistry
Background:
- Current reference ranges for liver biochemistry may not accurately reflect healthy infants.
- Infant feeding practices are suspected to influence liver enzyme levels.
Purpose of the Study:
- To establish liver biochemistry reference ranges in healthy term infants.
- To investigate the impact of feeding type on infant liver enzyme levels.
Main Methods:
- Analysis of serum samples from 619 healthy term infants at 3 and 6 months of age.
- Measurement of alanine aminotransferase (ALT), AST, ALP, GGT, and bilirubin levels using Siemens Atellica CH 930 analyzers.
- Longitudinal follow-up of infants up to 36 months.
Main Results:
- Upper 90% confidence intervals for ALT, AST, ALP, GGT, and bilirubin were higher than current laboratory limits at 3 months.
- Elevated ALT and AST levels persisted at 6 months, with feeding type significantly associated with variations.
- Breastfed infants exhibited higher ALT, AST, and bilirubin levels compared to formula-fed infants.
Conclusions:
- Established reference ranges for infant liver biochemistry are crucial for accurate diagnosis.
- Feeding type, particularly breastfeeding, influences liver enzyme levels in infants.
- Further research is needed to define age- and feeding-specific reference values for pediatric liver function tests.
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