更新了肝脏血液检测的参考限值,对长期肝脏相关结果进行验证
Fredrik Åberg1, Antti Jula2, Veikko Salomaa2
1Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
概括
在健康个体中建立了新的肝血测试参考限值. 亚斯巴酸氨基转移酶 (AST) 和玛-谷氨基转移酶 (GGT) 显示出对肝脏结果的预测力比氨基转移酶 (ALT) 强.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 临床生物化学 临床生物化学
- 人口健康 人口健康
背景情况:
- 已确定的肝血检参考值值可能无法准确预测长期肝脏风险.
- 以前的基准限值研究往往未能严格排除患有未诊断肝病或风险因素的个体.
研究的目的:
- 为了在严格定义的健康中年人群中建立精确的肝脏血液测试参考限值.
- 为了验证这些新的极限对肝脏重大不良结果 (MALOs) 的临床相关性.
主要方法:
- 来自芬兰2000年健康调查的5412名参与者的分析,有系统地排除患有肝病或风险因素的个人.
- 测量氨酸胺转移酶 (ALT),阿斯巴酸胺转移酶 (AST),胺转移酶 (GGT),酸酸酶 (ALP) 和胆红素.
- 在三个独立的FINRISK队列 (n=20,423) 中对事件MALO进行外部验证.
主要成果:
- 男性/女性的更新参考值 (第97.5百分位数):ALT 57/35 U/L,AST 49/33 U/L,GT 48/75 U/L,ALP 108/93 U/L,比利鲁宾 28/25 μmol/L. 这些是男性/女性的最新参考值 (97.5百分位数).
- 对于AST>2x和GGT>3x的上限,观察到10年MALO风险>5%;ALT升高没有达到这个风险水平.
- AST>2x上限指标表明MALO风险超过竞争死亡风险.
结论:
- 对肝脏血液检测的最新,精确的参考限值是在一个良好的健康人群中建立的.
- 酸氨基转移酶 (AST) 和胺转移酶 (GGT) 是MALO的更强的预测剂,而不是氨基转移酶 (ALT).
- 新的参考限值为评估长期肝脏健康风险提供了更可靠的基础.
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