Common reference intervals for aspartate aminotransferase (AST), alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT) in serum: results from an IFCC multicenter study
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Ferruccio Ceriotti
Abstract
Background: Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and γ-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 μkat/L), allowing a single RI of 11–34 U/L (0.18–0.57 μkat/L) to be defined. Interregional 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 μkat/L) for females and 9–59 U/L (0.15–0.99 μkat/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 μkat/L) for females and 12–68 U/L (0.20– 1.13 μkat/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.
©2010 by Walter de Gruyter Berlin New York
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- Editorial
- IFCC Scientific Division
- IFCC Documents
- Nucleic acid reference materials (NARMs): definitions and issues
- An appraisal of statistical procedures used in derivation of reference intervals
- An outline for a vocabulary of nominal properties and examinations – basic and general concepts and associated terms
- Review
- Standardizing plasma protein measurements worldwide: a challenging enterprise
- Status Reports
- Standardization activities in the field of thyroid function tests: a status report
- Toward standardization of carbohydrate-deficient transferrin (CDT) measurements: II. Performance of a laboratory network running the HPLC candidate reference measurement procedure and evaluation of a candidate reference material
- Research Articles
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- Letters to the Editor
- Thyroid hormones are stable even during prolonged frozen storage
- Thyroid hormones after long-term cold storage: stable or unstable, that is the question
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- Interferences in red blood cell counting in urinalysis using evacuated tubes
- Congress Abstracts
- 3rd Annual Congress of the Austrian Society for Laboratory Medicine and Clinical Chemistry Salzburg, Austria, 27-30 October 2010
Articles in the same Issue
- Editorial
- IFCC Scientific Division
- IFCC Documents
- Nucleic acid reference materials (NARMs): definitions and issues
- An appraisal of statistical procedures used in derivation of reference intervals
- An outline for a vocabulary of nominal properties and examinations – basic and general concepts and associated terms
- Review
- Standardizing plasma protein measurements worldwide: a challenging enterprise
- Status Reports
- Standardization activities in the field of thyroid function tests: a status report
- Toward standardization of carbohydrate-deficient transferrin (CDT) measurements: II. Performance of a laboratory network running the HPLC candidate reference measurement procedure and evaluation of a candidate reference material
- Research Articles
- Common reference intervals for aspartate aminotransferase (AST), alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT) in serum: results from an IFCC multicenter study
- Development of a candidate secondary reference procedure (immunoassay based measurement procedure of higher metrological order) for cardiac troponin I: I. Antibody characterization and preliminary validation
- Towards the development of a certified reference material for hemoglobin A2
- Short Communication
- First certified reference material for cystatin C in human serum ERM-DA471/IFCC
- General Clinical Chemistry and Laboratory Medicine
- Increased γ-glutamyltransferase and decreased total bilirubin are associated with metabolic syndrome in Korean postmenopausal women
- Effect of homeostasis model assessment computational method on the definition and associations of insulin resistance
- Association between thyroid hormones, lipids and oxidative stress biomarkers in overt hypothyroidism
- Biochemical markers of particle induced osteolysis in C57BL/6 mice
- An on-line solid phase extraction procedure for the routine quantification of urinary methylmalonic acid by liquid chromatography-tandem mass spectrometry
- Cancer Diagnostics
- Increased integrity of circulating cell-free DNA in plasma of patients with acute leukemia
- The relationship between three heat shock protein 70 gene polymorphisms and susceptibility to lung cancer
- Real-time polymerase chain reaction quantification of free DNA in serum of patients with polyps and colorectal cancers
- Letters to the Editor
- Thyroid hormones are stable even during prolonged frozen storage
- Thyroid hormones after long-term cold storage: stable or unstable, that is the question
- Biomarkers for early detection of mesothelioma in asbestos-exposed subjects
- Mean platelet volume and platelet distribution width are useful in the differential diagnosis of aplastic anemia and idiopathic thrombocytopenic purpura
- Kinetics of highly sensitive troponin I and T after eccentric exercise
- Interferences in red blood cell counting in urinalysis using evacuated tubes
- Congress Abstracts
- 3rd Annual Congress of the Austrian Society for Laboratory Medicine and Clinical Chemistry Salzburg, Austria, 27-30 October 2010
