Updated thresholds for serum alanine aminotransferase level in a large- scale po

StephenW

Aliment Pharmacol Ther. <http://www.ncbi.nlm.nih.gov/pubmed/> 2012 Jul 23. doi: 10.1111/j.1365-2036.2012.05224.x. [Epub ahead of print]

Updated thresholds for serum alanine aminotransferase level in a large- scale population study composed of 34 346 subjects.

Wu WC
, Wu CY
, Wang YJ
, Hung HH
, Yang HI
, Kao WY
, Su CW
, Wu JC
, Chan WL
, Lin HC
, Lee FY
, Lee SD


Source

Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Abstract

BACKGROUND:

The sensitivity of current upper limit of normal (ULN) of serum alanine aminotransferase (ALT) levels for detecting chronic liver disease has been challenged recently.

AIM:

To identify modulating factors for serum ALT levels and to refine its ULN threshold.

METHODS:

We enrolled 34 346 consecutive subjects who completed the health check-up at Taipei Veterans General Hospital from 2002 to 2009. ULN was set for healthy ALT level to the 95th percentile of the reference healthy population.

RESULTS:

A group of 21 282 subjects were used as a training set to define an ULN with the highest sensitivity; afterwards, this ULN was validated in another set of 13 064 subjects. A reference healthy population was selected from the training set after excluding subjects with any abnormalities in independent risk factors associated with elevated serum ALT level (>40 IU/L) by multivariate analysis like body mass index, waist circumference, glucose, cholesterol, high-density lipoprotein- cholesterol, triglyceride, hepatitis B virus surface antigen, anti- hepatitis C virus antibody and fatty liver. The new ULN of serum ALT level defined as the 95% percentile in the healthy population were 21 IU/L and 17 IU/L for men and women respectively. These cut-off values had the highest Youden's index and areas under the corresponding receiver operating curves among four widely applied thresholds in both the training and validation sets.

CONCLUSIONS:

The suggested threshold of upper limit of normal provides better discrimination between healthy and unhealthy status. Viral hepatitis, metabolic syndrome and fatty liver are the major risk factors of elevated serum alanine aminotransferase levels.

StephenW

aliment药理疗法。 <http://www.ncbi.nlm.nih.gov/pubmed/&gt; 2012年07月23日。 DOI：10.1111/j.1365-2036.2012.05224.x。 [出处提前打印]

更新为34 346科目组成了大规模的人口研究血清丙氨酸转氨酶水平的阈值。



源

胃肠病学，医学系，台北荣民总医院，台北，台湾。

抽象

背景：

目前正常值上限（ULN）的血清谷丙转氨酶（ALT）水平检测慢性肝病的敏感性最近受到了挑战。

目的：

以确定血清ALT水平的调节因素，并完善其ULN的门槛。

方法：

我们招收了34 346在台北荣民总医院完成健康检查，从2002年至2009年连续科目。 ULN的成立的第95百分位的参考健康人群的健康ALT水平。

结果：

被用来作为A组21 282科目设置定义ULN的灵敏度最高的培训;事后，这ULN的验证在另一组的13 064科目。参考健康人群选择不包括像身体质量指数，腰围，血糖，胆固醇高的多元分析与血清ALT水平（> 40 IU / L），相关的独立危险因素中的任何异常的科目后，设置培训密度脂蛋白胆固醇，甘油三酯，乙肝病毒表面抗原，抗丙型肝炎病毒抗体和脂肪肝。血清ALT水平定义为在健康人群的95％百分新的正常值上限为21 IU / L和17 IU / l对于男性和女性分别。这些截止值最高尤登指数和地区间广泛应用于培训和验证集的阈值根据相应的接收工作曲线。

结论：

正常上限的建议的门槛，提供更好的健康和不健康的状态之间的歧视。病毒性肝炎，代谢综合征和脂肪肝的主要危险因素，血清谷丙转氨酶水平。

MP4

标准又创新低了。
ALT正常值
男<21IU/L
女<17IU/L
男2UNL=42IU/L
女2UNL=34IU/L