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Researchers develop new reference for transaminase levels in children

Age, sex, BMI and puberty stage influenced the patterns of alanine aminotransferase, aspartate aminotransferase and gamma-glutamyltransferase in children aged between 11 months and 16 years, according to recently published data.

“The high prevalence of obesity and nonalcoholic fatty liver disease as well as the early onset of other liver diseases, require the availability and accuracy of diagnostic instruments for detection of liver damage during early life,” the researchers wrote. “This noninvasive scoring system could be a useful screening tool to select children with NAFLD who are at risk for advanced disease to undergo further investigations and more aggressive monitoring.”

To calculate age- and sex-related percentiles for ALT, AST and gamma-glutamyltransferase (GGT), the researchers reviewed the data of 1,746 children aged between 11 months and 16 years from 1,308 families enrolled in the Leipzig Research Centre for Civilization Diseases (LIFE) Child cohort. Researchers considered the children selected for the study as healthy and normal weight.

Results showed that AST levels decreased significantly with increasing age in children (95% CI, –1.52 to –1.31) whereas GGT levels increased significantly with age (95% CI, 0.32-0.43). Compared with boys, girls had lower mean levels of ALT (95% CI, –2.21 to –1.09), AST (95% CI, –2.32 to –1.21) and GGT (95% CI, –1.5 to –0.83). BMI was significantly correlated with ALT (95% CI, 1.85-2.56), which increased slightly higher in boys than in girls as BMI increased.

During Tanner stage 2 to 4 puberty, children had significantly higher ALT (95% CI, 3.36-9.22) and GGT (95% CI, 2.94-5.76) levels compared with Tanner stage 1 prepubertal children. This association increased with age for ALT and GGT, whereas AST levels (95% CI, –4.1 to 1.54) were negatively correlated with puberty.

Compared with prepubertal children, children in Tanner stage 5 or post-puberty had significantly lower levels of ALT (95% CI, –31.8 to –9.55), AST (95% CI, –31.59 to –10.36) and GGT (95% CI, –16.84 to –6.82).

“Children from socially disadvantaged families were underrepresented in the LIFE Child study, possibly due to a less pronounced health awareness. Due to the ethnic composition of the city of Leipzig and underrepresentation of non-Caucasians, this study does not describe the potential influence of ethnicity on transaminases,” the researchers advised. “Therefore, the suitability and/or comparability of these reference values for other ethnicities needs to be investigated.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.