Chhavi Nanda, Ojha Sachi, Awasthi Ashish, Goel Amit
Department of Pediatrics, Era's Lucknow Medical College, Lucknow, India.
Centre for Chronic Conditions and Injuries, Public Health, Foundation of India, Gurgaon, India.
J Clin Exp Hepatol. 2022 Mar-Apr;12(2):306-311. doi: 10.1016/j.jceh.2021.08.024. Epub 2021 Sep 23.
Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤40 IU/L is normal. This cutoff, although determined in adults, is widely used for newborns. We studied the reference ranges for ALT and AST in newborns in India.
We prospectively included babies with gestational age (GA) between 34 and 41weeks and birth weight (BW) ≥ 1500 g. We excluded the babies who either themselves or their mother had risk factors, which could cause elevation of serum levels of liver enzymes. Serum ALT and AST were measured in venous cord blood. The estimated percentile curves for ALT and AST, for BW and GA covariates, were drawn with General Additive Model for Location Scale and Shape (GAMLSS) with Box-Cox Power Exponential (BCPE).
Five-hundred thirty-seven babies (Boys 53.3%; GA 34-36 wks 19.7%; appropriate for GA 74.9%; BW < 2500 g 20.5%) were included. Overall, mean [SD] serum ALT and AST were 44 IU/L and 52 IU/L, respectively. The serum AST was significantly higher than the ALT level, regardless of gender, BW, GA, or fetal growth categories. The percentile curve against GA remained flat for ALT, although it showed a slight rise for AST. Serum levels of ALT and AST plotted against BW were also similar and showed an increase up to 2000 g and then remained stationary after that.
The serum levels of ALT and AST up to 44 IU/L and 52 IU/L, respectively, can be taken as normal in newborns with BW ≥ 2000 g or GA ≥34 weeks.
血清丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）≤40 IU/L为正常。这一临界值虽在成人中确定，但广泛应用于新生儿。我们研究了印度新生儿ALT和AST的参考范围。
我们前瞻性纳入了胎龄（GA）在34至41周之间且出生体重（BW）≥1500 g的婴儿。我们排除了自身或其母亲有可导致血清肝酶水平升高的危险因素的婴儿。在脐静脉血中检测血清ALT和AST。采用带Box-Cox幂指数（BCPE）的位置尺度和形状通用加性模型（GAMLSS）绘制了针对BW和GA协变量的ALT和AST估计百分位数曲线。
纳入了537名婴儿（男孩占53.3%；GA 34 - 36周占19.7%；适于胎龄占74.9%；BW < 2500 g占20.5%）。总体而言，血清ALT和AST的平均[标准差]分别为44 IU/L和52 IU/L。无论性别、BW、GA或胎儿生长类别如何，血清AST均显著高于ALT水平。针对GA的百分位数曲线，ALT保持平坦，而AST略有上升。针对BW绘制的ALT和AST血清水平也相似，在达到2000 g之前升高，之后保持稳定。
对于BW≥2000 g或GA≥34周的新生儿，血清ALT和AST水平分别高达44 IU/L和52 IU/L可视为正常。
