Raynor Alexandre, Soavelomandroso Anna, Robert-Mercier Tiphaine, Valla Dominique, Peoc'h Katell, Raulet-Bussian Célia
Ann Biol Clin (Paris). 2022 Jun 30;80(3):213-222. doi: 10.1684/abc.2022.1734.
Alanine (ALT) and aspartate aminotransferases (AST) are intracellular enzymes involved in the metabolism of amino acids. The measurements of their activities are two of the most ordered tests in clinical laboratories, used to screen, diagnose and follow diseases affecting the liver. Recent works highlighted that reference values for ALT and AST vary according to the analytical method and the individual’s characteristics, like with many other biomarkers. Reference values for ALT show clinically significant differences according to the analytical method (higher when supplementing samples with phosphate pyridoxal), gender (higher in males than in females), body mass index (positive correlation), and age (higher in infants and the elderly), but not according to ethnicity or employed analyzer. According to the analytical method and age, reported reference values for AST show clinically significant differences, similar to ALT. These observations prove clinical laboratories’ interest in updating their reference values according to sex, body mass index, age (especially when providing testing to pediatric or elderly populations), and the analytical method employed. If possible, a standardized method should be used, including sample supplementation with pyridoxal phosphate, to ensure the comparability of results between laboratories.
丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）是参与氨基酸代谢的细胞内酶。对其活性的检测是临床实验室中最常规的两项检测，用于筛查、诊断和跟踪影响肝脏的疾病。最近的研究强调，与许多其他生物标志物一样，ALT和AST的参考值会因分析方法和个体特征而有所不同。ALT的参考值根据分析方法（用磷酸吡哆醛补充样本时更高）、性别（男性高于女性）、体重指数（呈正相关）和年龄（婴儿和老年人更高）存在临床显著差异，但不受种族或所用分析仪的影响。根据分析方法和年龄，AST的报告参考值也显示出与ALT类似的临床显著差异。这些观察结果证明临床实验室有必要根据性别、体重指数、年龄（尤其是为儿童或老年人群提供检测时）以及所用分析方法更新其参考值。如果可能，应使用标准化方法，包括用磷酸吡哆醛补充样本，以确保实验室间结果的可比性。
