Degertekin Bulent, Tozun Nurdan, Demir Figen, Soylemez Gizem, Yapali Suna, Bozkurt Ugur, Gurtay Ezgi, Seymenoglu Tolga Hayrettin, Mutlu Deniz, Toraman Meltem
Department of Gastroenterology and Hepatology, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey.
Department of Social Health, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey.
Hepatol Forum. 2020 May 21;1(2):44-47. doi: 10.14744/hf.2020.2020.0012. eCollection 2020 May.
Recent studies have reported that the widely accepted range of upper limits of normal (ULN) alanine aminotransferase (ALT) levels (ULN<40U/L) is high for the healthy population. We aimed to find the correct ULN level for men and women in a presumed healthy liver population group.
The data of 7410 healthy subjects visiting the check-up clinics were retrospectively analysed in this study. Patients were divided in to "healthy liver group" (n=2694) and "high-risk liver group" (n=4716) based on fatty liver on ultrasound, existing of chronic liver disease, ongoing significant alcohol consumption, diabetes mellitus and dyslipidaemia. Receiver operating characteristic (ROC) curves were generated and the area under the curve (AUC) was calculated at the 95 percentiles for both men and women.
The AUC score of ALT for men was 0.92, and the ULN for the serum ALT in men was found as 32.10 U/L (sensitivity of 0.89, specificity 0.85). The AUC score of ALT for women was 0.90, and the ULN for serum ALT was found as 23.15 U/L (sensitivity of 0.90, the specificity of 0.88).
ULN for serum ALT level should be lowered and different cut-off values should be used for men (32.10 U/L) and women (23.15 U/L).
近期研究报道，广泛认可的正常上限（ULN）丙氨酸氨基转移酶（ALT）水平范围（ULN<40U/L）对于健康人群而言偏高。我们旨在确定假定健康的肝脏人群组中男性和女性的正确ULN水平。
本研究对7410名前往体检诊所的健康受试者的数据进行了回顾性分析。根据超声检查发现的脂肪肝、慢性肝病、持续大量饮酒、糖尿病和血脂异常情况，将患者分为“健康肝脏组”（n = 2694）和“高风险肝脏组”（n = 4716）。绘制受试者工作特征（ROC）曲线，并计算男性和女性在第95百分位数时的曲线下面积（AUC）。
男性ALT的AUC评分为0.92，男性血清ALT的ULN为32.10 U/L（敏感性为0.89，特异性为0.85）。女性ALT的AUC评分为0.90，血清ALT的ULN为23.15 U/L（敏感性为0.90，特异性为0.88）。
血清ALT水平的ULN应降低，并且男性（32.10 U/L）和女性（23.15 U/L）应使用不同的临界值。
