Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
J Pediatr Gastroenterol Nutr. 2024 Jun;78(6):1383-1388. doi: 10.1002/jpn3.12167. Epub 2024 Mar 13.
Data on alanine aminotransferase (ALT) measurement practices and diagnoses associated with increased values are limited. We evaluated these issues by collecting ALT measurements from 1- to 16-year-old patients investigated in 1992-2018 in a tertiary center. Diagnoses were gathered in 2008-2018. Altogether 145,092 measurements from 28,118 children were taken 42% undergoing repeated testing. Testing increased from 21/1000 to 81/1000 children and the prevalence of elevated values fluctuated between 18% and 26%. An increase was seen especially in emergency care and departments of rheumatology, gastroenterology, hemato-oncology, and psychiatry. Common acute causes associated with elevated ALT were infections (45%), hemato-oncologic conditions (17%), and external reasons (13%), whereas autoimmune diseases (28%), psychiatric conditions (14%), and metabolic-dysfunction associated steatotic liver disease (10%) were common chronic causes. In conclusion, ALT testing increased 3.9-fold while the proportion of increased values remained stable, indicating that increased testing was justified. However, in some departments the testing efficiency was low.
有关丙氨酸氨基转移酶（ALT）测量实践和与升高值相关的诊断的数据有限。我们通过收集 1992-2018 年在一家三级中心接受调查的 1-16 岁患者的 ALT 测量值来评估这些问题。诊断是在 2008-2018 年收集的。总共对 28118 名儿童的 145092 次测量值进行了分析，其中 42%的儿童进行了重复测试。检测次数从 21/1000 增加到 81/1000，升高值的患病率在 18%至 26%之间波动。这种增加尤其出现在急诊和风湿病、胃肠病、血液肿瘤和精神科。与 ALT 升高相关的常见急性原因是感染（45%）、血液肿瘤疾病（17%）和外部原因（13%），而自身免疫性疾病（28%）、精神科疾病（14%）和代谢功能紊乱相关的脂肪性肝病（10%）是常见的慢性原因。总之，ALT 检测增加了 3.9 倍，而升高值的比例保持稳定，这表明增加检测是合理的。然而，在某些科室，检测效率较低。
