Establishment of Reference Intervals For Serum Liver Function Tests Among Healthy Elderly Population In Northeast China: A Retrospective Study

Background: Liver function changes with age, however, there are few studies that are specific for the elderly. This study is aimed to establish reference intervals (RIs) of serum liver function tests among healthy elderly population aged between 60-89 in northeast China. Methods: : Subjects were colleted from laboratory information system (LIS) in the First Hospital of Jilin University. The following parameters were collected: aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), total protein (TP) albumin (ALB), total bilirubin (TBIL), and direct bilirubin (DBIL). Tukey method was used to eliminate outliers. The Harris and Boyd method and Mann-Whitney U-test were performed to evaluate significant differences between subgroups of sex and age. The lambda-mu-sigma (LMS) method was used to analyze the dynamic changes of analytes. RIs were established by the non-parametric method. Results: : A total of 23597 healthy individuals, including 20048 subjects (18-59 years old) and 3549 subjects (60-89 years old) were enrolled in the study. AST, ALT, TP and ALB required no sex partition. Except for AST, ALP and TBIL, ALT, GGT, TP, ALB and DBIL required different levels of age partitions. Serum ALT and ALB levels decreased with age, ALB showed apparent decreases throughout the aging process. DBIL showed an increase trend over time. This study showed different results compared with RIs in other studies. Conclusions: : The RIs for liver function tests among healthy elderly population were different from those of other young individuals. There were apparent sex or age differences in the RIs of liver function for the elderly. Therefore, it is necessary to establish sex- and age-specific RIs of serum liver function tests among elderly population.