An Assessment of Upper Limits of Normal for ALT and the Impact on Evaluating Natural Course of Chronic Hepatitis B Virus Infection in Chinese Children

doi:10.1038/s41395-018-0248-8

科研成果详情

题名	An Assessment of Upper Limits of Normal for ALT and the Impact on Evaluating Natural Course of Chronic Hepatitis B Virus Infection in Chinese Children
作者	Pan, Xiao-Ben 1,2; Lu, Yu-Qing 2; Lin, Sheng-Zhang 3; Ye, Jing 4; Wu, Nan 2; Lou, Yun-Yan 5; Ni, Li5; Han, Jin-Chao 2; Zheng, Xiao-Qun5; Wei, Lai 2
发表日期	2018-11
发表期刊	AMERICAN JOURNAL OF GASTROENTEROLOGY 影响因子和分区
语种	英语
原始文献类型	Article
其他关键词	SERUM ALANINE AMINOTRANSFERASE ; MEDIATED IMMUNE-RESPONSE ; HISTORY ; ANTIGEN ; TAIWAN ; DNA
摘要	BACKGROUND: The current upper limits of normal (ULN) for serum alanine aminotransferase (ALT) are increasingly challenged. We aimed to re-evaluate the ULN for ALT and assess the potential impact on the classification of natural course of chronic hepatitis B virus (HBV) infection in children. METHODS: Laboratory data obtained from three hospitals in China were retrospectively analysed. In total, 2054 children with chronic HBV infection and 8149 healthy children at age <= 18 years were included in the study. RESULTS: Age-specific and gender-specific ULNs for ALT, at averages of 30 U/L for boys and 24 U/L for girls, were calculated from the data of healthy children. Using the revised ULNs vs. the current ULNs (40-50 U/L), 31-60% vs. 9-17% of the 2054 HBV-infected children had an abnormal result as seen in their ALT baseline analysis, and the highest abnormality rate was seen in the infants. Data of 516 HBV-infected children were applied for the classification of clinical phase, 28.8% vs. 19.8% of the children were classified into the phases of hepatitis B e antigen (HBeAg-) positive/negative hepatitis. During a median follow-up of 62 months, 39 of 153 children underwent HBeAg seroconversion, whereas 3 of them had persistently normal ALT, according to the current ULN. CONCLUSIONS: The revision of ULN for ALT in children substantially impacts the classification of the natural course of chronic HBV infection. Mild ALT fluctuation is common during the stage childhood, suggesting a need to rethink the current conceptions of immune tolerance and natural course of chronic HBV infection in the children. SUPPLEMENTARY MATERIAL accompanies this paper
资助项目	National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81370540, 81670530]
出版者	NATURE PUBLISHING GROUP
出版地	NEW YORK
ISSN	0002-9270
EISSN	1572-0241
卷号	113 期号:11 页码:1660-1668
DOI	10.1038/s41395-018-0248-8
页数	9
WOS类目	Gastroenterology & Hepatology
WOS研究方向	Gastroenterology & Hepatology
WOS记录号	WOS:000454017900018
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	30353056
SCOPUSEID	2-s2.0-85055497929
通讯作者地址	[Pan, Xiao-Ben]Hangzhou Key Laboratory of Inflammation and Immunoregulation,Department of Basic Medical Science,School of Medicine,Hangzhou Normal University,Hangzhou,China
Scopus学科分类	Hepatology;Gastroenterology
TOP期刊	TOP期刊
引用统计	被引频次：6[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/9464
专题	第二临床医学院，附属第二医院、育英儿童医院附属第二医院第二临床医学院，附属第二医院、育英儿童医院_临床检验诊断学
通讯作者	Pan, Xiao-Ben
作者单位	1.Hangzhou Key Laboratory of Inflammation and Immunoregulation,Department of Basic Medical Science,School of Medicine,Hangzhou Normal University,Hangzhou,China; 2.Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases,Peking University People’s Hospital,Peking University Hepatology Institute,Beijing,China; 3.Department of Hepato-Biliary-Pancreatic Surgery,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,China; 4.Department of Surgery Intensive Care Unit,The Children’s Hospital,Zhejiang University School of Medicine,Hangzhou,China; 5.Department of Clinical Laboratory,The Yuying Children’s Hospital of Wenzhou Medical University and The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,China
推荐引用方式 GB/T 7714	Pan, Xiao-Ben,Lu, Yu-Qing,Lin, Sheng-Zhang,et al. An Assessment of Upper Limits of Normal for ALT and the Impact on Evaluating Natural Course of Chronic Hepatitis B Virus Infection in Chinese Children[J]. AMERICAN JOURNAL OF GASTROENTEROLOGY,2018,113(11):1660-1668.
APA	Pan, Xiao-Ben., Lu, Yu-Qing., Lin, Sheng-Zhang., Ye, Jing., Wu, Nan., ... & Wei, Lai. (2018). An Assessment of Upper Limits of Normal for ALT and the Impact on Evaluating Natural Course of Chronic Hepatitis B Virus Infection in Chinese Children. AMERICAN JOURNAL OF GASTROENTEROLOGY, 113(11), 1660-1668.
MLA	Pan, Xiao-Ben,et al."An Assessment of Upper Limits of Normal for ALT and the Impact on Evaluating Natural Course of Chronic Hepatitis B Virus Infection in Chinese Children".AMERICAN JOURNAL OF GASTROENTEROLOGY 113.11(2018):1660-1668.