Establishment of Biological Reference Interval for Liver Function Test in Tertiary Care Hospital in the Rural Area of Anand District
Authors/Creators
- 1. Associate Professor, Department of Biochemistry, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat
- 2. M.Sc. MLT Student, Bhaikaka University, Karamsad, Gujarat
Description
Background: The concept of reference intervals was introduced by the international federation of clinical chemistry IFCC to avoid the problems with normal values and values obtained from an individual under clinical investigation. In India, the reference value of LFT used in laboratories has been adopted from those reported for the western population. The reference range varies considerably from one laboratory to another and is dependent on the population diet, methodology, and selection of reference group needs of the clinicians. Aims and Objectives: To establish reference intervals of LFT which include alkaline phosphatase, bilirubin (total, direct, indirect), total protein, albumin, globulin, A/G ratio, SGPT, SGOT in healthy individuals attending routine health checkups at rural tertiary care hospital of Gujarat. Materials and Method: The posterior sampling was done over the period September 2018 to July 2019. The study was done at the clinical biochemistry department of tertiary care hospital in a rural area. In our study, we took 901 individuals who came to the hospital for their routine health check-ups after applying Inclusion & Exclusion criteria. The partitioning was done according to age (18-30, 31-40, 41-50, 51-60, 61-70, 70 and above years) and sex. Analysis was performed using the commercially available statistical software Stata for each analyte. Results: We compared the reference range derived with the biological reference interval being used currently in the laboratory. Values compared for ALP (u/l), Bilirubin Total (mg/dl), Bilirubin Direct (mg/dl), Bilirubin Indirect (mg/dl), Total protein (g/dl), Albumin (g/dl), A/G Ratio (g/dl), SGPT (u/l), SGOT (u/l). Values derived in our study for Males: – 54.07-87.70, 0.34-0.88, 0.08-0.22, 0.22-0.70, 6.91-7.81, 3.54-4.12, 0.91-1.27, 23.90-45.32, 17.41-30.39 and for Females: – 54.64-93.45, 0.28-0.70, 0.05-0.21, 0.17-0.53, 6.97-7.85, 3.45-4.01, 0.87-1.17, 20.44- 40.94, 16.15- 30.25 respectively. Conclusion: It was seen that the reference range of most liver function test parameters varies when compared with other reference ranges and reference ranges being used in the laboratory. The reason for the same was that the liver function test may vary according to age groups, epidemiological areas, and ethnicity.
Abstract (English)
Background: The concept of reference intervals was introduced by the international federation of clinical chemistry IFCC to avoid the problems with normal values and values obtained from an individual under clinical investigation. In India, the reference value of LFT used in laboratories has been adopted from those reported for the western population. The reference range varies considerably from one laboratory to another and is dependent on the population diet, methodology, and selection of reference group needs of the clinicians. Aims and Objectives: To establish reference intervals of LFT which include alkaline phosphatase, bilirubin (total, direct, indirect), total protein, albumin, globulin, A/G ratio, SGPT, SGOT in healthy individuals attending routine health checkups at rural tertiary care hospital of Gujarat. Materials and Method: The posterior sampling was done over the period September 2018 to July 2019. The study was done at the clinical biochemistry department of tertiary care hospital in a rural area. In our study, we took 901 individuals who came to the hospital for their routine health check-ups after applying Inclusion & Exclusion criteria. The partitioning was done according to age (18-30, 31-40, 41-50, 51-60, 61-70, 70 and above years) and sex. Analysis was performed using the commercially available statistical software Stata for each analyte. Results: We compared the reference range derived with the biological reference interval being used currently in the laboratory. Values compared for ALP (u/l), Bilirubin Total (mg/dl), Bilirubin Direct (mg/dl), Bilirubin Indirect (mg/dl), Total protein (g/dl), Albumin (g/dl), A/G Ratio (g/dl), SGPT (u/l), SGOT (u/l). Values derived in our study for Males: – 54.07-87.70, 0.34-0.88, 0.08-0.22, 0.22-0.70, 6.91-7.81, 3.54-4.12, 0.91-1.27, 23.90-45.32, 17.41-30.39 and for Females: – 54.64-93.45, 0.28-0.70, 0.05-0.21, 0.17-0.53, 6.97-7.85, 3.45-4.01, 0.87-1.17, 20.44- 40.94, 16.15- 30.25 respectively. Conclusion: It was seen that the reference range of most liver function test parameters varies when compared with other reference ranges and reference ranges being used in the laboratory. The reason for the same was that the liver function test may vary according to age groups, epidemiological areas, and ethnicity.
Files
IJPCR,Vol14,Issue4,Article47.pdf
Files
(240.1 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:892233c76da9f56009213a4446437e14
|
240.1 kB | Preview Download |
Additional details
Dates
- Accepted
-
2022-03-11
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue4,Article47.pdf
- Development Status
- Active
References
- 1. Green RM, Flamm S.AGA technical review on the evaluation of liver chemistry tests. Gastroenterology.2002; 123:1367- 1384. 2. international federation of clinical chemistry, expert panel on theory of reference values. Approved recommendation on the theory of reference values. part 1. The concept of reference values. J Clin chem Clin biochem 1987;25:337-42; part 2 selection of individual for the production of reference values. J Clin Chem Biochem 1987;25:693-43: part 3.preparation of individuals and collection of specimens for the production of reference values. J Clin chem Clin biochem 1988: 26:593-8: part 4. Control of analysis variation in the production transfer and application of reference values. Eur J Clin chem Clin Biochem 1991:29: 531-5, part-5. Statistical treatment of collected reference values: determination of reference limits. J Clin Chem Biochem 1987; 25:645-56; part-6. Presentation of observed values related to reference values. J Clin Chem Biochem 1987; 25:657-62. 3. Burtis CA, aswood ER, Eds, Establishment, and use of reference values: Tietz textbook of clinical biochemistry, WB saunders company,1990. 4. Solberg HE. International federation of clinical chemistry, expert panel on the theory of reference values: approved recommendation on the theory of reference values. Part 1-The concept of reference values. Journal of clinical chemistry and clinical biochemistry. 1987; 25:337-42. 5. Jorgensen LGM, Stahl M, brandslund I, Petersen HP, Jensen BK, olivaceous N plasma glucose reference interval in a low–risk population. 2 Impact of the WHO ADA recommendations on the diagnosis of diabetes Mellitus. Scand J Clin chem lab invest 2001;61 181-90. 6. Clinical and laboratory standards institute, defining, establishing, and verifying reference intervals in the clinical laboratory; Approved guideline.3rd edition. CLSI document C 28-A3. Wayne, PA; clinical and laboratory standards institute 2008.7. Burtis, C.A. and aswood, E.R. Establishment and use 0f Reference Values. In: Tietz Textbook of clinical chemistry. Chapter 14 3rd edition W.B. saunders company, Philadelphia U.S.A, 1999; 336-356. 8. Alice J, Eliud NM, Joseph JN. Estimation of reference values for liver function tests for the adult population in North‐Rift Valley, Kenya. Asian J Med Sci 2011; 3:243–249. 9. Sultana Furruqh, D. Anitha, and T. Venkatesh, Estimation of Reference Values In Liver Function Test In Health Plan Individuals Of An Urban South Indian Population. Indian journal of clinical biochemistry,2004,19(2):72- 79. 10. L. Xia, L. Qiu, X. Cheng, et al. Nationwide multicenter reference interval study for 28 common biochemical analytes in China. Medicine (Baltimore). 2016 Mar;95(9): e2915.