iBet uBet web content aggregator. Adding the entire web to your favor.
iBet uBet web content aggregator. Adding the entire web to your favor.



Link to original content: http://pubmed.ncbi.nlm.nih.gov/38722987/
Establishment of dry-chemistry-based reference intervals of routine liver function tests for the adult population of Gandaki Province, Nepal - PubMed Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 9;4(5):e0001865.
doi: 10.1371/journal.pgph.0001865. eCollection 2024.

Establishment of dry-chemistry-based reference intervals of routine liver function tests for the adult population of Gandaki Province, Nepal

Affiliations

Establishment of dry-chemistry-based reference intervals of routine liver function tests for the adult population of Gandaki Province, Nepal

Asmita Sharma et al. PLOS Glob Public Health. .

Abstract

Every clinical laboratory should ideally establish its own population-specific reference intervals (RIs) to promote precision and evidence-based medicine. However, clinical laboratories in Nepal find it easier to follow external RIs than establish their own, leading to a lack of RIs specific to the local population. This study thus aimed to establish RIs of routine LFTs for the adult population of Gandaki Province, Nepal, and compare them with the current RIs used by our laboratory. We established the dry-chemistry-based reference intervals of 11 common LFT parameters for the adult population of Gandaki Province, Nepal using the direct priori-based method. The combined and sex-specific 95% double-sided RIs of total protein, albumin, globulin, A/G ratio, bilirubin, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), AST/ALT ratio, and alkaline phosphatase (ALP) were established using non-parametric percentile method. The new RIs were also compared with the currently used RIs that were adopted from the reagent kit inserts. The newly established RIs for each LFT were: Total proteins: 68.0-69.0g/L, albumin: 39.0-52.0g/L; globulin: 27.0-42.0g/L; A/G ratio: 1.1-1.8; total bilirubin: 5.13-25.65μmol/L (0.30-1.50mg/dl); unconjugated bilirubin: 1.71-17.10μmol/L (0.10-1.00mg/dl); conjugated bilirubin: 0.00-10.26 μmol/L (0.00-0.60mg/dl); AST: 20.0-43.2U/L; ALT: 11.0-53.0 U/L; AST/ALT ratio: 0.7-2.1; ALP: 42.0-135.4U/L. The RIs of albumin, globulin, A/G ratio, AST, ALT, and AST/ALT ratio differed significantly (p < 0.05) between males and females. Moreover, calculated out-of-range values showed that up to 4-40% of apparently healthy adults were classified as having abnormal test results based on current RIs. The newly established RIs fulfil the need for population and platform-specific RIs for the adult population of Gandaki Province of Nepal and bring more conformity and accuracy in interpreting the LFT results, diagnosis of hepatobiliary diseases, clinical decision-making, monitoring the success of therapy and future liver specific biomedical researches within the Gandaki Province of Nepal.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The political map of Nepal and its Gandaki Province showing the area of study.
(https://www.researchgate.net/publication/352155539_Marginal_gains_borderland_dynamics_political_settlements_and_shifting_centre-periphery_relations_in_post-war_Nepal/figures?lo=1).
Fig 2
Fig 2. The distribution pattern of the liver function test parameters in the study participants observed (orange boxes) versus standard (blue curves).
Fig 3
Fig 3. Correlation matrix showing a linear monotonic association between LFT parameters and other baseline covariates.

Similar articles

References

    1. Trefts E, Gannon M, Wasserman DH. The liver. Curr Biol. 2017;27(21):R1147–51. doi: 10.1016/j.cub.2017.09.019 - DOI - PMC - PubMed
    1. Mijač D, Krstić MN, Marković AP, Popović DD, Krstić JM, Milosavljević T. Abnormal Liver Blood Tests: Primary Care Approach. Dig Dis. 2022;40(2):215–22. - PubMed
    1. Johnston DE. Special considerations in interpreting liver function tests. Am Fam Physician. 1999;59(8):2223–30. - PubMed
    1. Boyd JC. Defining laboratory reference values and decision limits: Populations, intervals, and interpretations. Asian J Androl [Internet]. 2010;12(1):83–90. Available from: doi: 10.1038/aja.2009.9 - DOI - PMC - PubMed
    1. Gary L. Horowitz Sousan Altaie, PhD, James C. Boyd MD et al.. MD. EP28-A3c: Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Guideline—Third Edition. Clin Lab Stand Inst. 2010;(October).

Grants and funding

AS got Masters Thesis Grant from the University Grants Commission Nepal (grant number (MRS-78-79-HS-05)) https://www.ugcnepal.edu.np and have met all the conditions. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

LinkOut - more resources