The present study aims to clarify the effects of sex, age, body mass index (BMI), and puberty on transaminase serum levels in children and adolescents and to provide new age‐ and sex‐related percentiles for alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ‐glutamyltransferase (GGT). Venous blood and anthropometric data were collected from 4,126 cases. Excluded were cases of participants with potential hepatotoxic medication, with evidence of potential illness at the time of blood sampling and non‐normal BMI (BMI <10th or >90th). The resulting data (N = 3,131 cases) were used for the calculations of ALT, AST, and GGT percentiles. Age‐ and sex‐related reference intervals were established by using an LMS method of Cole–type method. Serum levels of transaminases follow age‐specific patterns and relate to the onset of puberty. This observation is more pronounced in girls than in boys. ALT percentiles showed similar‐shaped patterns in both sexes. Multivariate regression confirmed significant effects of puberty and BMI‐SDS (β = 2.21) on ALT. Surprisingly, AST serum levels were negatively influenced by age (β = −1.42) and BMI‐SDS (β = −0.15). GGT percentiles revealed significant sex‐specific differences, correlated positively with age (β = 0.37) and showed significant association with BMI‐SDS (β = 1.16). Conclusion: Current reference values of ALT, AST, and GGT serum levels were calculated for children between 11 months and 16.0 years, using modern analytical and statistical methods. This study extends the current knowledge about transaminases by revealing influences of age, sex, BMI, and puberty on serum concentrations of all three parameters and has for these parameters one of the largest sample sizes published so far. (Hepatology 2017).

中文翻译：

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新的儿科肝酶血清水平百分位数（ALT、AST、GGT）：年龄、性别、BMI 和青春期阶段的影响

本研究旨在阐明性别、年龄、体重指数 (BMI) 和青春期对儿童和青少年血清转氨酶水平的影响，并为丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶提供新的年龄和性别相关百分位数。 (AST) 和 γ-谷氨酰转移酶 (GGT)。从 4,126 例病例中收集了静脉血和人体测量数据。排除了具有潜在肝毒性药物、在采血时有潜在疾病证据和非正常 BMI（BMI <10th 或 >90th）的参与者的病例。所得数据（N = 3,131 例）用于计算 ALT、AST 和 GGT 百分位数。使用Cole-type方法的LMS方法建立与年龄和性别相关的参考区间。血清转氨酶水平遵循特定年龄模式，并与青春期的开始有关。这种观察在女孩中比在男孩中更为明显。ALT 百分位数在两性中都显示出相似形状的模式。多变量回归证实了青春期和 BMI-SDS (β = 2.21) 对 ALT 的显着影响。令人惊讶的是，AST 血清水平受年龄 (β = -1.42) 和 BMI-SDS (β = -0.15) 的负面影响。GGT 百分位数显示出显着的性别差异，与年龄呈正相关（β = 0.37），并与 BMI-SDS 显着相关（β = 1.16）。结论：使用现代分析和统计方法计算了 11 个月至 16.0 岁儿童的 ALT、AST 和 GGT 血清水平的当前参考值。本研究通过揭示年龄、性别、BMI 和青春期对所有三个参数的血清浓度的影响，并且这些参数是迄今为止公布的最大样本量之一。（肝病学 2017）。