title: Reference intervals for total bilirubin, ALT, AST and creatinine in healthy Chinese elderly.
abstract: BACKGROUND
  The aim of this study was to establish the reference intervals (RIs) of total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate transaminase (AST), and creatinine (CREA) for apparently healthy elderly (Han ethnicity) in Shuyang, China.
  
  
  METHODS
  A total of 54 912 blood specimens from elderly residents age 65-104 years were collected by standard procedures in Shuyang county of Jiangsu province. TBIL, ALT, AST, and CREA for each participant were determined by automatic biochemical analyzer. Distribution and differences of TBIL, ALT, AST, and CREA were analyzed and compared between the elderly of the same age of different sexes and different ages of the same sex. RIs of TBIL, ALT, AST, and CREA were compared with the current RIs. The RIs and 95% confidence intervals were calculated using nonparametric method (2.5th-97.5th percentiles) according to the guideline of the Clinical and Laboratory Standards Institute.
  
  
  RESULTS
  RIs established for the healthy elderly include: TBIL 7.8~30.6 µmol/L for males and 7.3~26.1 µmol/L for females; ALT 8.7~47.3 U/L for males and 8.4~45.2 U/L for females; AST 15.7~46.9 U/L for males and 15.1~46.2 U/L for females; and CREA 45.1~100.9 µmol/L for males and 38.7~85.0 µmol/L for females. Reference intervals of TBIL, ALT, AST, and CREA for male elderly were higher than those of females, and values of CREA increased with increasing age.
  
  
  CONCLUSIONS
  We have established a panel of locally relevant RIs. It is necessary to establish scientific and reasonable RIs of TBIL, ALT, AST, and CREA for the healthy elderly in our region, which will provide a reference for clinicians and inspection officers.
authors.affiliation: Laboratory, Shuyang People's Hospital, Shuyang, China (mainland).
authors.forename: Guo-ming
authors.initials: GM
authors.lastname: Zhang
authors.affiliation: School of Public Healths, Fudan University, Shanghai, China (mainland).
authors.forename: Yong-jie
authors.initials: YJ
authors.lastname: Xia
authors.affiliation: Laboratory, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China (mainland).
authors.forename: Xu-xiao
authors.initials: XX
authors.lastname: Guo
authors.affiliation: Department of Orthopaedics, Shuyang People's Hospital, Shuyang, China (mainland).
authors.forename: Bao-lin
authors.initials: BL
authors.lastname: Zhu
authors.affiliation: Laboratory, Shuyang People's Hospital, Shuyang, China (mainland).
authors.forename: Gao-ming
authors.initials: GM
authors.lastname: Zhang
authors.affiliation: Laboratory, Shuyang People's Hospital, Shuyang, China (mainland).
authors.forename: Xiao-bo
authors.initials: XB
authors.lastname: Ma
authors.affiliation: Laboratory, Shuyang People's Hospital, Shuyang, China (mainland).
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.affiliation: Laboratory, Shuyang People's Hospital, Shuyang, China (mainland).
authors.forename: Hong-jian
authors.initials: HJ
authors.lastname: Wang
authors.affiliation: Department of Neurology, Shuyang People's Hospital, Shuyang, China (mainland).
authors.forename: Guang-sheng
authors.initials: GS
authors.lastname: Wang
authors.affiliation: Laboratory, Shuyang People's Hospital, Shuyang, China (mainland).
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of General Surgery, Shuyang People's Hospital, Shuyang, China (mainland).
authors.forename: Ye-ting
authors.initials: YT
authors.lastname: Zhou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood*; D044466:Asian People; D001219:Aspartate Aminotransferases / Q000097:blood*; D001663:Bilirubin / Q000097:blood*; D002681:China; D003404:Creatinine / Q000097:blood*; D005260:Female; D006262:Health; D006801:Humans; D008297:Male; D012016:Reference Values
chemical_list: D003404:Creatinine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin