title: Estimation of normal values of serum transaminases based on liver histology in healthy Asian Indians.
abstract: OBJECTIVE
  Liver biopsy-based studies have shown that serum levels of aminotransferases are lower than conventional cut-off of 40 IU/mL in persons with normal histology. There is no such study in Indian population based on liver histology. This study aims to estimate normal values of serum aminotransferases in healthy Indian population with normal liver histology.
  
  
  METHODS
  This retrospective study includes all liver donors who underwent liver donation at our centre and had a preoperative liver biopsy done for various reasons. All the donors had negative viral markers. Nonalcoholic fatty liver (NAFL) was defined as > 5% hepatocytes having steatosis and no changes of steatohepatitis.
  
  
  RESULTS
  The study included 331 donors (147 males) with the ages of 35.7 ± 10.2 years. NAFL was present in 167 donors (50.4%). In comparison with male donors with normal histology (n = 67), donors with NAFL (n = 80) had significantly higher age, body mass index, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, gamma-glutamyl transpeptidase, total cholesterol, low-density lipoprotein, and fasting blood sugar. In comparison with female donors with normal histology, donors with NAFL had significantly higher body mass index, ALT, and triglycerides; however, there was no significant difference regarding other parameters. Of the AST and ALT in normal histology donors, 95th percentile were 33.8 IU/L and 38.6 IU/L for males and 31 IU/L and 35.2 IU/L for females. Twenty-five donors had lean NAFL (body mass index < 23 kg/m2).
  
  
  CONCLUSIONS
  Serum aminotransferase values in healthy Asian Indian population with normal histology are provided. Histological NAFL is present in half of apparently normal donors, and it has different clinical and biochemical associations in males and females.
authors.affiliation: Medanta Liver Institute, Medanta The Medicity, Gurgaon, Haryana, India.
authors.forename: Narendra S
authors.initials: NS
authors.lastname: Choudhary
authors.forename: Neeraj
authors.initials: N
authors.lastname: Saraf
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Saigal
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Gautam
authors.forename: Lipika
authors.initials: L
authors.lastname: Lipi
authors.forename: Arvinder S
authors.initials: AS
authors.lastname: Soin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008099:Liver / Q000473:pathology*; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology* / Q000473:pathology*; D012016:Reference Values; D012189:Retrospective Studies; D012727:Sex Characteristics; D000637:Transaminases / Q000097:blood*
chemical_list: D000637:Transaminases
keywords: alanine aminotransferase; aspartate aminotransferase; biopsy; donor; histology; liver