Reference Interval of Some Liver Function Parameters in Adults of a Section of Indian Population and Age-Gender Variation

Abstract

Reference interval with age-gender variation for 4 liver function parameters in an adult segment of the Indian population L aboratory parameters have acquired a central role in medical practice because they provide an objective assessment of specific aspects of the health condition of an individual. The reference intervals of these parameters serve as a comparator to establish the diagnosis, interpret the severity of the condition, calibrate the treatment, and assess the prognosis, particularly when a patient is seen for the first time at a particular clinic. The appropriate intervals are necessary for the correct interpretation of the values of individuals seen in clinical practice. Preventive health checkups can use intervals to flag a warning sign. Most clinicians and laboratories in India use the reference intervals reported in books or literature provided by diagnostic kit manufacturers [1]. These are generally based on an American or European population, which in India are usually identified as Western [2]. However, as with almost all biological parameters, laboratory parameters, too, are likely to be affected by local factors such as genetic profile, ethnicity, physical characteristics, dietary habits, and environment. Thus, it is likely that they are different for the Indian population. There is a need to establish more specific reference intervals and examine if they are different from the norms currently in use. If they are different, the use of Western intervals may be causing unknown errors of misdiagnosis and missed diagnosis. If they are nearly the same, we can be confident of the validity in our practice. The Clinical and Laboratory Standards Institute (CLSI) mandates that the exercise of establishing norms should be based Objectives: The proper interpretation of the laboratory values seen in individuals depends on the validity of the reference intervals. These intervals may differ from one population to another due to variation in factors such as genetic profile, physical characteristics, and dietary intake. Reference intervals for most parameters are not available for the Indian population. This study presents reference intervals for 4 liver function parameters: total protein, albumin, globulin, and the albumin-globulin ratio for a segment of the Indian population, as well as a study of age trend and gender differences. Methods: The results were based on a minimum of 12.264 values for each parameter from individuals aged 0 to 98 years. These values were extracted from a large database of the laboratory of a tertiary care hospital after careful filtration of the appropriate reference values. The age-gender variation in the mean and median was examined and the reference intervals were obtained as 2.5 th to 97.5 th percentile. Results: There was a sufficient number of values in the various age groups and by gender except for the group aged 0-14 years. Therefore, this age group was excluded. The age trend was studied for males and females separately, as gender differences were substantial and consist...

Gender and Liver Steatosis Discriminate Different Physiological Patterns in Obese Patients Undergoing Bariatric Surgery: Obesity Center Cohort

“…Gender-related differences were not observed for WBC, neutrophils, and lymphocytes in the current study, unlike in previous findings [ 23 ], probably due to the pathological obesity condition. As demonstrated in literature, although its basis is still unclear, the A/G ratio was different by gender [ 24 ], but in this context, a lower ratio level (i.e., less albumin and more globulin) could be associated with a worse health condition in female patients. In the same health condition, higher beta globulin 2 was associated with peripheral arterial disease [ 25 ], and in our cohort, also with hypertension, that was a risk factor for vascular disorders [ 26 ].…”