Reference Intervals of Total Bilirubin, ALT, AST, and Creatinine in Healthy Elderly Chinese

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. Material/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 similar to 30.6 mu mol/L for males and 7.3 similar to 26.1 mu mol/L for females; ALT 8.7 similar to 47.3 U/L for males and 8.4 similar to 45.2 U/L for females; AST 15.7 similar to 46.9 U/L for males and 15.1 similar to 46.2 U/L for females; and CREA 45.1 similar to 100.9 mu mol/L for males and 38.7 similar to 85.0 mu mol/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.