An exploratory study of some pediatric liver function parameters in a segment of North Indian children

INTRODUCTION: Western clinical reference levels may not be valid for children in India because of differences in genetic profile, physique, dietary intake, lifestyle, and environmental factors; however, appropriate values for most biochemical parameters for children in India remain unknown. This study is an analysis of the total protein, albumin, globulin, albumin-globulin ratio, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, and alkaline phosphatase (ALP) levels in the serum of a segment of apparently healthy Indian children of aged 0-14 years.
METHODS: Liver function data from tests conducted between January and June of 2019 for 371 children were extracted from the laboratory records of a tertiary care hospital and double-filtered to obtain uncontaminated values. The data were statistically tested for significance by age group and sex. Reference ranges of 2.5th and 97.5th percentiles were determined for age groups of 1-4, 5-9, and 10-14 years. Due to the limitation of the sample size, we did not provide a reference range for children aged less than 1 year.
RESULTS: A significant sex difference (p<0.001) was observed only for the ALP level. Age group differences were not significant (all p>0.05); however, reference ranges were provided for age groups within 1-14 years to provide specificity and assist with comparisons. The liver function values in the study group of Indian children differed from what have been reported for Western children.
DISCUSSION AND CONCLUSION: The findings are suggestive and not confirmatory, as our sample was insufficient for a determination of definitive values. Nonetheless, the results provide valuable information and indicate a need to carry out more studies to delineate liver function parameters in Indian children since the values may differ from those of other populations.