中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 6
Jun.  2025
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(6): 1062-1067

Correlation between the serum levels of aminotransferases and liver inflammation activity in pediatric chronic hepatitis B patients： An analysis of 1 267 cases

DOI: 10.12449/JCH250610
  • 1.

    307 Clinical College，Anhui Medical University，Beijing 100071，China

  • 2a.

    Department of Pathology and Hepatology，The Fifth Medical Center of Chinese PLA General Hospital，Beijing 100039，China

  • 2b.

    Department of Clinical Laboratory，The Fifth Medical Center of Chinese PLA General Hospital，Beijing 100039，China

Research funding:

National Key R & D Program of China (2023YFC2308104);

National Key R & D Program of China (2023YFC2308100);

Beijing Natural Science Foundation-Haidian Primitive Innovation Joint Fund (L202025)

More Information
  • Corresponding author: ZHAO Jingmin， jmzhao302@163.com （ORCID： 0000-0003-4345-2149）
  • Received Date: 2024-03-03
  • Accepted Date: 2024-12-30
  • Published Date: 2025-06-25
    Abstract
  •   Objective  To investigate the correlation of the serum levels of aminotransferases and their ratios with liver inflammation activity in pediatric chronic hepatitis B （pCHB） patients， and to provide a basis for selecting the dominant population for treatment.  Methods  This study was conducted among 1 267 pCHB patients who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2010 to August 2022 and these patients did not receive antiviral therapy. The patients were analyzed in terms of demographic features， blood routine， blood biochemistry， HBV serological markers， and liver biopsy data. According to liver inflammation activity based on liver biopsy， the patients were divided into no or mild inflammation activity （G0‍ ‍—‍ ‍G1） group and significant inflammation activity （G2‍ ‍—‍ ‍G4） group. The serum levels of aminotransferases and their ratios were compared between groups， and their correlation with liver inflammation activity in pCHB patients was analyzed. Additionally， the patients were stratified by the age， and the relationship between serum aminotransferase levels and liver inflammation activity was analyzed in each age group. For comparison of continuous data between two groups， the independent samples t-test was used when the data were normally distributed， while the Mann-Whitney U test was used when the data were not normally distributed； the chi-square test was employed for comparison of categorical data between two groups. A Spearman’s correlation analysis was performed for correlation assessment.  Results  Among the 1 267 pCHB patients， there were 468 （36.9%） in the G0‍ ‍—‍ ‍G1 group and 799 （63.1%） in the G2‍ ‍—‍ ‍G4 group， and there were significant differences between the two groups in the levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， AST/ALT ratio， gamma-glutamyl transpeptidase （GGT）， total bilirubin， direct bilirubin， HBeAg quantification， low-density lipoprotein， and platelet count （PLT） （all P<0.05）. The correlation analysis showed that liver inflammation activity was negatively correlated with PLT and low-density lipoprotein （both P<0.05） and was positively correlated with GGT， total bilirubin， direct bilirubin， and HBeAg titer （all P<0.05）， while it was not significantly correlated with ALT， AST， and AST/ALT ratio （all P>0.05）. In the 0‍ ‍—‍ ‍12 years group， the 13‍ ‍—‍ ‍18 years male group， and the 13‍ ‍—‍ ‍18 years female group， liver inflammation activity aggravated with the increases in the serum levels of ALT and AST， and there were significant differences between groups （all P<0.05）. In the 0‍ ‍—‍ ‍12 years group， there was a significant difference in significant liver inflammation activity between the AST/ALT ratio >1 group and the AST/ALT ratio ≤1 group （P<0.001）. Among the 1 267 patients， 447 （35.28%） had an ALT level of <2×upper limit of normal （ULN）， among whom 196 （43.85%） had G≥2 liver inflammation， accounting for 15.47% of all children enrolled.  Conclusion  Liver inflammation activity is not significantly correlated with ALT， AST， and AST/ALT ratio in pCHB patients， suggesting that the serum levels of aminotransferases cannot truly reflect liver inflammation activity in pCHB patients with an aminotransferase level of <2×ULN. In clinical practice， liver biopsy should be performed for children with an aminotransferase level of <2×ULN to clarify whether antiviral therapy should be performed.

     

    • FullText(HTML)
  • loading
    • References(21)
  • [1]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B[J]. Infect Dis Info, 2023, 36( 1): 1- 17. DOI: 10.3969/j.issn.1007-8134.2023.01.01.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2022年版)[J]. 传染病信息, 2023, 36( 1): 1- 17. DOI: 10.3969/j.issn.1007-8134.2023.01.01.
    [2]
    CUI F, SHEN L, LI L, et al. Prevention of chronic hepatitis B after 3 decades of escalating vaccination policy, China[J]. Emerg Infect Dis, 2017, 23( 5): 765- 772. DOI: 10.3201/eid2305.161477.
    [3]
    Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J]. J Clin Hepatol, 2011, 27( 1): 113- 128.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2010年版)[J]. 临床肝胆病杂志, 2011, 27( 1): 113- 128.
    [4]
    DESMET VJ, GERBER M, HOOFNAGLE JH, et al. Classification of chronic hepatitis: diagnosis, grading and staging[J]. Hepatology, 1994, 19( 6): 1513- 1520.
    [5]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and therapy of hepatic fibrosis(2019)[J]. J Clin Hepatol, 2019, 35( 10): 2163- 2172. DOI: 10.3969/j.issn.1001-5256.2019.10.007.

    中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会. 肝纤维化诊断及治疗共识(2019年)[J]. 临床肝胆病杂志, 2019, 35( 10): 2163- 2172. DOI: 10.3969/j.issn.1001-5256.2019.10.007.
    [6]
    National Health Commission. Reference intervals of clinical biochemistry tests commonly used for children: WS/T 780-2021[S/OL].( 2021-04-09). http://www.nhc.gov.cn/wjw/s9492/202105/170ca00246014d18b82a61cabf9fdb2f.shtml. http://www.nhc.gov.cn/wjw/s9492/202105/170ca00246014d18b82a61cabf9fdb2f.shtml

    国家卫生健康委员会. 儿童临床常用生化检验项目参考区间: WS/T 780-2021[S/OL].( 2021-04-09). http://www.nhc.gov.cn/wjw/s9492/202105/170ca00246014d18b82a61cabf9fdb2f.shtml. http://www.nhc.gov.cn/wjw/s9492/202105/170ca00246014d18b82a61cabf9fdb2f.shtml
    [7]
    LEE HM, BANINI BA. Updates on chronic HBV: Current challenges and future goals[J]. Curr Treat Options Gastroenterol, 2019, 17( 2): 271- 291. DOI: 10.1007/s11938-019-00236-3.
    [8]
    LIU CR, LI YP, DANG HX, et al. Predictors of clinical cure for chronic hepatitis B[J/CD]. Chin J Liver Dis(Electronic Version), 2024, 16( 4): 1- 7. DOI: 10.3969/j.issn.1674-7380.2024.04.001.

    刘晨瑞, 李亚萍, 党寒香, 等. 慢性乙型肝炎临床治愈预测指标[J/CD]. 中国肝脏病杂志(电子版), 2024, 16( 4): 1- 7. DOI: 10.3969/j.issn.1674-7380.2024.04.001.
    [9]
    QI Q, YAO X, YANG GD, et al. Clinical application of recommended antiviral drugs for patients with hepatitis B virus-related decompensated cirrhosis[J]. Int J Virol, 2023, 30( 3): 248- 250. DOI: 10.3760/cma.j.issn.1673-4092.2023.03.015.

    其七, 姚欣, 杨国栋, 等. 推荐用于乙肝肝硬化失代偿期病例抗病毒治疗药物的临床应用现状[J]. 国际病毒学杂志, 2023, 30( 3): 248- 250. DOI: 10.3760/cma.j.issn.1673-4092.2023.03.015.
    [10]
    European Association for the Study of the Liver. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection[J]. J Hepatol, 2017, 67( 2): 370- 398. DOI: 10.1016/j.jhep.2017.03.021.
    [11]
    AMERNIA B, MOOSAVY SH, BANOOKH F, et al. FIB-4, APRI, and AST/ALT ratio compared to FibroScan for the assessment of hepatic fibrosis in patients with non-alcoholic fatty liver disease in bandar Abbas, Iran[J]. BMC Gastroenterol, 2021, 21( 1): 453. DOI: 10.1186/s12876-021-02038-3.
    [12]
    NI LP, YU D, WU TF, et al. Gender-specific association between non-alcoholic fatty liver disease and type 2 diabetes mellitus among a middle-aged and elderly Chinese population: An observational study[J]. Medicine(Baltimore), 2021, 100( 6): e24743. DOI: 10.1097/MD.0000000000024743.
    [13]
    HUI CK, LEUNG N, YUEN ST, et al. Natural history and disease progression in Chinese chronic hepatitis B patients in immune-tolerant phase[J]. Hepatology, 2007, 46( 2): 395- 401. DOI: 10.1002/hep.21724.
    [14]
    TERRAULT NA, LOK ASF, MCMAHON BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance[J]. Hepatology, 2018, 67( 4): 1560- 1599. DOI: 10.1002/hep.29800.
    [15]
    ZHUANG H. Should chronic hepatitis B in the indeterminate phase be treated?[J]. J Clin Hepatol, 2021, 37( 9): 2033- 2036. DOI: 10.3969/j.issn.1001-5256.2021.09.007.

    庄辉. 不确定期慢性乙型肝炎应否治疗?[J]. 临床肝胆病杂志, 2021, 37( 9): 2033- 2036. DOI: 10.3969/j.issn.1001-5256.2021.09.007.
    [16]
    SCHWARZ KB, LOMBARDERO M, DI BISCEGLIE AM, et al. Phenotypes of chronic hepatitis B in children from a large North American cohort[J]. J Pediatr Gastroenterol Nutr, 2019, 69( 5): 588- 594. DOI: 10.1097/MPG.0000000000002467.
    [17]
    KUMAR K, DIXIT I. Letter to the editor: retreatment decision for hepatitis B flare in HBeAg-negative chronic hepatitis B[J]. Hepatology, 2021, 73( 5): 2081- 2082. DOI: 10.1002/hep.31589.
    [18]
    CHENG JL, WANG XL, YANG SG, et al. Non-ALT biomarkers for markedly abnormal liver histology among Chinese persistently normal alanine aminotransferase-chronic hepatitis B patients[J]. World J Gastroenterol, 2017, 23( 15): 2802- 2810. DOI: 10.3748/wjg.v23.i15.2802.
    [19]
    CHAO DT, LIM JK, AYOUB WS, et al. Systematic review with meta-analysis: The proportion of chronic hepatitis B patients with normal alanine transaminase≤40 IU/L and significant hepatic fibrosis[J]. Aliment Pharmacol Ther, 2014, 39( 4): 349- 358. DOI: 10.1111/apt.12590.
    [20]
    ZHU SS, ZHANG HF, DONG Y, et al. Antiviral therapy in hepatitis B virus-infected children with immune-tolerant characteristics: A pilot open-label randomized study[J]. J Hepatol, 2018, 68( 6): 1123- 1128. DOI: 10.1016/j.jhep.2018.01.037.
    [21]
    MARRONE A, ZAMPINO R, PORTELLA G, et al. Three-phase sequential combined treatment with lamivudine and interferon in young patients with chronic hepatitis B[J]. J Viral Hepat, 2005, 12( 2): 186- 191. DOI: 10.1111/j.1365-2893.2005.00619.x.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(5)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (803) PDF downloads(39) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return