DOI: 10.1002/jcla.24995 ISSN: 0887-8013

Age‐specific reference intervals for liver function tests in healthy neonates, infants, and young children in Iran

Seyede Negin Badakhshan, Hamideh Ghazizadeh, Maryam Mohammadi‐Bajgiran, Habibollah Esmaily, Mahdiyeh Yaghooti Khorasani, Mary Kathryn Bohn, Mehran Pashirzad, Atieh Kamel Khodabandeh, Sara Ghazi Zadeh, Iman Alami‐Arani, Hamidreza Rahimi, Gordon A. Ferns, Hassan Boskabadi, Reza Assaran‐Darban, Khosrow Adeli, Majid Ghayour‐Mobarhan
  • Microbiology (medical)
  • Biochemistry (medical)
  • Medical Laboratory Technology
  • Clinical Biochemistry
  • Public Health, Environmental and Occupational Health
  • Hematology
  • Immunology and Allergy



The reference intervals (RIs) for liver function tests (LFTs) were determined in Iranian children for the first time.


A total of 344 healthy pediatrics aged 3 days to 30 months old were recruited. Serum levels of ALT, AST, ALP, direct bilirubin, and total bilirubin were measured. RIs were determined using CLSI Ep28‐A3 guidelines.


All analytes demonstrated age‐specific differences except AST. ALT and ALP demonstrated significantly elevated levels in infants 0 to <5 months relative to the remainder of the age range. Direct and total bilirubin demonstrated markedly elevated levels in early life with mean of 0.28 mg/dL and 1.64 mg/dL observed for direct and total bilirubin, respectively, decreasing by ~50% in the adjacent partition.


These novel data will help improve the clinical interpretation of biochemical test results in young Iranian neonates and children and can be of value to clinical laboratories with similar populations.

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