Data on alanine aminotransferase (ALT) measurement practices and diagnoses associated with increased values are limited. We evaluated these issues by collecting ALT measurements from 1- to 16-year-old patients investigated in 1992-2018 in a tertiary center. Diagnoses were gathered in 2008-2018. Altogether 145,092 measurements from 28,118 children were taken 42% undergoing repeated testing. Testing increased from 21/1000 to 81/1000 children and the prevalence of elevated values fluctuated between 18% and 26%. An increase was seen especially in emergency care and departments of rheumatology, gastroenterology, hemato-oncology, and psychiatry. Common acute causes associated with elevated ALT were infections (45%), hemato-oncologic conditions (17%), and external reasons (13%), whereas autoimmune diseases (28%), psychiatric conditions (14%), and metabolic-dysfunction associated steatotic liver disease (10%) were common chronic causes. In conclusion, ALT testing increased 3.9-fold while the proportion of increased values remained stable, indicating that increased testing was justified. However, in some departments the testing efficiency was low.

中文翻译：

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儿童丙氨酸氨基转移酶的测量实践：值增加的时间变化和病因。

有关丙氨酸氨基转移酶 (ALT) 测量实践和与升高值相关的诊断的数据有限。我们通过收集 1992 年至 2018 年在三级中心调查的 1 至 16 岁患者的 ALT 测量值来评估这些问题。诊断数据收集于 2008 年至 2018 年。总共对 28,118 名儿童进行了 145,092 次测量，其中 42% 进行了重复测试。测试儿童数量从 21/1000 增加到 81/1000，升高值的发生率在 18% 到 26% 之间波动。尤其是急诊科以及风湿科、胃肠病科、血液肿瘤科和精神病科的人数有所增加。与 ALT 升高相关的常见急性原因是感染（45%）、血液肿瘤疾病（17%）和外部原因（13%），而自身免疫性疾病（28%）、精神疾病（14%）和代谢功能障碍相关的脂肪肝病（10%）是常见的慢性原因。总之，ALT 检测增加了 3.9 倍，而增加值的比例保持稳定，表明增加检测是合理的。但部分部门检测效率较低。