Serum Aspartate Aminotransferase and Alanine Aminotransferase in Newborn Libyan Babies

Abdalgader Saleh Ali; Mahtab Alam; Mohamed M. Ahmed; Faraj Omar Matoug

doi:10.51984/6m2zc013

Authors

Abdalgader Saleh Ali Department of Biochemistry, Faculty of Medicine, Sebha University, Sebha, Libya
Mahtab Alam Department of Biochemistry, Faculty of Medicine, Sebha University, Sebha, Libya
Mohamed M. Ahmed Department of Paediatrics, Sebha Medical Center, Sebha, Libya
Faraj Omar Matoug Department of Paediatrics, Faculty of Medicine, Benghazi University, Benghazi, Libya

DOI:

https://doi.org/10.51984/6m2zc013

Keywords:

Alanine aminotransferase, Aspartate aminotransferase, Bilirubin, Newborn babies

Abstract

Introduction: Transaminases are enzymes involved in transfer of amino groups from α-amino acid to α-keto acid using pyridoxal phosphate as a cofactor. Aspartate aminotransferase (AST) is widely distributed, whereas, alanine aminotransferase (ALT) is high in liver and to a lesser extent in skeletal muscle, kidney and heart. Both rise in serum after tissue damage. Bilirubin is an end product of the breakdown of haem, and its deposition leads to hyperbilirubinaemia which can cause brain damage, as a result long-life neurological disability.

Objective: This study was carried-out to evaluate the ALT and AST activity, and the bilirubin (total and direct) level in newborn Libyan babies, as well as evaluating their inter-relationship.

Materials and Methods: Blood was collected for routine investigation from 200 newborn Libyan babies, aged 1 to 18 days (X = 6.3 ± 4.0 days), admitted in the neonatal unit, Sebha Teaching Hospital, Sebha, Libya. A part of this blood were used to investigate the ALT and AST activity, and the bilirubin level, which were performed by Kinetic test-IFCC recommended from Biomaghreb (Tunisa) and Biocon (Hecke, Germany) based on Jendrassik-Grof method, respectively.

Results: In these two hundred newborn babies, the activity of ALT was 23.59 ± 13.5 U/l and AST was 58.20 ± 35.6 U/l. We observed a significant difference between the two means (P<0.001), as well as a significant correlation (r = 0.75, P< 0.001). The ratio of ALT to AST was 1: 2.47. The total and direct bilirubin was 9.5 ± 4.9 mg/dl and 1.3 ± 1.5 mg/dl, respectively. We found no significant correlation between the activity of AST and ALT, and the bilirubin level. However, in group-I (41.5%) of these babies (n = 83, age = 5.9 ± 3.5 days) the total bilirubin was 9.2 ± 5.3 mg/dl and the direct bilirubin was 0.7 ± 0.5 mg/dl. While, the ALT activity was 19.1 ± 9.7 U/l and AST activity was 46.1 ± 17.2 U/l. The ratio of ALT to AST was 1 : 2.41. Again, we found , a significant difference between the means of AST and ALT activity (P < 0.001), as well as a significant correlation (r = 0.44, P < 0.001). In the other group-II, (58.5%, n = 117) the total bilirubin was 9.6 ± 4.7 mg/dl, but the direct bilirubin was 3.0 ± 2 mg/dl. While, the activity of ALT was 25.7 ± 15.7 U/l and AST was 65.9 ± 43.2 U/l. The ratio of ALT to AST was 1: 2.56. Interestingly, we observed a significant correlation between the activity of AST and ALT (r = 0.78, P < 0.001), and negative correlation between the activity of both AST and ALT, and the bilirubin (P = NS).

Conclusion: Establishment of reference values for newborn babies would be helpful in achieving the most accurate diagnosis.

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References

Beath, S.V. Hepatic function and physiology in the newborn. Seminars in Neonatology, 2003; 8(5): 337-346.

Marks, D.B., Marks, A.D., & Simith, C.M. Nitrogen Metabolism. Basic Medical Biochemistry, a clinical approach. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2009:P701-765.

Kachmar, J.F., & Moss, D.W. Enzymes. In Tietz, N.W. (ed.), Fundamentals of clinical chemistry. Philadelphia: W.B. Saunders Company;1976:565-693.

Gowenlock, A., McMurray, J.R. & McLauchlan, D.M. Varley’s Practical Clinical Biochemistry. 6th ed. London. Heinemann Medical Books;1988:477-521.

Zilva, J.F., & Pannall, P.R. Clinical Chemistry in Diagnosis and Treatment. London: Lloyd-Luke, Ltd.; 1984:366-382.

Rodwell, V.W. Catabolism of the carbon skeletons of amino acids. In Murray, R.K., Bende, D.K., & Botham, K.M. (eds.), Harper`s illustrated Biochemistry (28th ed.). New York. McGraw-Hill companies, Inc. 2011:248-261.

Kove, S., Goldstein, S., & Wróblewski, F. Measurement of activity of transaminases in the serum as an aid in differential diagnosis of jaundice in the neonatal period. Paediatrics, 1957;20:590-600.

Kove, S., Goldstein, S., & Wróblewski, F. Serum transaminase activity in neonatal period: valuable aid in differential diagnosis of jaundice in the newborn infant. JAMA, 1958;168 (7) : 860-867.

Zanardo, V., Bondio, M., & Perini, G. Serum Glutamic-Oxaloacetic Transaminase and Glutamic-Pyruvic Transaminase Activity in Premature and Full-Term Asphyxiated Newborns. Biology of Neonate,1985;47:61-69.

Roberts, E.A. Neonatal hepatitis syndrome. Seminars in neonatology,2003; 8(5):357-374.

Cokugras, F.C., & Beser, F.O. (2012). Cholestasis in newborn and infancy period. Turk Archive Paediatric,2012;47:1-7

Smith, A.F., Beckett, G.J., & Walker, S.W. Lecture notes on clinical biochemistry (6th ed.). Blackwell Science Ltd.Oxford. 1998: 101-109.

Bhutani, V.K., & Johnson, L. (2005). Kernicterus: A preventable neonatal brain injury. Journal of Arab Neonatal Forum, 2005;2:13-24.

Shapiro, S.M. Bilirubin toxicity in the developing nervous system. Paediatric Neurology, 2003;29(5):41-421.

Bishop, M.L., Fody, E.P., & Schoeff, L.E. Clinical Chemistry, Principles, Procedures, Correlations. (5th edition). Philadelphia: Lippincott Williams & Wilkins.2005.

Clark, M.L & Kumar, P.J. Liver, biliary and pancreatic diseases. In Kumar, P.J., & Clark, M.L. (eds). Clinical Medicine. (2nd edition). London: Bailliere Tindall; 1990: 237-293.