Drawing Conclusions about Short-Term Variability in Liver Function Test Results
Authors: Mariana Lazo, Elizabeth Selvin, Jeanne M. Clark
Journal: Annals of Internal Medicine (2008)

Letters15 July 2008Drawing Conclusions about Short-Term Variability in Liver Function Test ResultsMariana Lazo, MD, ScM, Elizabeth Selvin, PhD, MPH, and Jeanne M. Clark, MD, MPHMariana Lazo, MD, ScMFrom Johns Hopkins University, Baltimore, MD 21205.Search for more papers by this author, Elizabeth Selvin, PhD, MPHFrom Johns Hopkins University, Baltimore, MD 21205.Search for more papers by this author, and Jeanne M. Clark, MD, MPHFrom Johns Hopkins University, Baltimore, MD 21205.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-2-200807150-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the readers' interest in our study. As indicated by Drs. Arora and Triadafilopoulos, because our study was based on a nonrandom sample of the NHANES III population, selection bias remains a possibility. However, even if selection bias were present, it doesn't change the fact that, although sociodemographic and other patient-level characteristics may be associated with the absolute level of liver enzymes, such factors are unlikely to affect variability, which is a biological phenomenon. Indeed, we did not observe differences in estimates of variability by demographic or other patient-level characteristics. We agree that because Asians make up ...References1. Prati D, Taioli E, Zanella A, Della Torre E, Butelli S, Del Vecchio E, et al. Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann Intern Med. 2002;137:1-10. [PMID: 12093239] LinkGoogle Scholar2. Neuschwander-Tetri BA, Unalp A, Creer MH; Nonalcoholic Steatohepatitis Clinical Research Network. Influence of local reference populations on upper limits of normal for serum alanine aminotransferase levels [Letter]. Arch Intern Med. 2008;168:663-6. [PMID: 18362260] CrossrefMedlineGoogle Scholar3. Kaplan MM. Alanine aminotransferase levels: what's normal? [Editorial]. Ann Intern Med. 2002;137:49-51. [PMID: 12093245] LinkGoogle Scholar4. Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al; STROBE initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Ann Intern Med. 2007;147:W163-94. [PMID: 17938389] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Mariana Lazo, MD, ScM; Elizabeth Selvin, PhD, MPH; Jeanne M. Clark, MD, MPHAffiliations: From Johns Hopkins University, Baltimore, MD 21205.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUpdated Definitions of Healthy Ranges for Serum Alanine Aminotransferase Levels Daniele Prati , Emanuela Taioli , Alberto Zanella , Emanuela Della Torre , Sonia Butelli , Emanuela Del Vecchio , Luciana Vianello , Francesco Zanuso , Fulvio Mozzi , Silvano Milani , Dario Conte , Massimo Colombo , and Girolamo Sirchia Alanine Aminotransferase Levels: What's Normal? Marshall M. Kaplan Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration Jan P. Vandenbroucke , Erik von Elm , Douglas G. Altman , Peter C. Gøtzsche , Cynthia D. Mulrow , Stuart J. Pocock , Charles Poole , James J. Schlesselman , Matthias Egger , and Brief Communication: Clinical Implications of Short-Term Variability in Liver Function Test Results Mariana Lazo , Elizabeth Selvin , and Jeanne M. Clark Drawing Conclusions about Short-Term Variability in Liver Function Test Results Gaurav Arora and George Triadafilopoulos Drawing Conclusions about Short-Term Variability in Liver Function Test Results Weekitt Kittisupamongkol Drawing Conclusions about Short-Term Variability in Liver Function Test Results Liu Hong , Kaichun Wu , and Daiming Fan Drawing Conclusions about Short-Term Variability in Liver Function Test Results Agostino Colli and Daniele Prati Metrics 15 July 2008Volume 149, Issue 2Page: 145-146KeywordsAlanine aminotransferaseBilirubinClinical epidemiologyConflicts of interestEnzymesEpidemiologyLiverLiver function testsObservational studiesStatins ePublished: 15 July 2008 Issue Published: 15 July 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...