Reference intervals for eight enzymes in blood of adult females and males measured in accordance with the International Federation of Clinical Chemistry reference system at 37 degrees C: part of the Nordic Reference Interval Project

Scand J Clin Lab Invest. 2004;64(4):371-84. doi: 10.1080/00365510410002742.


As part of the Nordic Reference Interval Project we present reference intervals for alanine transaminase (ALT), aspartate transaminase (AST), creatine kinase (CK), lactate dehydrogenase (LD), alkaline phosphatase (ALP), gamma-glutamyltransferase (GT), amylase (AMY) and pancreatic type of AMY in blood of adult males and females. A total of 3036 reference persons, all of whom considered themselves to be in good health, were recruited by 102 Nordic clinical biochemical laboratories. Exclusions were undertaken on the basis of predefined biochemical and clinical criteria. Enzyme activities in serum and plasma were measured in the different laboratories using various commercially available routine measurement systems at 37 degrees C. Only results obtained with the International Federation of Clinical Chemistry (IFCC) compatible measuring systems were selected for estimation of the enzyme reference intervals. The final number of results on each enzyme varied from 459 (LD) to 2300 (ALT). The 2.5 and 97.5 percentile reference limits were calculated by a non-parametric method in accordance with the IFCC recommendations, using the Refval 4.0 data program. Statistical partitioning testing was undertaken to decide whether the reference intervals ought to be partitioned according to gender and/or age. For most of the enzymes, but not for all, the upper reference limits were found to be higher than those that have been in general use until now.

MeSH terms

  • Adult
  • Chemistry, Clinical / standards*
  • Chemistry, Clinical / statistics & numerical data
  • Clinical Enzyme Tests / standards*
  • Clinical Enzyme Tests / statistics & numerical data
  • Clinical Medicine / methods
  • Clinical Medicine / standards*
  • Clinical Medicine / statistics & numerical data
  • Enzymes / blood*
  • Europe
  • Female
  • Humans
  • International Cooperation*
  • Laboratories, Hospital / standards
  • Male
  • Reference Values*
  • Temperature


  • Enzymes