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What are AST and Alt tests?
What does Alt mean in a blood test?
Is Alt higher than AST?
What causes high ALT / AST levels?
Levels of ALT and AST are usually high in conditions such as hepatitis – possibly twenty to fifty times higher than normal. The ALT ‘value’, or level, is more specific to the liver than the AST value because the AST value may also be high if there is muscle damage elsewhere in the body.
- Tests, Diagnosis and Screening
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- Tests, Diagnosis and Screening
May 1, 2024 · Assessing liver function. There is no single specific method of determining a patient’s liver function. A combination of liver blood tests, causes of liver disease, and signs and symptoms of liver disease are required to estimate liver function. When to refer.
- Introduction
- Why Check Lfts?
- Reference Ranges
- Alt / Ast
- Alp / GGT
- Bilirubin
- Albumin
- LFT Interpretation Method
- Further Investigations
- References
Liver function tests(LFTs) are among the most commonly ordered blood tests and include: 1. Alanine transaminase (ALT) 2. Aspartate aminotransferase (AST) 3. Alkaline phosphatase (ALP) 4. Gamma-glutamyltransferase (GGT) 5. Bilirubin 6. Albumin This guide gives an overview of LFTsand a structured approachto their interpretation.
LFTs can be requested for multiple reasons:1 1. To investigate patients with suspected liver disease 2. To monitor patients with confirmed liver disease (e.g. cirrhosis) 3. To monitor the effects of potentially hepatotoxic medications LFTs are often sent as part of a ‘baseline’ screening panel of investigations for patients presenting with a wide r...
Table 1. Liver function test reference ranges These reference ranges can varybetween laboratories, so always check local guidelines.
Alanine aminotransferase (ALT) andaspartate aminotransferase(AST) are enzymes found within liver cells at high concentrations. Raised ALT / AST levels in the blood occur in pathologies that cause liver cell (hepatocyte) inflammation or damage. Therefore, raised ALT / AST levels are a marker of hepatocellular injury. Common causes of hepatocellular ...
Serumalkaline phosphatase (ALP) is derived from biliary epithelial cells (cells lining the biliary tract) and bones.3 Raised ALP levels can therefore be caused by cholestasis orbone disease. Gamma-glutamyltransferase (GGT) is found in hepatocytes and also biliary epithelial cells.2 It is a non-specific buthighly sensitivemarker of liver damage and ...
Bilirubin is a waste product of haemoglobin breakdown. It is predominantly metabolised and excreted by the liver. Raised levels of bilirubin in the blood will lead to a yellowing of the skin, known as jaundice. Hint: Jaundice is usually absent until the bilirubin level exceeds 50 micromol/L.
Albumin is synthesised in the liver and helps to bind water, cations, fatty acids and bilirubin. It also plays a crucial role in maintaining the oncotic pressure of blood. Albumin is used as a non-specific marker of the synthetic functionof the liver. Albumin levels can fall due to: 1. Decreased albumin production: malnutrition, severe liver diseas...
Determine the pattern of LFT derangement
The pattern of ALT to ALP risecan indicate whether the pathology is primarily cholestatic or hepatocellular: 1. A greater than 10-fold increase in ALT and a less than 3-fold increase in ALP suggests a predominantly hepatocellular injury 2. Aless than 10-fold increase in ALT and a more than 3-fold increase in ALP suggests cholestasis 3. It is possible to have a mixed picture involving both hepatocellular injury and cholestasis An isolated ALP rise without a GGT rise should raise your suspicion...
Assess the bilirubin
Bilirubin is a marker of severity in acute cholestatic pathology and acute hepatocellular liver injuries. The presence of clinical jaundice is generally an indication of severe diseaserequiring urgent referral to secondary care for prompt assessment and management. An isolated bilirubin risewithout further LFT derangement suggests pre-hepatic jaundice or Gilbert’s disease.
Assess synthetic function
In severe hepatocellular injuries, the synthetic functions of the liver also become impaired, leading to decreased albumin. Coagulation studiesmay show prolonged prothrombin time, and in very severe disease, serum blood glucose may be low due to impaired gluconeogenesis. Hint: In chronic hepatocellular pathology (e.g. cirrhosis), the ALT / AST may return to within the normal range, however synthetic function of the liver can be markedly impaired.
Once the pattern of LFT derangement has been established, it is essential to determine the underlying cause. If cholestasis is suspected, an ultrasound should be arranged to assess the biliary tree for a potential site/cause of biliary obstruction. If hepatocellular injury is suspected, a liver ultrasound is generally arranged to assess for any str...
Coates P. Liver Function Tests. Australian Family Physician. March 2011. Available at [LINK].UpToDate. Approach to the patient with abnormal liver biochemical and function tests. May 2023. Available at [LINK].Patient.info Professional. Abnormal Liver Function Tests. July 2019. Available at [LINK].UpToDate. Bilirubin metabolism. October 2022. Available at [LINK].Jun 1, 2023 · Transferases (AST or SGOT and ALT or SGPT). Gamma GT. Creatine kinase. Calcium and corrected calcium. Prothrombin time or International Normalised Ratio (INR). Each of these is discussed below. The liver performs hundreds of different functions, so there are many other possible tests that look at its health.
Jul 9, 2024 · Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are two enzymes measured in a blood test to check the health of your liver. High AST and ALT levels are a general sign of a liver problem.
Jan 31, 2018 · Elevated levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are the most common abnormalities seen in liver blood tests. Both AST and ALT are enzymes present in hepatocytes that are released into the blood following hepatocyte injury or death. 3 Alanine aminotransferase is present at low concentrations in non-hepatic ...
Alanine transaminase (ALT). ALT is an enzyme found in the liver that helps convert proteins into energy for the liver cells. When the liver is damaged, ALT is released into the bloodstream and levels increase. This test is sometimes referred to as SGPT. Aspartate transaminase (AST). AST is an enzyme
