Vasilenko V.V. Interpretation of liver tests / GastroScan.ru, 2021

ALT analysis

An analysis to determine the concentration of this substance in the body is used to diagnose liver disease and monitor the effectiveness of prescribed therapy. The main indication for the study is suspicion of acute or chronic hepatitis of viral or toxic origin, cirrhosis of the liver, primary malignant neoplasms of the organ or secondary metastatic lesions.

The growth of this substance in the body during hepatitis begins much earlier than the disease enters the icteric stage. In this way, it is possible to diagnose the disease at an early stage and begin treatment in a timely manner.

The analysis is also carried out as part of a comprehensive screening examination in order to assess the condition of the liver. The study is carried out before planned hospitalization for surgical treatment. The analysis is prescribed in conjunction with an aspartate aminotransferase test.

The level of ALT must be assessed together with other enzymes in pathologies of the pancreas and gallbladder - pancreatitis, cholecystitis, cholelithiasis. An analysis may be prescribed if the patient complains of general weakness of unknown etiology, fatigue, icteric skin and sclera, abdominal pain, a feeling of heaviness in the right hypochondrium, nausea, vomiting.

This analysis should also be performed in case of myocardial infarction and myocarditis. But in case of heart damage, assessing the ALT level is of secondary importance. The study is prescribed if the patient is suspected of myositis, myodystrophy, pain in the heart muscle, which cannot be explained by excessive physical exertion or another objective reason.

All donors are required to undergo this test.

The concentration of the level of this substance in the body must be assessed in case of chronic diseases, before prescribing medications - antitumor, antituberculosis. The study is also prescribed to assess the condition of the liver over time to assess the tolerability of a particular drug.

ALT (ALT, Alanine aminotransferase, alanine transaminase)

For research, blood is taken from a vein. Usually, AST (AST, Aspartate aminotransferase) is determined simultaneously and the AST/ALT ratio (de Ritis coefficient) is assessed. You can take a blood test for ALT (ALT, Alanine aminotransferase, alanine transaminase) at the nearest INVITRO medical office. A list of offices where biomaterial is accepted for laboratory research is presented in the “Addresses” section. Interpretation of study results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. The doctor makes an accurate diagnosis using both the results of this examination and the necessary information from other sources: medical history, results of other examinations, etc.

Deciphering the ALT analysis

Alanine aminotransferase reference values ​​for adults:

WHY IS ALT LEVEL DETERMINED?

ALT is an enzyme of the transaminase group, present in a certain amount in the cells of the liver, kidneys and cardiovascular system. Determining the concentration of this substance allows you to get an idea of ​​the condition of the liver and heart, as well as the effectiveness and safety of the treatment. The basic indication for diagnosis is the suspicion of liver disease, cirrhosis, viral or toxic hepatitis (chronic and acute). Also, a blood test for ALT allows for the timely detection of malignant primary or secondary metastatic liver lesions.

An increase in the level of the above enzyme in various types of hepatitis manifests itself much earlier than the pathology progresses to the icteric stage. Thanks to this, it becomes possible to timely diagnose the disease at the initial stage of its development and begin treatment, which can significantly increase the survival rate of patients with this diagnosis.

The analysis is part of standard screening diagnostics, which allows for a comprehensive assessment of the patient’s liver condition. The study is also carried out as part of preparation before planned hospitalization for surgical intervention. Often the analysis is prescribed in combination with an analysis of aspartate aminotransferase levels.

To assess the health status of a patient suffering from diseases of the pancreas (diabetes, pancreatitis, etc.) and gall bladder (cholecystitis, cholelithiasis, etc.), determining the level of ALT is also necessary, as is identifying the amount of other enzymes. Diagnosis is carried out as prescribed by the attending physician, in the presence of objective indications - general weakness of unknown origin, fatigue, icteric coloration of the skin and sclera, vomiting, nausea, pain and heaviness in the abdomen and right hypochondrium.

In addition, identifying the level of this enzyme is included in the standard diagnostic protocol for diseases of the cardiovascular system, especially when examining patients with suspected myocardial infarction or myocarditis. In case of organic lesions of the heart muscle, determining the level of ALT is not of paramount importance. Diagnosis is carried out if the patient is suspected of having myositis, muscular dystrophy and pain in the heart, which cannot be explained by excessive physical activity or any other objective reason.

All donors without exception undergo diagnostic testing of ALT levels. The concentration of this enzyme is necessarily assessed in the presence of certain types of chronic pathologies and before prescribing hepatotoxic drugs (antirheumatic, anticancer, antituberculosis and antimicrobial), as well as to monitor the liver condition during their use.

What may affect the results

Intense physical activity the day before and even a few days before the test can lead to damage to muscle tissue (the so-called muscle fiber tear) and, accordingly, an increase in ALT levels. For the same reason, analysis taken after injury is uninformative. Taking alcohol and certain medications (antibiotics, nonsteroidal anti-inflammatory drugs, antitumor drugs, oral contraceptives, etc.) often distort the results of the study. The list of medications taken should be discussed with the doctor who prescribed the test, and those that are taken should be discontinued without risk to health.

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Normal indicators

Units of measurement: U/l.
Reference values

What is alanine aminotransferase (ALAT)

The functioning of the human body is ensured by multiple chemical processes that are both cyclical and interconnected, continuous and consistent. Enzymes play a major role in blood filtration and digestion systems. Alanine aminotransferase (ALAT) is the main liver enzyme involved in amino acid metabolism. Most of the enzyme is found in the liver, with small amounts in the kidneys, cardiac and skeletal muscles.

Alanine itself is important as a source of rapid glucose production to nourish the brain and central nervous system. Studying the level of ALT and AST in the blood greatly facilitates the diagnosis and prognosis of severe diseases and damage to the liver, heart and pancreas.

The specificity of ALT makes it possible to differentiate diseases according to the degree of excess of standard values, which is very important when symptoms are weak and the manifestations of various diseases are similar. Using ALT readings in combination with other tests, the doctor can determine the extent of organ damage and make a prognosis for the course of the disease.

What is aspartate aminotransferase (AST)

The endogenous enzyme aspartate aminotransferase (AST) is responsible for accelerating the release of ammonia from amino acids for its subsequent processing in the urea cycle. AST is found not only in the liver, but also in the heart muscle and brain, kidneys and spleen, lungs and pancreas. Due to the intracellular nature of synthesis, AST is successfully used in diagnosing the condition of the myocardium and liver. Using a biochemical blood test for AST and ALT, as well as their ratio, doctors are able to predict a heart attack even before the appearance of the main symptoms.

AST is also used as a marker in the differentiated diagnosis of a number of diseases:

• Cirrhosis and hepatitis;
• Metastases in the liver;
• Jaundice of various origins.

If, according to the results of the study, high ALT levels are much greater than the excess of the norm for AST, this is a characteristic sign of liver damage. If AST is increased more than ALT, the possibility of myocardial cell death should be considered. Excessive activity of alanine aminotransferase is also possible during the period of taking certain medications. Reduced values ​​of AST and ALT are possible during pregnancy, renal failure or pyridoxine deficiency.

ALT elevation levels

The standard ALT indicator as part of the diagnostic complex “blood biochemistry” may differ slightly in different laboratories, but on average the limits of this indicator for men are 10–40 U/l, for women – from 7 to 35 U/l. The criteria for differentiating diseases are levels of excess of the ALT norm:

Minor:

• taking medications and chemicals (antibiotics and barbiturates, chemotherapy and drugs),
• cirrhosis of the liver,
• fatty liver disease;

Moderate and medium:

• alcohol poisoning,
• some forms of hepatitis,
• growth problems in adolescents;

High:

• cancer tumor necrosis,
• viral hepatitis,
• state of shock.

AST blood test

Aspartate aminotransferase (AST) is an enzyme that is present in all cells of the body. However, the largest amount of the substance is found in the heart and liver; the enzyme is also present in sufficient concentrations in the kidneys and muscles. If a person is healthy, the concentration of AST in the body will be low. And if we are talking about damage to the liver or muscles, the enzyme is released, as a result of which its concentration in the blood increases. Thus, in medical practice, an increase in AST levels in the blood indicates serious liver damage. AST analysis is carried out as part of a complex of liver tests - studies that can be used to detect the slightest deviations in liver function.

The liver is a vital organ located in the upper right side of the abdominal cavity. It takes part in many functions of the body - it synthesizes essential proteins, processes nutrients, produces bile, and breaks down potentially toxic compounds.

Due to the development of certain pathologies in the body, the liver also suffers, as is clearly evidenced by an increase in the level of AST in the blood.

Most often, an AST test is prescribed to check whether the patient has hepatitis, liver cirrhosis, or is taking toxic drugs. But the AST level can indicate more than just the condition of the liver. The concentration of this enzyme also changes in other diseases, including myocardial infarction.

Purpose of analysis

First of all, the study is prescribed if liver damage is suspected. Typically, an AST test is prescribed in combination with an ALT test or as part of a general liver function test. AST and ALT concentrations are the most important indicators of liver damage. Also, with the help of these tests, you can indirectly find out the reasons that led to liver problems.

The results of the AST analysis are compared with the results of other studies - total protein, bilirubin, alkaline phosphatase. Using the available data, it is possible to determine the specific form of liver disease.

Also, a referral for analysis is issued in order to monitor the dynamics of the effectiveness of the prescribed treatment for liver pathologies.

The analysis is indicated for patients taking medications that are potentially toxic to the liver. If enzyme activity increases, it is likely that the patient’s attending physician will reconsider treatment tactics and prescribe other medications.

Interpretation of AST analysis results.

Age and gender are two main factors influencing AST levels in the human body. In middle-aged women, the normal level of this enzyme in the blood is 31 units/l. With age, the production of the substance becomes less and less. The main reason for this phenomenon is a slowdown in metabolism in general. In addition, pregnancy also has a significant impact on the concentration of the enzyme in the body. While expecting a child, AST levels may fluctuate slightly, both down and up.

The concentration of AST in a man’s body is consistently higher starting from adolescence. This is very easily explained - men have more muscle tissue, so the body needs more enzyme. Already during puberty, the average concentration of AST in a boy’s body is 29 units/l. If we are talking about a middle-aged man, the enzyme content reaches 37 units/l, which is 6 more than in women of the same age.

Features of ALT norms in pregnant women

In a healthy woman, the ALT norm does not change during pregnancy and should coincide with the values ​​before conception. In cases where ALT is slightly increased during pregnancy, causes not related to diseases can be considered:

• course of intramuscular injections;
• physical activity that is excessive for a pregnant woman;
• addiction to fast food;
• uncontrolled intake of dietary supplements;
• obesity;
• fetal pressure on the biliary tract, preventing the outflow of bile.

Normalization of nutrition, moderation of physical activity, weight control and choleretic drugs normalize enzyme parameters.