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Standard liver tests for assessing liver damage include alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP). Bilirubin may be used to estimate the excretory function of the liver and coagulation tests and albumin can be used to evaluate the metabolic activity of the liver.
The proportion of AST to ALT in hepatocytes is about 2.5:1, but because AST is removed from serum by the liver sinusoidal cells twice as quickly (serum half-life t 1/2 = 18 hr) compared to ALT (t 1/2 = 36 hr), so the resulting serum levels of AST and ALT are about equal in healthy individuals, resulting in a normal AST/ALT ratio around 1.
Significantly elevated levels of ALT (SGPT) often suggest the existence of other medical problems such as viral hepatitis, diabetes, congestive heart failure, liver damage, bile duct problems, infectious mononucleosis, or myopathy, so ALT is commonly used as a way of screening for liver problems.
However, very high elevations of the transaminases suggests severe liver damage, such as viral hepatitis, liver injury from lack of blood flow, or injury from drugs or toxins. Most disease processes cause ALT to rise higher than AST; AST levels double or triple that of ALT are consistent with alcoholic liver disease. [citation needed]
[citation needed] For example, the presence of elevated transaminases can be an indicator of liver and cardiac damage. Two important transaminase enzymes are aspartate transaminase (AST), also known as serum glutamic oxaloacetic transaminase (SGOT); and alanine transaminase (ALT), also called alanine aminotransferase (ALAT) or serum glutamate ...
Analysis of liver biopsies will show the levels of alkaline phosphatase, aspartate transaminase, and alanine transaminase in the patient, which has a negative correlation with liver function. [27] Normal levels of these enzymes indicate that there is no significant hepatocellular damage. [27]
FibroTest has been evaluated in relation to liver biopsy (the current reference standard in liver disease assessment) in people with hepatitis C, hepatitis B, [1] alcoholic liver disease, [2] and non-alcoholic fatty liver disease. [3] They are most useful for cirrhosis and less useful for other stages of liver disease. [4]
Enzyme activity is commonly used for e.g. liver function tests like AST, ALT, LD and γ-GT in Sweden. [ 5 ] Percentages and time-dependent units (mol/s) are used for calculated derived parameters, e.g. for beta cell function in homeostasis model assessment or thyroid's secretory capacity .
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