AST + ALT (Liver enzymes)

General information:

ALT, AST is one of the most investigated indicators in the clinical laboratory.

Enzyme transaminase contained primarily in liver cells. In smaller quantities it is found in the heart and skeletal muscles. Its main function is the transfer of amino groups between alpha-amino and alpha-keto acids into hepatocytes. This process is aided by coenzyme pyridoxalphosphate. AST has cytoplasmic and mitochondrial (isoenzymes) that have a similar catalytic function but a different structure. In case of damage to organs containing them, elevated values ​​are observed.

! It is included in all prophylactic packages

In case of suspected liver damage (cirrhosis, viral hepatitis, tumors, after ingestion of hepatotoxic drugs (anabolics, contraceptives, chemotherapy)
Myocardial infarction
Muscular diseases
Anemic conditions with haemolysis
! Attention: Some drugs may increase the enzyme values ​​temporarily without lasting effects (antibiotics, temperature-reducing, NSAIDs, antidepressants)

Other factors: diabetes, obesity, fatty liver, alcohol abuse also influence these indicators.
The hepatic enzyme value does not always correlate with the severity and prognosis of various liver diseases. Further refinement studies such as coagulation status, albumin, bilirubin, fibrinogen
The ratio of the values ​​of these enzymes has informative value for the treating physician.

AST / ALT = 1, both enzymes are high in acute viral hepatitis, drug or toxic hepatitis
AST / ALT greater than 2: 1 (ACAT is 2 times higher than ALT) with alcohol impairment
AST> ALT> 1 in cirrhosis of another nature

Increased activity:
1. Increase 10 times or more above the upper reference limit:
- acute hepatitis and hepatic necrosis (hepatocytosis);
- "Cirrhosis syndrome" (predominantly of muscular origin);
- severe tissue hypoxia.
2. Increase between 5 and 10 times above the upper reference limit:
- acute myocardial infarction (after 12 hours, until 7-8 days);
- Surgical and other muscular traumas;
- diseases of skeletal muscles;
- cholestasis and chronic hepatitis.
3. Increase to 5 times above the upper reference limit:
- newborns;
- hepatic diseases (with hepatocytosis);
- pancreatitis;
- haemolysis.
Decreased serum transaminase activity is of no clinical significance.

Sample required:

Venous blood in the morning in fasting

Key words:

 AST, SGOT, SGPT, ALT