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Liver Enzymes (AST/ALT)


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HCV ANONYMOUS The Library The Library Tests and diagnostics. Liver Enzymes (AST/ALT) Pages: [1] Author OZ
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Topic: Liver Enzymes (AST/ALT) (Read 43378 times) Liver Enzymes (AST/ALT)
on: June 14, 2005, 03:09:50 PM Liver Blood Enzymes An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured, these enzymes are spilled into the blood stream. Among the most sensitive and widely used of these liver enzymes are the aminotransferases. They include aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). These enzymes are normally contained within liver cells. If the liver is injured, the liver cells spill the enzymes into blood, raising the enzyme levels in the blood and signaling the liver damage. What are the aminotransferases? The aminotransferases catalyze chemical reactions in the cells in which an amino group is transferred from a donor molecule to a recipient molecule. Hence, the names "aminotransferases". Normally, where are the aminotransferases? AST (SGOT) is normally found in a diversity of tissues including liver, heart, muscle, kidney, and brain. It is released into serum when any one of these tissues is damaged. For example, its level in serum rises with heart attacks and with muscle disorders. It is therefore not a highly specific indicator of liver injury. ALT (SGPT) is, by contrast, normally found largely in the liver. This is not to say that it is exclusively located in liver but that is where it is most concentrated. It is released into the bloodstream as the result of liver injury. It therefore serves as a fairly specific indicator of liver status. What are normal levels of AST and ALT? The normal range of values for AST (SGOT) is from 5 to 40 units per liter of serum (the liquid part of the blood). The normal range of values for ALT (SGPT) is from 7 to 56 units per liter of serum. What do elevated AST and ALT mean? AST (SGOT) and ALT (SGPT) are sensitive indicators of liver damage from different types of disease. But it must be emphasized that higher-than-normal levels of these liver enzymes should not be automatically equated with liver disease. They may mean liver problems or they may not. The interpretation of elevated AST and ALT levels depends upon the whole clinical picture and so it is best done by doctors experienced in evaluating liver disease. What liver diseases cause abnormal aminotransferase levels? The highest levels of AST and ALT are found with disorders that cause the death of numerous liver cells (extensive hepatic necrosis). This occurs in such conditions as acute viral hepatitis A or B, pronounced liver damage inflicted by toxins as from an overdose of acetaminophen (brand-name Tylenol), and prolonged collapse of the circulatory system (shock) when the liver is deprived of fresh blood bringing oxygen and nutrients. AST and ALT serum levels in these situations can range anywhere from ten times the upper limits of normal to thousands of units/liter.
Last Edit: June 14, 2005, 03:14:04 PM by wheeldm Logged

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Re: Liver Enzymes

Reply #1 on: June 14, 2005, 03:11:49 PM

What medications cause abnormal aminotransferase levels? A host of medications can cause abnormal liver enzymes levels. Examples include:

Liver Enzymes (AST/ALT)

A host of medications can cause abnormal liver enzymes levels. Examples include: Pain relief medications such as aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), neproxen (Narosyn), diclofenac (Voltaren), and phenybutazone (Butazolidine) Anti-seizure medications such as phenytoin (Dilantin), valproic acid, carbamazepine (Tegretol), and phenobarbital Antibiotics such as the tetracyclines, sulfonamides, isoniazid (INH), sulfamethoxazole, trimethoprim, nitrofurantoin, etc. Cholesterol lowering drugs such as the "statins" (Mevacor, Pravachol, Lipitor, etc.) and niacin Cardiovascular drugs such as amiodarone (Cordarone), hydralazine, quinidine, etc. Anti-depressant drugs of the tricyclic type


What are less common causes of abnormal aminotransferase levels? Less common causes of abnormal liver enzymes in the United States include chronic hepatitis B, hemachromatosis, Wilson's disease, alpha-1-antitrypsin deficiency, and autoimmune hepatitis. Though not as common as hepatitis C, hepatitis B can cause chronic liver disease with persistently abnormal liver enzymes. Hemachromatosis is a genetic (inherited) disorder in which there is excessive absorption of dietary iron leading to accumulation of iron in the liver with resultant inflammation and scarring of the liver. How are healthy people evaluated for mild to moderate rises in aminotransferase levels? Evaluation of healthy patients with abnormal liver enzymes needs to be individualized. A doctor may ask for blood test data from old records for comparison. If no old records are available, the doctor may repeat blood tests in weeks to months to see whether these abnormalities persist. The doctor will search for risk factors for hepatitis B and C including sexual exposures, history of blood transfusions, injectable drug use, and occupational exposure to blood products. A family history of liver disease may raise the possibility of inherited diseases such as hemachromatosis, Wilson's disease, or alpha-1- antitrypsin deficiency. How about monitoring aminotransferase levels? What is usually most helpful is serial testing of AST (SGOT) and ALT (SGPT) over time to determine whether the levels are going up, staying stable, or going down. For example, patients undergoing treatment for chronic hepatitis C should be monitored with serial liver enzyme tests. Those responding to treatment will experience lowering of liver enzyme levels to normal or near normal levels. Those who develop relapse of hepatitis C after completion of treatment will usually develop abnormal liver enzyme levels again. What about other liver enzymes? Aside from AST and ALT, there are other enzymes including alkaline phosphatase, 5'-nucleotidase ("5 prime" nucleotidase), and gamma-glutamyltranspeptidase (GGT) that are often tested for liver disease. We have restricted this consideration of liver enzymes to AST and ALT because they are biochemically related to each other and, more importantly, they are the two most useful liver enzymes.
Last Edit: June 14, 2005, 03:15:40 PM by wheeldm Logged

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Re: Liver Enzymes (AST/ALT)

Reply #2 on: June 14, 2005, 03:20:01 PM

Elevated Liver Enzymes Definition A liver enzyme is a protein that helps to speed up a chemical reaction in the liver. Liver function tests are blood tests that are used to evaluate various functions of the liver - for example, metabolism, storage, filtration and excretion, which are often performed by liver enzymes. However, not all liver function tests are measures of enzyme function. Description The liver is an important internal organ because it performs many functions. It helps detoxify the many toxins in the body, makes proteins that are used to help clot the blood (clotting factors) and other proteins that help draw fluid into our blood vessels (e.g., albumin). Liver function tests are blood tests that include alkaline phosphatase, prothrombin time (PT, a measure of blood clotting), serum bilirubin and serum albumin. The most commonly used indicators of liver damage are the alanine aminotransferase (ALT) and aspartate aminotransferase (AST), formally referred to as SPGT and SGOT. These are enzymes normally found in liver cells that leak out of these cells and make their way to the blood when liver cells are injured. The ALT is felt to be a more specific indicator of liver inflammation, as AST is also found in other organs, such as the heart and skeletal muscle. In acute injury to the liver, as in viral hepatitis, the level of the ALT and AST may be used as a general measure of the degree of liver inflammation or damage. In chronic liver disease, this is not the case, for these enzymes may be entirely within the normal range, even in the presence of cirrhosis (scarring of the liver). Increased levels of ALT and AST can have a large number of clinical implications. Elevated levels might involve hepatocellular disease, active cirrhosis, metastatic liver tumor, infection or toxic hepatitis, severe burns, pancreatitis, myocardial infarction (heart attack), trauma, severe burns, acute hemolytic anemia, crushing injuries, gangrene or shock. Alkaline phosphatase is the most frequently used test to detect obstruction in the biliary system. Elevation of this enzyme may be found in a large number of disorders as common as gallstone disease, alcohol abuse and drug-induced hepatitis, or in less common disorders, such as primary biliary cirrhosis or biliary tumors. Although this enzyme is found both in the liver and the bile, it leaks into the bloodstream in a manner similar to that of the ALT and AST. Alkaline phosphatase is also found in other organs, such as bone, placenta and intestine. Prothrombin time (PT) is a one measure of blood clotting. It may be elevated when there is damage to the liver, meaning that there is a greater tendency to bleed. PT is also used to monitor the appropriate dose of coumadin (warfarin) for certain patients who need bloodthinners (anti-coagulation). Low serum albumin may cause blood vessels to be leaky and allow fluid to accumulate in the abdomen (ascites) or elsewhere in the body. Serum bilirubin is usually elevated in patients with jaundice.


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Re: Liver Enzymes (AST/ALT)

Reply #3 on: October 16, 2005, 03:10:51 AM


Liver Enzymes (AST/ALT)

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A few links on ALT and AST tests;

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