What are ALT and AST liver enzymes. How do they reflect liver health. What are considered normal and optimal levels. What factors can influence ALT and AST levels. How can you improve your liver enzyme values.

Understanding ALT and AST: Key Indicators of Liver Health

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are crucial enzymes primarily found in liver cells. When liver damage occurs, these enzymes are released into the bloodstream, making them valuable markers for assessing liver health. However, it’s important to note that elevated levels can also result from muscle damage.

The standard reference ranges for these enzymes are:

• AST: 10-40 U/L
• ALT: 7-56 U/L

But are these ranges truly optimal for long-term health and longevity? Recent research suggests that lower levels within these ranges may be more beneficial.

Optimal ALT and AST Levels: Insights from Large-Scale Studies

A comprehensive meta-analysis by Kunutsor et al. (2014) examined data from approximately 9 million adults with an average age of 51 years, followed for up to two decades. The study revealed intriguing findings regarding the relationship between AST and ALT levels and all-cause mortality risk:

AST Optimal Range

For AST, the study included data from 4 studies encompassing 9,046,609 subjects. The analysis showed that AST levels between 10-15 U/L were associated with the lowest all-cause mortality risk.

ALT Optimal Range

The ALT data, derived from 8 studies with 9,087,436 subjects, indicated that levels between 12-15 U/L were linked to the most significant reduction in all-cause mortality risk.

These findings suggest that maintaining liver enzyme levels on the lower end of the standard reference range may be more beneficial for overall health and longevity.

Liver Enzymes in Centenarians: Clues to Longevity

Examining the liver enzyme levels of individuals who have reached the age of 100 or beyond provides valuable insights into the potential role of these markers in exceptional longevity. Interestingly, the AST and ALT values observed in centenarians closely align with the optimal ranges identified in the meta-analysis for middle-aged adults:

• Centenarians’ AST range: 17-23 U/L
• Centenarians’ ALT range: 9-14 U/L

This correlation further supports the notion that maintaining lower liver enzyme levels throughout life may contribute to increased longevity and overall health.

Factors Influencing ALT and AST Levels

Several lifestyle and dietary factors can impact liver enzyme levels. Understanding these influences can help individuals make informed choices to optimize their liver health:

Fructose Intake

High fructose consumption has been linked to increased liver cell damage and elevated AST and ALT levels. Studies by Le et al. (2009) and Perez-Pozo et al. (2010) have demonstrated this connection. Reducing dietary fructose intake, particularly from added sugars and sweetened beverages, may help improve liver enzyme levels.

Green Tea Consumption

While green tea is often touted for its health benefits, excessive consumption may negatively impact liver health. Research by Mazzanti et al. (2009) suggests that high doses of green tea can potentially harm the liver. Moderation in green tea intake may be advisable for those seeking to optimize liver enzyme levels.

Niacin Intake

Niacin, also known as vitamin B3, is essential for overall health. However, intake significantly above the Recommended Dietary Allowance (RDA) of 15 mg/day for males may potentially impact liver enzyme levels. While high-dose niacin supplements (in grams) are known to induce liver damage, even moderately elevated intake from dietary sources could potentially influence AST and ALT levels.

Selenium Status

Selenium, a trace mineral with antioxidant properties, may play a role in liver health. Some research suggests that adequate selenium intake could potentially help optimize liver enzyme levels, although more studies are needed to confirm this relationship.

Strategies for Improving ALT and AST Levels

For individuals looking to optimize their liver enzyme levels, several strategies may be beneficial:

1. Reduce fructose intake: Limit added sugars and sweetened beverages in your diet.
2. Moderate green tea consumption: Aim for 2-4 cups per day rather than excessive amounts.
3. Balance niacin intake: Ensure your niacin consumption aligns with the RDA, avoiding excessive intake from dietary sources or supplements.
4. Optimize selenium status: Include selenium-rich foods in your diet, such as Brazil nuts, fish, and whole grains.
5. Maintain a healthy weight: Excess body fat, particularly around the liver, can contribute to elevated enzyme levels.
6. Limit alcohol consumption: Excessive alcohol intake can damage liver cells and elevate enzyme levels.
7. Exercise regularly: Physical activity can help improve overall liver health and function.

Monitoring and Interpreting Liver Enzyme Levels

Regular blood tests to measure ALT and AST levels can provide valuable insights into your liver health over time. When interpreting these results, consider the following:

• Trend over time: Look for consistent patterns rather than focusing on a single measurement.
• Ratio between AST and ALT: In healthy individuals, ALT is typically higher than AST. A reversed ratio may indicate more severe liver issues.
• Other liver markers: Consider ALT and AST results in conjunction with other liver function tests for a more comprehensive assessment.
• Individual variability: Some people may naturally have slightly higher or lower baseline levels.

If you consistently observe elevated liver enzyme levels, consult with a healthcare professional to determine the underlying cause and develop an appropriate treatment plan.

The Role of Nutrition in Liver Health

A balanced diet plays a crucial role in maintaining optimal liver function and enzyme levels. Consider incorporating the following nutritional strategies:

Antioxidant-Rich Foods

Fruits and vegetables high in antioxidants can help protect liver cells from oxidative stress. Include a variety of colorful produce in your diet, such as berries, leafy greens, and citrus fruits.

Healthy Fats

Omega-3 fatty acids found in fatty fish, flaxseeds, and walnuts may help reduce liver inflammation. Include these foods regularly in your diet while limiting saturated and trans fats.

Fiber-Rich Foods

Adequate fiber intake supports healthy digestion and may help reduce the burden on the liver. Whole grains, legumes, and vegetables are excellent sources of dietary fiber.

Herbs and Spices

Certain herbs and spices, such as turmeric, milk thistle, and garlic, have shown potential liver-protective properties in some studies. While more research is needed, incorporating these into your diet may offer additional benefits.

Lifestyle Factors Affecting Liver Enzyme Levels

Beyond nutrition, several lifestyle factors can significantly impact liver health and enzyme levels:

Stress Management

Chronic stress can negatively affect liver function. Implement stress-reduction techniques such as meditation, yoga, or deep breathing exercises to support overall liver health.

Quality Sleep

Adequate sleep is crucial for liver regeneration and overall health. Aim for 7-9 hours of quality sleep per night to support optimal liver function.

Avoiding Environmental Toxins

Minimize exposure to environmental toxins, such as pesticides and certain cleaning products, which can burden the liver. Choose organic produce when possible and opt for natural cleaning alternatives.

Medication Management

Some medications can impact liver enzyme levels. Always follow your healthcare provider’s guidance regarding medication use and inform them of any supplements you’re taking.

The Importance of Regular Liver Health Monitoring

Maintaining awareness of your liver health through regular monitoring can help detect potential issues early and guide lifestyle interventions. Consider the following approaches:

Routine Blood Tests

Schedule regular comprehensive metabolic panels that include liver enzyme measurements. This allows you to track changes over time and identify trends.

Imaging Studies

In some cases, your healthcare provider may recommend imaging studies such as ultrasounds or CT scans to assess liver structure and detect any abnormalities.

Lifestyle Tracking

Keep a journal of your diet, exercise, and other lifestyle factors. This can help you identify correlations between your habits and liver enzyme levels.

Genetic Considerations

Some genetic factors can influence liver enzyme levels and overall liver health. Discuss your family history with your healthcare provider to determine if genetic testing might be beneficial.

Emerging Research in Liver Health Optimization

The field of liver health is continuously evolving, with new research shedding light on potential strategies for optimization:

Microbiome Connection

Recent studies have explored the relationship between gut microbiome composition and liver health. Probiotics and prebiotics may play a role in supporting optimal liver function.

Chronobiology and Liver Function

Research into circadian rhythms suggests that the timing of meals and sleep patterns can impact liver health. Aligning your eating schedule with your body’s natural rhythms may offer benefits.

Personalized Nutrition Approaches

Advances in nutrigenomics are paving the way for more personalized dietary recommendations based on individual genetic profiles. This could lead to tailored strategies for optimizing liver enzyme levels.

Novel Biomarkers

While ALT and AST remain important indicators, researchers are investigating additional biomarkers that may provide more comprehensive insights into liver health and function.

As our understanding of liver health continues to grow, it’s clear that maintaining optimal ALT and AST levels is crucial for overall well-being and longevity. By implementing evidence-based strategies and staying informed about the latest research, individuals can take proactive steps to support their liver health and potentially reduce their risk of liver-related health issues in the future.

Circulating Liver Enzymes: AST and ALT, What’s Optimal For Health?

Two blood markers of liver health are aspartate aminotransaminase (AST) and alanine aminotransaminase (ALT). AST and ALT are proteins that are usually found inside liver cells, but when there is liver cell damage, they’re released into the blood. It’s important to note that these proteins can also be elevated in the blood because of muscle damage. The reference range for AST is 10-40 U/L, and 7-56 U/Lfor ALT, but are these values optimal for health and longevity?

In a meta-analysis that included ~9 million adults (average age, 51y) that were followed for up to 20 years, Kunutsor et al. (2014) reported the association between AST and ALT with all-cause mortality risk. For AST (4 studies, 9,046,609 subjects), 10-15 U/L was associated with maximally reduced all-cause mortality risk:

For ALT (8 studies, 9,087,436 subjects), 12-15 U/L was associated with maximally reduced all-cause mortality risk:

While these studies are relevant for middle-aged adults between ~50-70y, what about at older ages? Shown below are the AST and ALT values for adults older than 100 years (centenarians):

Interestingly, the centenarians’ AST and ALT values are not far from the meta-analysis data for middle-aged adults. For example, the centenarians’ AST values range from 17-23, and their ALT values from 9-14.

What are my my AST and ALT values? As shown below, I’ve measured them 9 times in the past 10 years. Based on the all-cause mortality and centenarian data my AST and ALT values are too high!

What am I doing to reduce my AST and ALT? Fructose is metabolized by the liver, where high amounts can increase liver cell damage, resulting in increased circulating AST and ALT (Le et al. 2009, Perez-Pozo et al. 2010). Therefore, I’ve reduced my total dietary fructose intake from ~16-18% during the 3 months prior to my last blood test (August, 2015), to ~11-14%. I plan on retesting within the next 2 months, to see if this approach works!

3/23/2016 Update: My average daily fructose intake, expressed as a percentage of total calories, for the 3-month period before my August 2015 blood test was 15.9%. During the 3-month period before my latest blood test (3/2016), my average daily fructose intake was 12. 9%. Although a 3% decrease doesn’t seem like much, the difference between these 2 values is highly statistically significant (p value = 7.5E-12). Nonetheless, my liver enzymes didn’t change, with AST and ALT values of 28 and 30, respectively.

My next attempt to reduce my liver enzymes involves reducing my daily green tea intake.  High doses of green tea have been shown to negatively affect the liver (Mazzanti et al. 2009). I currently drink ~6 cups of green tea per day, which may be too much. To test that hypothesis, I’ll reduce my daily green tea to 4 cups/day, and retest my liver enzymes in a few months.

12/8/2017 Update: Since 3/2016, I’ve tested my blood 7 times, and on each measurement, my ALT and AST were both still in the mid 30’s (or higher!). The green tea reduction experiment didn’t work, nor did ~30g of milk thistle seeds/day for 30+ days, nor did reducing my fructose intake to ~9% of total calories. Because I’ve tracked my nutrition in concordance with blood testing, I can look at which nutrients correlate with my liver enzymes, and reduce/increase certain foods that may impact them. 2=0.50):

Note that the RDA for niacin is ~15 mg/day for males, and my average niacin intake in more than 2-fold higher than that! This may be a case where higher than the RDA is not optimal for health. Niacin in high doses, albeit in grams, not milligrams, is well known to induce liver damage, so isn’t it possible that my 2-fold higher than the RDA niacin intake is inducing liver damage? Sometime in January, I’ll retest my liver enzymes (and everything else, of course) while reducing my dietary niacin intake from the low 40’s to the low 30’s. As I’ve mentioned in previous posts, I eat lots of mushrooms, around 300 grams at a time, which supply around 11 mg of niacin. That’s atop the list to reduce my niacin intake. Stay tuned for the data!

1/6/2018 Update: Finally, progress! On my 1/3/2018 blood test, I was able to reduce my ALT from my average 37 U/L (over 9 different tests) value to 29! To reduce it, I tried two main things: reducing my dietary niacin intake, and increasing my selenium intake. 2 = 0.28) as the correlation between selenium density with ALT.

Is my ALT sensitive to changes in niacin, selenium, or both? Alternatively, maybe it wasn’t niacin or selenium, but an aberrant reading? I’ll keep my niacin relatively low, and my selenium relatively high, so let’s see on my next test at the end of the month.

If you’re interested, please have a look at my book!

References

Arai Y, Takayama M, Gondo Y, Inagaki H, Yamamura K, Nakazawa S, Kojima T, Ebihara Y, Shimizu K, Masui Y, Kitagawa K, Takebayashi T, Hirose N. Adipose endocrine function, insulin-like growth factor-1 axis, and exceptional survival beyond 100 years of age. J Gerontol A Biol Sci Med Sci. 2008 Nov;63(11):1209-18.

Davey A, Lele U, Elias MF, Dore GA, Siegler IC, Johnson MA, Hausman DB, Tenover JL, Poon LW; Georgia Centenarian Study. Diabetes mellitus in centenarians. J Am Geriatr Soc. 2012 Mar;60(3):468-73.

Kunutsor SK, Apekey TA, Seddoh D, Walley J.  Liver enzymes and risk of all-cause mortality in general populations: a systematic review and meta-analysis. Int J Epidemiol. 2014 Feb;43(1):187-201.

Lê KA, Ith M, Kreis R, Faeh D, Bortolotti M, Tran C, Boesch C, Tappy L. Fructose overconsumption causes dyslipidemia and ectopic lipid deposition in healthy subjects with and without a family history of type 2 diabetes. Am J Clin Nutr. 2009 Jun;89(6):1760-5.

Lio D, Malaguarnera M, Maugeri D, Ferlito L, Bennati E, Scola L, Motta M, Caruso C. Laboratory parameters in centenarians of Italian ancestry. Exp Gerontol. 2008 Feb;43(2):119-22.

Mazzanti G, Menniti-Ippolito F, Moro PA, Cassetti F, Raschetti R, Santuccio C, Mastrangelo S. Hepatotoxicity from green tea: a review of the literature and two unpublished cases. Eur J Clin Pharmacol. 2009 Apr;65(4):331-41.

Perez-Pozo SE, Schold J, Nakagawa T, Sánchez-Lozada LG, Johnson RJ, Lillo JL. Excessive fructose intake induces the features of metabolic syndrome in healthy adult men: role of uric acid in the hypertensive response.  Int J Obes (Lond). 2010 Mar;34(3):454-61.

Willcox DC, Willcox BJ, Wang NC, He Q, Rosenbaum M, Suzuki M. Life at the extreme limit: phenotypic characteristics of supercentenarians in Okinawa. J Gerontol A Biol Sci Med Sci. 2008 Nov;63(11):1201-8.

Vasto S, Scapagnini G, Rizzo C, Monastero R, Marchese A, Caruso C. Mediterranean diet and longevity in Sicily: survey in a Sicani Mountains population. Rejuvenation Res. 2012 Apr;15(2):184-8.

Like this:

Like Loading…

ALT:AST Ratio | Optimal DX

Enzymes are here and there but they shouldn’t be everywhere!

Part 1: ALT:AST Ratio

By Dicken Weatherby, N.D. and Beth Ellen DiLuglio, MS, RDN, LDN

Alanine aminotransferase (ALT)) and aspartate aminotransferase (AST) are enzymes that participate in gluconeogenesis by transferring amino groups to alpha-ketoglutaric acid
from alanine (to produce pyruvic acid) or from aspartic acid (to produce oxaloacetic acid). They are often called “liver enzymes” though they are found in other tissues.

ALT is found in high concentrations in the liver and lower concentrations in the brain, intestines, muscle, adipose tissue, and prostate. Elevated serum levels of ALT tend to be more specific to liver injury than other tissue injury.[i]

AST is found in the liver, muscle, brain, kidneys, pancreas, lungs, and white and red blood cells. Increased release of both enzymes into the bloodstream is a sign of tissue damage which can eventually lead to loss of function.[ii]

In this first part of our 2-part series on the ratios of ALT and AST we will be diving into the ALT:AST ratio and discussing the types of conditions that are associated with an elevated ratio. Part 2 will focus on the AST:ALT ratio!

ALT:AST ratio

An increasing ratio of ALT to AST is associated with the closely related disorders of insulin resistance, metabolic syndrome, non-alcoholic fatty liver disease, and cardiovascular disease.[iii] [iv] Research strongly suggests that the ratio may be used as a marker of metabolic health. A health survey of 16,371 adults revealed that increasing ALT:AST ratios correlated with impaired fasting glucose, insulin resistance/HOMA-IR, undiagnosed type 2 diabetes, and declining metabolic health.[v]

Insulin resistance

The presence of insulin resistance should be assessed in view of its role in metabolic syndrome, diabetes, cardiovascular disease, dyslipidemia, and hypertension and extensive research is warranted.

An increased ratio of ALT to AST is independently associated with insulin resistance (IR) and considered a primary marker for the disorder. Researchers in a large cross-sectional study of 8398 adults suggested a cut-off point for ALT:AST of 0.80 in non-centrally obese individuals and 0.78 in the centrally obese for identifying IR.[vi]

Insulin resistance[vii]

• Insulin resistance is identified as an impaired biologic response to insulin stimulation of target tissues, primarily the liver, muscle, and adipose tissue.
• Insulin resistance impairs glucose disposal, resulting in a compensatory increase in beta-cell insulin production and hyperinsulinemia.
• The metabolic consequences of insulin resistance can result in hyperglycemia, hypertension, dyslipidemia, visceral adiposity, hyperuricemia, elevated inflammatory markers, endothelial dysfunction, and a prothrombic state.
• Progression of insulin resistance can lead to metabolic syndrome, nonalcoholic fatty liver disease (NAFLD), and type 2 diabetes mellitus.
• Screening for insulin resistance can be achieved by calculating the homeostatic model assessment- insulin resistance (HOMA-IR): fasting insulin (μU/ml) x fasting glucose (mmol/l) /22.5.[viii]

In a cross-sectional study of 587 male and 755 female adults, increased risk of insulin resistance was identified by an increasing ratio of ALT to AST in both overweight (BMI greater than 25) and normal weight individuals (BMI less than 25).[ix] The study identified insulin resistance in overweight subjects with an ALT:AST ratio greater than or equal to 1.02. Insulin resistance was identified in normal weight individuals with an ALT:AST ratio of 0. 82 or greater, a level associated with a 1.91-fold increase in insulin resistance. The ALT:AST ratio was a better predictor of insulin resistance than blood pressure, low HDL, or ALT and AST alone. The study defined insulin resistance as a HOMA-IR value of 2.5 or greater.

Cardiovascular disease

Cardiovascular disease, insulin resistance, and other metabolic disorders are closely linked, and assessment of the ALT:AST ratio can help confirm this morbid relationship. The ratio of ALT to AST was calculated in 1063 patients with proven coronary artery disease. Research revealed that an ALT:AST ratio of 1.1 was “strongly and significantly” able to predict adverse cardiovascular events in those CAD patients with insulin resistance (defined by a HOMA-R of greater than 2.5).[x]

Metabolic syndrome

The phenomenon of metabolic syndrome is characterized by insulin resistance, glucose intolerance, atherogenic dyslipidemia, hypertension, abdominal obesity, inflammation, and a prothrombotic state and represents a cluster of metabolic abnormalities. Use of the ALT:AST ratio can help identify those at risk for, or in the throes of, metabolic syndrome. A ratio of greater than 1 was observed in 60 adults with established metabolic syndrome.[xi]

The ALT:AST ratio may even help identify those with metabolic syndrome in its “silent” stage. A cross-sectional examination of 1643 male and 1764 female subjects revealed significantly higher ratios of ALT to AST in those identified as having metabolic syndrome. Elevated ALT:AST ratios in both males and females diagnosed with metabolic syndrome significantly correlated with greater waist circumference as well. [xii] The study also confirmed a close association of metabolic syndrome with non-alcoholic fatty liver disease, another metabolic abnormality associated with elevated ALT:AST ratios.

Non-alcoholic liver disease (NAFLD)

The health of the liver is closely tied to blood glucose regulation and insulin resistance, as the liver is responsible for clearing insulin from the bloodstream. [xiii] It comes as no surprise that insulin resistance in turn is closely tied to NAFLD. An increased ALT:AST ratio is considered a surrogate marker for non-alcoholic fatty liver disease, an all-too-common phenomenon associated with accumulation of fat in the liver (hepatosteatosis).[xiv]

The strong association between ALT:AST ratio and NAFLD is evident even in children and adolescents. Those with an ALT:AST ratio of greater than 0.98 had a 2.19-fold greater risk of NAFLD. Low-grade NAFLD was characterized by an ALT:AST ratio of 1.07 while a ratio higher than 1.46 was associated with higher grade NAFLD. Individuals with NAFLD were heavier with a greater waist circumference and had significantly higher blood pressure and dyslipidemia.[xv]

It is imperative to identify NAFLD early as it is closely related to oxidative stress, endothelial dysfunction, adverse cardiovascular events, and metabolic syndrome.[xvi]  Evaluation of the ALT:AST ratio can be a significant predictor for hepatosteatosis/NAFLD in individuals with chronic hepatitis C infection as well. [xvii]

An optimal ratio of ALT to AST may reflect metabolic health and absence of liver disease. However, an extremely low ALT:AST may be due to extremely low ALT levels which are in turn associated with frailty and aging.[xviii]

Calculating The Ratio – Let ODX Do the Work!

Good news! The ALT:AST ratio is now being automatically calculated by the Optimal DX software if both the ALT and AST are added into the system. No need to do any conversions as the software will do this for you and will now show the result in the Blood Test Results Report:

However, if you simply want to do the calculation manually then please follow these instructions:

The ALT:AST ratio is calculated by dividing the ALT result by the AST result.

Here’s an example:

ALT is 22 and the AST is 26: 22 / 26 = 0.85
So, the ALT:AST Ratio in this example is 0.85

References

[i] Woreta TA, Alqahtani SA. Evaluation of abnormal liver tests. Med Clin North Am. 2014 Jan;98(1):1-16.

[ii] Thapa BR, Walia A. Liver function tests and their interpretation. Indian J Pediatr. 2007 Jul;74(7):663-71. Review. PubMed PMID: 17699976. [R]

[iii] Rief P, Pichler M, Raggam R, et al. The AST/ALT (De-Ritis) ratio: A novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. Medicine (Baltimore). 2016 Jun;95(24):e3843. [R]

[iv] Hall P, Cash J. What is the real function of the liver ‘function’ tests? Ulster Med J. 2012 Jan;81(1):30-6. [R]

[v] Gowda S, Desai PB, Hull VV, et al. A review on laboratory liver function tests. Pan Afr Med J. 2009 Nov 22;3:17. [R]

[vi] Woreta TA, Alqahtani SA. Evaluation of abnormal liver tests. Med Clin North Am. 2014 Jan;98(1):1-16. [R]

[vii] Giannini E, Risso D, Botta F, et al. Validity and clinical utility of the aspartate aminotransferase-alanine aminotransferase ratio in assessing disease severity and prognosis in patients with hepatitis C virus-related chronic liver disease. Arch Intern Med. 2003 Jan 27;163(2):218-24. [R]

[viii] Newsome PN, Cramb R, Davison SM, et al. Guidelines on the management of abnormal liver blood tests. Gut. 2018 Jan;67(1):6-19. [R]

[ix] Hall P, Cash J. What is the real function of the liver ‘function’ tests? Ulster Med J. 2012 Jan;81(1):30-6. [R]

[x] Giannini E, Risso D, Botta F, et al. Validity and clinical utility of the aspartate aminotransferase-alanine aminotransferase ratio in assessing disease severity and prognosis in patients with hepatitis C virus-related chronic liver disease. Arch Intern Med. 2003 Jan 27;163(2):218-24. [R]

[xi] Botros M, Sikaris KA. The de ritis ratio: the test of time. Clin Biochem Rev. 2013 Nov;34(3):117-30. Review. [R]

[xii] Botros M, Sikaris KA. The de ritis ratio: the test of time. Clin Biochem Rev. 2013 Nov;34(3):117-30. Review. [R]

[xiii] Kawachi I, Robinson GM, Stace NH. A combination of raised serum AST:ALT ratio and erythrocyte mean cell volume level detects excessive alcohol consumption. N Z Med J. 1990 Apr 11;103(887):145-8. [R]

[xiv] Lala V, Goyal A, Bansal P, Minter DA. Liver Function Tests. 2020 Mar 27. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.Available from [R]

[xv] Thapa BR, Walia A. Liver function tests and their interpretation. Indian J Pediatr. 2007 Jul;74(7):663-71. Review. [R]

[xvi] Alempijevic T, Krstic M, Jesic R, et al. Biochemical markers for non-invasive assessment of disease stage in patients with primary biliary cirrhosis. World J Gastroenterol. 2009 Feb 7;15(5):591-4. [R]

[xvii] Hall P, Cash J. What is the real function of the liver ‘function’ tests? Ulster Med J. 2012 Jan;81(1):30-6. [R]

[xviii] Rief P, Pichler M, Raggam R, et al. The AST/ALT (De-Ritis) ratio: A novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. Medicine (Baltimore). 2016 Jun;95(24):e3843. doi: 10.1097/MD.0000000000003843. Erratum in: Medicine (Baltimore). 2016 Aug 07;95(31):e5074. [R]

[xix] Rej R. Aminotransferases in disease. Clin Lab Med. 1989 Dec;9(4):667-87. PMID: 2686908. [R]

[xx] Lin S, Tang L, Jiang R, et al. The Relationship Between Aspartate Aminotransferase To Alanine Aminotransferase Ratio And Metabolic Syndrome In Adolescents In Northeast China. Diabetes Metab Syndr Obes. 2019 Nov 18;12:2387-2394[R]

[xxi] Hanley AJ, Williams K, Festa A, et al. Liver markers and development of the metabolic syndrome: the insulin resistance atherosclerosis study. Diabetes. 2005 Nov;54(11):3140-7. [R]

Complex of analyzes Basic biochemical indicators (ALT, AST Glucose, Creatinine (with determination of GFR), Urea, Total protein, Total bilirubin, Total cholesterol) in St. Petersburg

Back to list

Number of tests included in the complex: 8 pcs.

Composition of the complex

ALT (ALT, Alanine aminotransferase, alanine transaminase, SGPT, Alanine aminotransferase)

AST (AST, aspartate aminotransferase, AST, SGOT, Aspartate aminotransferase)

Bilirubin total (Bilirubin total)

Glucose (in plasma) (Glucose)

Creatinine (in blood) (Creatinine)

Urea (in blood) (Urea)

Total protein in blood (Protein total)

Cholesterol total (cholesterol, Cholesterol total)

Biomaterial and collection method

Deadline: up to 2 days.

Download sample analysis

Analysis for basic biochemical parameters (Biochemical profile) includes the determination of indicators of ALT, AST, glucose, creatinine (with determination of GFR), urea, total protein, total bilirubin, total cholesterol. The main biochemical indicators of blood reflect the health of the organs and systems of the body. Examination is recommended for preventive purposes for early detection of diseases, as well as for diagnosis in the presence of symptoms of pathology.

• donate blood on an empty stomach;
• shortly before taking blood, drink 1-2 glasses of plain non-carbonated water;
• when taking tests against the background of taking medications, this fact must be indicated in the referral form;
• do not play sports on the day of the test;
• exclude increased emotional stress;
• a few minutes before taking blood, take a comfortable position (sit down), relax, calm down;
• refrain from drinking alcohol for 72 hours before testing;
• do not smoke for at least 30 min. before taking blood

Each of the indicators has its own reference values ​​and possible causes of deviation from the norm. Among them are disorders of lipid and carbohydrate metabolism, acute and chronic diseases of the kidneys, liver and gallbladder, pancreas, rheumatoid arthritis, tuberculosis, etc. Changes in biochemical parameters are also noted during pregnancy, malnutrition, and long-term use of drugs. If abnormalities are identified, additional examinations are recommended to make a final diagnosis.

Important!
If an examination is to be performed using the CITO service, pack the sample in a separate bag and label with the CITO sticker.

Collection and Transport Recommendations

Vacuum Tube, Clotting Activator Gel (yellow cap), 4 ml

Sample Processing

room temperature (35-40 min.)

Sample storage

at +2. ..+8°C

Sample transport

at +2…+8°C

Vacuum tube filled with Na fluoride + Na2-EDTA ( gray cap), 4 ml

Sample processing

• Mix 5-6 times
• Centrifuge at 2000-2200 g* for 10 minutes.
• Store and transport sample at +2…+8°C

Sample storage

at +2…+8°C

Sample transport

at +2…+8°C

Investigation / TOA

Screening for drugs and psychoactive substances (THC., OPI.,AMP.)

Deadline

up to 3 days.

Price

590 ₽

Research / 99-000-030

Liver and pancreas function screening

Deadline

2 – 3 days.

Price

1 125 ₽

Study

With care for women’s health

Price

2 990 ₽

Study

Extended biochemical blood test

Deadline

up to 2 days.

Price

4 450 ₽

Thank you, message sent successfully!

Page address *

Specify the exact address of the page where you noticed the error

Error description *

Describe the error in as much detail as possible so that we can quickly fix it

In case of errors related to pre-orders, please kindly indicate the list of ordered analyzes, as well as the checkout step at which the error occurred.

Email *

He may be needed to contact you to clarify some details to correct

I agree to the terms of the privacy policy

Health Clinic 365 Yekaterinburg

Prices

Check your health. Joints (Pain in joints)

1400 i

AST (aspartate aminotransferase)

A protein molecule that promotes the activation of biochemical processes in the body. Measurement of AST activity is indicated in the monitoring and differential diagnosis of diseases of the hepatobiliary system, myocardial infarction and damage to skeletal muscles. Elevated AST: long-term use of aspirin or hormonal contraceptives, infectious diseases, muscle injuries, pancreatitis, cirrhosis, hepatitis, liver cancer, heart disease, pulmonary thrombosis. Reduced AST: vitamin B6 deficiency, after repeated hemodialysis, severe necrotic processes in the liver.

Reference values: 0-38 U/L (60 years – 9-48 U/L).

ALT (alanine aminotransferase)

This enzyme is synthesized in a greater amount in the liver, in a smaller amount in the kidneys, pancreas, myocardium, skeletal muscles. Normally, the concentration of ALT in the blood is low. Elevated ALT: malnutrition, uncontrolled misuse of dietary supplements, excessive exercise, viral infection, blood diseases, pancreatitis, shock, hepatitis, cirrhosis, severe heart failure. Decreased ALT: lack of vitamin B6 in the body, taking drugs containing: aspirin, interferon, phenothiazine, cirrhosis, necrosis, liver rupture.

Reference values: 5-41 U/l.

! Steroids, choleretics, oral contraceptives, immunosuppressants, psychotropic drugs, antitumor drugs, nicotinic acid, etc. can affect the blood levels of AST and ALT. Elevated creatinine: excessive or rapid muscle gain, excessive exercise, muscle breakdown, kidney disease, gangrene, burns, dehydration, diabetes mellitus, rheumatoid arthritis, leptospirosis, heart failure, toxemia during pregnancy, pregnancy and lactation. Decreased creatinine: cachexia, rapid weight loss, muscle wasting, pregnancy.

Reference values: women – 58-96 µmol/l, men – 72-127 µmol/l.

Uric acid

Removes excess nitrogen from the body. Elevated uric acid: excessive exercise, fasting, gout, leukemia, lymphoma, anemia (caused by vitamin B12 deficiency), pneumonia, scarlet fever, tuberculosis, liver, kidney, biliary tract diseases, diabetes mellitus, eczema, psoriasis, urticaria, toxemia in pregnant women , acidosis, alcohol poisoning. Low uric acid: Wilson-Konovalov disease, Fanconi syndrome, improper diet, taking certain medications.

Reference values: women – 140-390 µmol/l, men – 260-450 µmol/l.

Rheumatoid factor

Autoantibodies that mistakenly attack the body’s own tissues, mistaking them for foreign ones. The blood test for rheumatoid factor is used as a marker of inflammatory and autoimmune activity. Most often, this test is used to diagnose rheumatoid arthritis and Sjögren’s syndrome, but the level of RF in the blood can also increase in other inflammatory and autoimmune diseases. Increased rheumatoid factor: rheumatoid arthritis, Sjögren’s syndrome, systemic lupus erythematosus, endocarditis, syphilis, tuberculosis, certain cancers and sarcomas, infectious diseases, liver, kidney and lung diseases.

Reference values: <14 IU/ml.

Calcium

It is found in the body mainly in bone tissue and teeth in the form of hydroxyapatites (compound of calcium and phosphates). It enters the body with food and is spent on the construction of bone tissue, on the processes of contraction of the muscles of the body and heart, participates in the transmission of nerve impulses and in the processes of blood clotting. An analysis of the calcium content in the blood is prescribed for the diagnosis of bone tissue diseases, the detection of thyroid dysfunction, and for the study of kidney function. Increased calcium in the blood (hypercalcemia): hyperparathyroidism (pathology of the parathyroid gland), malignant tumors, less often – stomach ulcers, pancreatitis.