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Blood work for liver functions: Liver function tests – Mayo Clinic

Liver Function Tests: Purpose, Procedure, and Results

Liver function tests are blood tests that can be used to monitor the health of your liver. Ask the doctor what you need to do to prepare. In some cases you may need to avoid food or certain medications before the test.

Liver function tests, also known as liver chemistries, help determine the health of your liver by measuring the levels of proteins, liver enzymes, and bilirubin in your blood. They can also monitor the progression or treatment of an existing disease.

Depending on the test, either higher- or lower-than-typical levels of these enzymes or proteins can indicate a problem with your liver.

Some of the reasons liver function tests may be performed include screening for diseases such as hepatitis, monitoring the side effects of your medications, and examining the severity of liver disease.

In this article, we take a look at when you might need a liver function test, the different types of tests used, and how to interpret results.

A liver function test is often recommended in the following situations:

  • to check for damage from liver infections, such as hepatitis B and hepatitis C, especially if it’s suspected you were exposed to a virus that causes hepatitis
  • to monitor the side effects of certain medications because some medications are known to affect the liver, including:
    • NSAIDs
    • statins
    • antibiotics
    • antiseizure medications
    • tuberculosis drugs
  • if you already have liver disease, to monitor the disease and how well a particular treatment is working
  • if you’re experiencing the symptoms of a liver disorder or have a family history of a liver disease, such as fatty liver disease
  • if you have certain medical conditions, such as:
    • high triglycerides
    • diabetes
    • high blood pressure
    • anemia
  • if you drink alcohol frequently
  • if you have gallbladder disease

Certain tests can reflect different aspects of liver function. For example, elevated alanine transaminase and aspartate transaminase disproportional to bilirubin and alkaline phosphatase levels often indicates liver disease.

Liver function tests are used to measure specific enzymes and proteins in your blood.

Having atypical results on any of these liver tests usually requires a follow-up to determine the cause of the atypical characteristics. Even mildly elevated results can be associated with liver disease.

Common liver function tests include:

Alanine transaminase (ALT) test

Alanine transaminase (ALT) is used by your body to metabolize protein. If the liver is damaged or not functioning properly, ALT can be released into the blood. This causes ALT levels to increase. A higher result than what’s typical on this test can be a sign of liver damage.

It’s estimated that about 10 percent of people in the United States have elevated ALT levels.

Aspartate aminotransferase (AST) test

Aspartate aminotransferase (AST) is an enzyme found in several parts of your body, including your:

  • heart
  • brain
  • pancreas
  • liver
  • muscles

When the liver is damaged, AST can be released into the bloodstream. A high result on an AST test might indicate a problem with the liver or muscles.

Since AST levels aren’t as specific of a marker for liver damage as ALT, it’s usually measured together with ALT to check for liver problems. For example, a high AST:ALT ratio may indicate alcoholic liver disease.

Alkaline phosphatase (ALP) test

Alkaline phosphatase (ALP) is an enzyme found in your bones, bile ducts, and liver. An ALP test is typically ordered in combination with several other tests. An ALP test can be used to evaluate the bile duct system of the liver.

Albumin test

Albumin is the main protein made by your liver. It performs many important bodily functions.

For example, albumin nourishes your tissues and transports hormones, vitamins, and other substances throughout your body. An albumin test measures how well your liver is making this particular protein.

Bilirubin test

Bilirubin is a waste product from the breakdown of red blood cells. It’s ordinarily processed by the liver. It passes through the liver before being excreted through your stool.

A damaged liver can’t properly process bilirubin. This leads to an atypically high level of bilirubin in the blood. Certain inherited diseases can raise bilirubin levels, even when liver function works as expected.

The following table shows what liver function tests may indicate in terms of higher or lower results than typical. Following any liver function test, you should have a discussion with your doctor about your test results and what they mean for you.

Problems with the liver can make a person very sick and can even be life threatening. Approximately 4.5 million adults in the United States have chronic liver disease.

Symptoms of a liver disorder include:

  • weakness
  • fatigue or loss of energy
  • weight loss
  • jaundice (yellow skin and eyes)
  • fluid collection in the abdomen, known as ascites
  • discolored bodily discharge (dark urine or light stools)
  • nausea
  • vomiting
  • diarrhea
  • abdominal pain
  • atypical bruising or bleeding

Your doctor may order a liver function test if you’re experiencing symptoms of a liver disorder.

Liver function tests can also monitor the progression or treatment of a disease and test for the side effects of certain medications.

Your doctor will give you complete instructions on how to prepare for the blood sample portion of the test.

Certain medications and foods may affect levels of these enzymes and proteins in your blood. Your doctor may ask you to avoid some types of medications, or they may ask you to avoid eating anything for a period of time before the test. Be sure to continue drinking water prior to the test.

You may want to wear a shirt with sleeves that can easily be rolled up to make it easier for the medical expert to collect the blood sample.

You may have your blood drawn in a hospital or at a specialized testing facility. To administer the test:

  1. The healthcare technician will clean your skin before the test to decrease the likelihood that any microorganisms on your skin will cause an infection.
  2. They’ll likely wrap an elastic strap on your arm. This will help your veins become more visible. They’ll then use a needle to draw samples of blood from your arm.
  3. After the draw, the technician will place some gauze and a bandage over the puncture site. Your blood sample will be sent to a laboratory for testing.

Potential risks of a liver function test

Blood draws are routine procedures and rarely cause any serious side effects. However, the risks of giving a blood sample can include:

  • bleeding under the skin, or hematoma
  • excessive bleeding
  • fainting
  • infection

Was this helpful?

After the test, you can usually resume everyday activities. However, if you feel faint or lightheaded during the blood draw, you should rest before you leave the testing facility.

The results of these tests may not tell your doctor exactly which condition you have or the degree of liver damage, but they might help your doctor determine the next steps. Your doctor will call you with the results or discuss them with you at a follow-up appointment.

In general, if your results indicate a problem with your liver function, your doctor will review your medications and your past medical history to help determine the cause.

If you drink alcohol frequently, then you’ll need to stop drinking it. If your doctor identifies that a medication is causing the elevated liver enzymes, they’ll advise you to stop the medication.

Other diagnostic tests

Your doctor may decide to test you for hepatitis, other infections, or other diseases that can affect the liver. They may also choose to do imaging tests, like an ultrasound or CT scan.

In addition, they may recommend a liver biopsy to evaluate the liver for fibrosis, fatty liver disease, or other liver conditions.

Liver function tests are blood tests used to help determine the health of your liver. Changes in certain levels of proteins or enzymes can alert doctors of potential problems such as liver cancer, fatty liver disease, or hepatitis.

Liver function tests can also help determine if certain medications are damaging your liver or help you monitor the progression of liver disease.

After you get a liver function test, your doctor can help you interpret the results and discuss what the results mean for you. If they suspect you have liver disease, you may need to undergo other tests such as imaging or a liver biopsy.

Liver Function Tests: Purpose, Procedure, and Results

Liver function tests are blood tests that can be used to monitor the health of your liver. Ask the doctor what you need to do to prepare. In some cases you may need to avoid food or certain medications before the test.

Liver function tests, also known as liver chemistries, help determine the health of your liver by measuring the levels of proteins, liver enzymes, and bilirubin in your blood. They can also monitor the progression or treatment of an existing disease.

Depending on the test, either higher- or lower-than-typical levels of these enzymes or proteins can indicate a problem with your liver.

Some of the reasons liver function tests may be performed include screening for diseases such as hepatitis, monitoring the side effects of your medications, and examining the severity of liver disease.

In this article, we take a look at when you might need a liver function test, the different types of tests used, and how to interpret results.

A liver function test is often recommended in the following situations:

  • to check for damage from liver infections, such as hepatitis B and hepatitis C, especially if it’s suspected you were exposed to a virus that causes hepatitis
  • to monitor the side effects of certain medications because some medications are known to affect the liver, including:
    • NSAIDs
    • statins
    • antibiotics
    • antiseizure medications
    • tuberculosis drugs
  • if you already have liver disease, to monitor the disease and how well a particular treatment is working
  • if you’re experiencing the symptoms of a liver disorder or have a family history of a liver disease, such as fatty liver disease
  • if you have certain medical conditions, such as:
    • high triglycerides
    • diabetes
    • high blood pressure
    • anemia
  • if you drink alcohol frequently
  • if you have gallbladder disease

Certain tests can reflect different aspects of liver function. For example, elevated alanine transaminase and aspartate transaminase disproportional to bilirubin and alkaline phosphatase levels often indicates liver disease.

Liver function tests are used to measure specific enzymes and proteins in your blood.

Having atypical results on any of these liver tests usually requires a follow-up to determine the cause of the atypical characteristics. Even mildly elevated results can be associated with liver disease.

Common liver function tests include:

Alanine transaminase (ALT) test

Alanine transaminase (ALT) is used by your body to metabolize protein. If the liver is damaged or not functioning properly, ALT can be released into the blood. This causes ALT levels to increase. A higher result than what’s typical on this test can be a sign of liver damage.

It’s estimated that about 10 percent of people in the United States have elevated ALT levels.

Aspartate aminotransferase (AST) test

Aspartate aminotransferase (AST) is an enzyme found in several parts of your body, including your:

  • heart
  • brain
  • pancreas
  • liver
  • muscles

When the liver is damaged, AST can be released into the bloodstream. A high result on an AST test might indicate a problem with the liver or muscles.

Since AST levels aren’t as specific of a marker for liver damage as ALT, it’s usually measured together with ALT to check for liver problems. For example, a high AST:ALT ratio may indicate alcoholic liver disease.

Alkaline phosphatase (ALP) test

Alkaline phosphatase (ALP) is an enzyme found in your bones, bile ducts, and liver. An ALP test is typically ordered in combination with several other tests. An ALP test can be used to evaluate the bile duct system of the liver.

Albumin test

Albumin is the main protein made by your liver. It performs many important bodily functions.

For example, albumin nourishes your tissues and transports hormones, vitamins, and other substances throughout your body. An albumin test measures how well your liver is making this particular protein.

Bilirubin test

Bilirubin is a waste product from the breakdown of red blood cells. It’s ordinarily processed by the liver. It passes through the liver before being excreted through your stool.

A damaged liver can’t properly process bilirubin. This leads to an atypically high level of bilirubin in the blood. Certain inherited diseases can raise bilirubin levels, even when liver function works as expected.

The following table shows what liver function tests may indicate in terms of higher or lower results than typical. Following any liver function test, you should have a discussion with your doctor about your test results and what they mean for you.

Problems with the liver can make a person very sick and can even be life threatening. Approximately 4.5 million adults in the United States have chronic liver disease.

Symptoms of a liver disorder include:

  • weakness
  • fatigue or loss of energy
  • weight loss
  • jaundice (yellow skin and eyes)
  • fluid collection in the abdomen, known as ascites
  • discolored bodily discharge (dark urine or light stools)
  • nausea
  • vomiting
  • diarrhea
  • abdominal pain
  • atypical bruising or bleeding

Your doctor may order a liver function test if you’re experiencing symptoms of a liver disorder.

Liver function tests can also monitor the progression or treatment of a disease and test for the side effects of certain medications.

Your doctor will give you complete instructions on how to prepare for the blood sample portion of the test.

Certain medications and foods may affect levels of these enzymes and proteins in your blood. Your doctor may ask you to avoid some types of medications, or they may ask you to avoid eating anything for a period of time before the test. Be sure to continue drinking water prior to the test.

You may want to wear a shirt with sleeves that can easily be rolled up to make it easier for the medical expert to collect the blood sample.

You may have your blood drawn in a hospital or at a specialized testing facility. To administer the test:

  1. The healthcare technician will clean your skin before the test to decrease the likelihood that any microorganisms on your skin will cause an infection.
  2. They’ll likely wrap an elastic strap on your arm. This will help your veins become more visible. They’ll then use a needle to draw samples of blood from your arm.
  3. After the draw, the technician will place some gauze and a bandage over the puncture site. Your blood sample will be sent to a laboratory for testing.

Potential risks of a liver function test

Blood draws are routine procedures and rarely cause any serious side effects. However, the risks of giving a blood sample can include:

  • bleeding under the skin, or hematoma
  • excessive bleeding
  • fainting
  • infection

Was this helpful?

After the test, you can usually resume everyday activities. However, if you feel faint or lightheaded during the blood draw, you should rest before you leave the testing facility.

The results of these tests may not tell your doctor exactly which condition you have or the degree of liver damage, but they might help your doctor determine the next steps. Your doctor will call you with the results or discuss them with you at a follow-up appointment.

In general, if your results indicate a problem with your liver function, your doctor will review your medications and your past medical history to help determine the cause.

If you drink alcohol frequently, then you’ll need to stop drinking it. If your doctor identifies that a medication is causing the elevated liver enzymes, they’ll advise you to stop the medication.

Other diagnostic tests

Your doctor may decide to test you for hepatitis, other infections, or other diseases that can affect the liver. They may also choose to do imaging tests, like an ultrasound or CT scan.

In addition, they may recommend a liver biopsy to evaluate the liver for fibrosis, fatty liver disease, or other liver conditions.

Liver function tests are blood tests used to help determine the health of your liver. Changes in certain levels of proteins or enzymes can alert doctors of potential problems such as liver cancer, fatty liver disease, or hepatitis.

Liver function tests can also help determine if certain medications are damaging your liver or help you monitor the progression of liver disease.

After you get a liver function test, your doctor can help you interpret the results and discuss what the results mean for you. If they suspect you have liver disease, you may need to undergo other tests such as imaging or a liver biopsy.

Liver test up to 50% off

Description of analysis

A comprehensive analysis for the liver, which includes tests that allow you to evaluate both the general functional state of the liver: ALT, AST; the function of protein metabolism: total protein, albumin, urea; synthesis of bilirubin and bile production: bilirubin and its fractions; bile secretion: GGTP, alkaline phosphatase.

The complex is recommended at any age in case of suspected damage and inflammation of the liver, before and against the background of taking hepatotoxic drugs, to control the treatment of liver diseases, cholelithiasis. Also, the complex is suitable for the initial assessment of the state of the liver against the background of diseases of other organs, for example, kidneys, stomach, intestines, diabetes mellitus, rheumatological diseases, parasitic infections.

Research material
— Blood serum

includes 8 studies

  • Enzyme of liver cells, increases when they are damaged

  • Major substance carrier protein, decreases with malnutrition and liver dysfunction

  • Enzyme of liver and muscle cells, increases when they are damaged

  • Pigment formed during the breakdown of blood cells indicates increased breakdown of blood or impaired functioning of the liver and biliary tract

  • Enzyme of cells of the liver, biliary tract and pancreas

  • Metabolic product of liver proteins, excreted by kidneys

  • Total amount of protein produced by the liver and supplied with food

  • Enzyme of cells of the biliary tract and bones, increases when they are damaged

Order other complexes suitable for you

if the analyzes are repeated, the price of the complex will decrease by their cost

  • Current complex

    Liver function, complex of analyzes (liver tests) – 8 studies

  • Another

    Biochemical blood test (advanced) – 20 studies

How to prepare

In advance

  • do not take blood tests immediately after X-ray, fluorography, ultrasound, physiotherapy

The day before

  • limit fatty and fried foods, do not take alcohol
  • avoid strenuous exercise
  • 8 to 14 hours before blood donation, do not eat, drink only pure still water

On the day of donation

Before the procedure blood sampling

  • 60 minutes no smoking
  • 15-30 minutes quiet

Result

  • Electronic result

    At the post office and in your personal account when ready

    View example

  • Expert interpretation of results

    Transcription created based on our expert algorithms, medical and statistical data. She will talk about each analysis separately and, most importantly, how they affect each other. All analyzes of the complex are grouped by organs, diseases or processes.

    We will decipher your tests if you are not pregnant, you are over 18 years old, you do not have chronic diseases and all the results of the analyzes of the complex are completed. We may refuse to decrypt at our discretion with a refund.

    We will send the transcript within 1 day after the analysis is ready, excluding Saturday and Sunday.

  • Medical consultation

    Online consultation based on test results and a questionnaire that you fill out in advance. It will be available to order in 2024.

    View example

Liver function, complex of analyzes (liver tests)

A comprehensive analysis for the liver, which includes tests that allow you to evaluate both the general functional state of the liver: ALT, AST; the function of protein metabolism: total protein, albumin, urea; synthesis of bilirubin and bile production: bilirubin and its fractions; bile secretion: GGTP, alkaline phosphatase.

Many types of metabolism take place in the liver cells. Protein metabolism involves enzymes of liver cells (hepatocytes), called transaminases (ALT and AST). An increase in transaminases in the blood can be observed during cytolysis (destruction) of hepatocytes. An increase in ALT often indicates liver damage, while an increase in AST can also be observed with muscle damage, myocardial infarction, hemolysis of red blood cells. In acute viral hepatitis, the levels of enzymes exceed the upper limit of the norm by 5-10 times, and in chronic hepatitis by 1.5-2 times, increasing approximately the same. In alcoholic hepatitis, cirrhosis, liver metastases, there is a predominant increase in AST.

The biliary function of the liver and biliary tract is assessed by the enzymes alkaline phosphatase (AP) and gamma-glutamyl transpeptidase (GGTP). In the case of their simultaneous increase, first of all, obstruction (blockage) of the biliary tract is excluded, for example, with cholelithiasis. High levels of GGTP are characteristic of cirrhosis and liver metastases. A moderate increase in GGTP (2-5 times) is observed in viral hepatitis. Unlike GGTP, alkaline phosphatase also increases in diseases of the bones and intestines.

For hepatic jaundice and obstruction of the biliary tract, the increase in total bilirubin is also typical more due to the direct fraction. Violation of the synthesis of bilirubin occurs with hereditary Gilbert’s syndrome, when there is not enough enzyme that neutralizes indirect bilirubin.

Many drugs are hepatotoxic, causing temporary damage to liver cells. To exclude the development of toxic hepatitis during the treatment of certain diseases, it is necessary to regularly evaluate liver function.

The general assessment of the results of the research, the establishment of a diagnosis and the appointment of therapy is carried out by the attending physician.

Complete laboratory examination of the liver

Comprehensive laboratory examination of the liver, including indicators of protein, fat and pigment metabolism, markers of viral hepatitis and tumor marker alpha-fetoprotein (AFP).

Russian synonyms

Complete laboratory examination of the liver, screening for liver diseases.

English synonyms

Laboratory liver panel, Tests to diagnose liver diseases, Liver check-up.

Which biomaterial can be used for research?

Venous blood.

How to properly prepare for an examination?

  • Do not eat for 12 hours before the test, you can drink pure non-carbonated water.
  • Avoid physical and emotional stress for 30 minutes prior to examination.
  • Do not smoke for 30 minutes before the test.

General information about the study

The liver is the largest gland in the human body. This organ performs about 5,000 different functions, the main of which are the synthesis of proteins, including albumin, globulins and blood coagulation proteins, hormone metabolism, detoxification of harmful substances and metabolic products, the synthesis of cholesterol and glucose, the storage of vitamins and iron, and many others. No wonder, then, that the liver is so prone to disease. Liver diseases can have different etiologies (hereditary metabolic disorders, intoxication, diabetes mellitus, viral infection, autoimmune disorders) and are very common among the population.

Laboratory diagnostics plays a leading role in assessing the condition of the liver. Especially convenient for the doctor and the patient is a comprehensive analysis that includes all laboratory markers of liver diseases.

1. To assess the synthetic function of the liver, the concentration of the following clinical and laboratory markers is examined: albumin, blood coagulation factors (coagulogram) and cholesterol.

  • Albumin is the main blood protein that performs a transport function and maintains oncotic pressure. In violation of the synthetic function of the liver, the concentration of this protein, as a rule, decreases. It should be noted that this decrease is observed in severe liver diseases, such as fulminant hepatitis and severe liver failure. On the contrary, with torpid or latent liver diseases (hepatitis C, alcoholic hepatitis), the level of total protein may remain within the normal range. In addition, changes in albumin concentration can be observed in many other diseases and conditions, such as starvation, malabsorption, nephrotic syndrome, infectious diseases, and others.
  • Quick prothrombin (another name is prothrombin time) and international normalized ratio (INR, INR) are the main indicators used to assess external pathways of blood coagulation (fibrinogen, prothrombin, factor V, VII and X). The liver is the main source of synthesis of these factors, and diseases of this organ can be accompanied by a violation of the coagulation mechanism and lead to increased bleeding. Clinically significant disorders of blood coagulation are observed in the late stages of liver disease.
  • Cholesterol can be synthesized in almost any cell of the body, but most of it (up to 25%) is synthesized in the liver, from where this compound enters the systemic circulation as part of very low density lipoproteins (VLDL) or into the gastrointestinal tract as part of bile acids. Hypercholesterolemia is a characteristic feature of hepatic cholestasis observed in cholelithiasis, primary sclerosing cholangitis, viral hepatitis, primary biliary cirrhosis, and some other diseases. Hypocholesterolemia has less clinical significance. Different fractions of cholesterol are associated with different effects on human health. Thus, low-density lipoprotein cholesterol (LDL-C) is a well-known risk factor for heart disease, while HDL-C is considered one of the protective factors.

2. In diseases accompanied by a violation of the integrity of hepatocytes (for example, viral hepatitis), hepatic intracellular enzymes are released into the blood and their concentration in the blood increases. This laboratory phenomenon is called cytolysis syndrome. In clinical practice, the liver enzymes ALT and AST are examined to diagnose cytolysis.

  • ALT and AST are transaminases that catalyze the transfer of amino groups between amino acids. Although these enzymes can also be found in many other tissues and organs (heart, skeletal muscle, kidneys, brain, red blood cells), changes in their concentration in the blood are more often associated with liver disease, which leads to their name – hepatic transaminases. ALT is a more specific marker of liver disease than AST. With viral hepatitis and toxic liver damage, as a rule, the same increase in the level of ALT and AST is observed. In alcoholic hepatitis, liver metastases, and cirrhosis, there is a more pronounced increase in AST than ALT.

3. To exclude obstruction of the biliary tract by gallstones or tumors (liver, pancreas, papilla of Vater), the total concentration of bilirubin and its fractions, total alkaline phosphatase and gamma-HT are examined.

  • Bilirubin is a pigment formed during the breakdown of hemoglobin and some other heme-containing proteins in the liver, spleen and bone marrow. It exhibits toxicity to the nervous system and must be eliminated from the body in the bile or urine. Excretion of bilirubin is a multi-step process in which the liver plays a major role. There are two main fractions of bilirubin: direct and indirect. When bilirubin binds to glucuronic acid, conjugated bilirubin is formed in the liver. Since this type of bilirubin can be determined directly with a direct laboratory test, it is also called direct bilirubin. Bilirubin that has not undergone conjugation with glucuronic acid is called unbound. In laboratory conditions, it is not possible to investigate the level of unbound bilirubin: its concentration is calculated based on the concentrations of total and bound bilirubin. For this reason, this type of bilirubin is also called indirect. Total bilirubin consists of both fractions. An increase in the level of bilirubin can be observed in many liver diseases, but the greatest value of this marker lies in the differential diagnosis of jaundice. Hemolytic (prehepatic) jaundice is characterized by an increase in total and indirect bilirubin. For hepatic jaundice, an increase in both fractions (direct and indirect bilirubin) and total bilirubin is typical. Obstructive (subhepatic) jaundice is characterized by an increase in total and direct bilirubin.
  • Alkaline phosphatase, ALP, is an enzyme found in the membrane of the biliary pole of hepatocytes, as well as in bone tissue and intestinal cells. The concentration of total alkaline phosphatase is increased in almost 100% of cases of extrahepatic obstruction of the biliary tract. As a rule, complete obstruction is accompanied by a significant increase in total alkaline phosphatase (more than 3-5 times). With intrahepatic obstruction, the level of total alkaline phosphatase also increases, but not so sharply (less than 3 times). It should be noted that an increase in total alkaline phosphatase can also be observed in other diseases, such as bone disease, myocardial infarction and sarcoidosis. Therefore, to confirm that the cause of the increase in the level of total alkaline phosphatase is precisely the liver disease, it is advisable to conduct an additional study – an analysis for gamma-HT.
  • Gamma-glutamyl transpeptidase, gamma-GT is also a membrane-bound liver enzyme that catalyzes the transfer of the gamma-glutamyl group of glutathione to other molecules. Gamma-HT is currently the most sensitive marker of liver disease. An increase in gamma-HT levels is the earliest sign of liver damage. An increase in the concentration of gamma-HT can be observed in all liver diseases, but the greatest value of this marker is in the diagnosis of biliary tract obstruction. With obstruction of the biliary tract, the concentration of gamma-HT increases by 5-30 times. The study of the level of gamma-HT allows you to make sure that the increase in total alkaline phosphatase is caused precisely by liver disease, and not by other causes, primarily diseases of the skeletal system. As a rule, with obstruction of the biliary tract, there is a parallel increase in the level of gamma-HT and total alkaline phosphatase. High levels of gamma-HT are characteristic of liver metastases and alcoholic cirrhosis. In viral hepatitis, there is a moderate increase in the level of gamma-HT (2-5 times). It should be noted that an increase in total ALP and gamma-HT is also observed in obstruction of the biliary tract caused by diseases of the pancreas (cancer of the pancreatic head).

4. The liver is one of the organs in which iron is stored. In the presence of a genetic defect in iron metabolism (primary hemochromatosis), as well as in chronic iron overload (secondary hemochromatosis: multiple blood transfusions, chronic hemolytic anemia), there is an excessive accumulation of iron in the liver and other tissues, which ultimately leads to the development of liver failure. When examining a patient with signs of liver failure, one should always be aware of hemochromatosis. To exclude it as a cause of liver damage, the level of iron in the blood is examined. It is elevated in hemochromatosis.

5. Viral hepatitis (B and C) is very common in the general population. Often they are asymptomatic or with minimal symptoms (weakness, heaviness in the right hypochondrium) and therefore remain unrecognized. On the other hand, over time, chronic hepatitis can lead to the development of liver cirrhosis and hepatocellular carcinoma. For this reason, all patients should be tested for hepatitis, especially those at risk for these diseases (living in a region with a high prevalence of viral hepatitis B and C, including in Russia, injecting drugs, homosexual sexual contacts, hemodialysis, HIV infection, changing sexual partners, and others). This comprehensive analysis included the main markers of hepatitis: antibodies to hepatitis C virus (anti-HCV) and hepatitis B surface antigen (HBsAg).

6. If liver cancer is suspected, the level of alpha-fetoprotein (AFP) is examined. AFP is a tumor marker for hepatocellular carcinoma. In this disease, the level of AFP, as a rule, exceeds 400 ng / ml.

This comprehensive analysis allows you to comprehensively assess the condition of the liver and exclude its underlying diseases. In some situations, however, additional research may be required.

What is research used for?

  • For evaluation of function and early diagnosis of liver diseases.

When is the test ordered?

  • At a preventive examination;
  • in the presence of symptoms of diseases of the liver, gallbladder and bile ducts: pain or discomfort in the right hypochondrium, nausea, stool disorders, darkening of urine color, jaundice, edema, increased bleeding, fatigue;
  • when observing a patient receiving hepatotoxic drugs for any disease (methotrexate, tetracyclines, amiodarone, valproic acid, salicylates).

What do the results mean?

Reference values ​​

For each indicator included in the complex:

  • [03-007] Coagulogram No. 1 (prothrombin (according to Quick), INR)
  • [06-003] Alanine aminotransferase (ALT)
  • [06-004] Serum albumin
  • [06-010] Aspartate aminotransferase (AST)
  • [06-013] Gamma-glutamyl transpeptidase (gamma-GT)
  • [06-017] Serum iron
  • [06-036] Bilirubin total
  • [06-037] Bilirubin direct
  • [06-045] General alkaline phosphatase
  • [06-048] Cholesterol, total
  • [07-009] anti-HCV, antibodies
  • [07-025] HBsAg
  • [08-016] Alpha-fetoprotein (alpha-FP)
  • [30-002] Bilirubin indirect

Important notes

  • To obtain an accurate result, follow the test preparation guidelines;
  • the results of the study are evaluated taking into account additional anamnestic, instrumental and laboratory data.

Also recommended

[40-085] Viral hepatitis B. Control of viral activity before treatment

[40-091] Viral hepatitis C. Tests before treatment

[42-028] Efficacy of treatment with PEG-interfer drugs he and Ribavirin

[13-022] Antibodies to the microsomal fraction of the liver and kidneys (anti-LKM)

[13-021] Anti-mitochondrial antibodies (AMA)

[13-068] Antibodies to antigens of autoimmune liver diseases (antibodies to type 1 liver-kidney microsomes (LKM-1), mitochondrial pyruvate decarboxylase complex (PDC/M2), cytosolic antigen (LC-1) and soluble liver antigen (SLA/LP))

[13-069] Extended serology of autoimmune liver diseases

[12-005] Cytological examination of material obtained during surgery

Who appoints the study?

Therapist, general practitioner, infectious disease specialist, gastroenterologist, hepatologist.

Literature

  1. McPhee S.