What is the ALT blood test used for. How are ALT levels interpreted. What can cause abnormal ALT results. What are the symptoms of liver disease and cirrhosis. What other tests are often done with ALT.

What is the ALT Blood Test?

The ALT (alanine aminotransferase) blood test measures the amount of this enzyme in the bloodstream. ALT is primarily found in liver cells and is released into the blood when the liver is damaged. This test is a crucial part of liver function panels used to assess overall liver health and function.

Other Names for the ALT Test

• Alanine aminotransferase
• Serum glutamic-pyruvic transaminase (SGPT)

Why is the ALT Test Performed?

The ALT test is primarily used to detect liver damage or disease. Healthcare providers may order this test if they suspect liver problems based on symptoms or risk factors. What are the common symptoms that might prompt an ALT test?

• Extreme fatigue or weakness
• Loss of appetite
• Jaundice (yellowing of the eyes and skin)
• Dark urine or light-colored stool
• Abdominal pain
• Nausea and vomiting
• Diarrhea
• Headache

Additionally, the ALT test can help diagnose or monitor cirrhosis, a condition characterized by liver scarring and damage. What are the potential causes of cirrhosis?

• Long-term hepatitis infection
• Excessive alcohol consumption
• Obesity
• Exposure to certain medications or toxins

Understanding ALT Test Results

Interpreting ALT test results requires consideration of various factors, including the laboratory’s specific reference range and the individual’s overall health. What is generally considered a normal ALT level?

Normal ALT levels are typically less than 40 international units per liter (IU/L). However, it’s important to note that “normal” can vary slightly between laboratories and based on factors such as age and gender.

High ALT Levels

Elevated ALT levels, particularly those above 1,000 IU/L, may indicate significant liver damage. What conditions can cause such high ALT levels?

• Acute viral hepatitis
• Ischemic liver injury (lack of blood flow to the liver)
• Liver damage from drugs or toxins

The AST/ALT Ratio

Healthcare providers often consider the ratio of AST (aspartate aminotransferase) to ALT when interpreting results. Typically, AST levels are lower than ALT levels. However, in certain conditions, AST may be higher than ALT. What might cause this shift in the AST/ALT ratio?

An elevated AST/ALT ratio can occur in conditions such as alcoholic liver disease or advanced liver cirrhosis. This ratio provides additional diagnostic information to healthcare providers.

Other Tests Commonly Performed with ALT

ALT is often part of a comprehensive liver function panel. What other tests might be included alongside ALT?

• Albumin
• Bilirubin
• Alkaline phosphatase (ALP)
• Aspartate aminotransferase (AST)
• Prothrombin time (PT)

These tests collectively provide a more complete picture of liver health and function.

Symptoms of Liver Disease and Cirrhosis

Understanding the symptoms of liver disease and cirrhosis is crucial for early detection and treatment. What are the common signs of liver disease?

• Fatigue and weakness
• Jaundice
• Abdominal pain and swelling
• Nausea and loss of appetite
• Dark urine and pale stools

Cirrhosis, a more advanced form of liver disease, may present with additional symptoms. What are the specific signs of cirrhosis?

• Ascites (fluid accumulation in the abdomen)
• Spider angiomas (visible blood vessels on the skin)
• Pruritus (itchy skin)
• Edema (swelling) in the legs, feet, or ankles
• Unintentional weight loss

Factors Affecting ALT Test Results

Various factors can influence ALT test results, making it essential to interpret them in the context of an individual’s overall health profile. What can affect ALT levels besides liver disease?

• Medications: Certain drugs can elevate ALT levels without necessarily indicating liver damage.
• Exercise: Intense physical activity can temporarily increase ALT levels.
• Body mass index (BMI): Higher BMI is associated with slightly elevated ALT levels.
• Gender: Men typically have slightly higher ALT levels than women.
• Age: ALT levels can vary with age, often decreasing in older adults.

Understanding these factors helps healthcare providers interpret ALT results more accurately and avoid misdiagnosis.

Causes of Elevated ALT Levels

While liver disease is a primary cause of high ALT levels, other conditions can also lead to elevations. What are some non-hepatic causes of increased ALT?

• Muscle disorders or injuries
• Celiac disease
• Hemochromatosis (iron overload)
• Thyroid disorders
• Certain medications (e.g., statins, some antibiotics)

Identifying the underlying cause of elevated ALT is crucial for appropriate treatment and management.

Acute vs. Chronic Elevations

The duration and pattern of ALT elevation can provide valuable diagnostic information. How do acute and chronic ALT elevations differ?

Acute elevations are often dramatic and short-lived, typically associated with sudden liver injury from causes like viral hepatitis or drug toxicity. Chronic elevations, on the other hand, are more modest but persistent, often seen in conditions like non-alcoholic fatty liver disease (NAFLD) or chronic viral hepatitis.

Managing Abnormal ALT Levels

When ALT levels are found to be abnormal, healthcare providers will recommend appropriate steps for management and further evaluation. What are common approaches to addressing elevated ALT?

1. Additional testing: This may include more specific liver function tests, imaging studies (ultrasound, CT, or MRI), or liver biopsy in some cases.
2. Lifestyle modifications: Recommendations often include reducing alcohol intake, improving diet, increasing physical activity, and maintaining a healthy weight.
3. Treating underlying conditions: If a specific cause is identified (e.g., viral hepatitis, autoimmune liver disease), targeted treatment will be initiated.
4. Medication adjustments: If medications are contributing to elevated ALT, dosages may be adjusted or alternative drugs considered.
5. Regular monitoring: Follow-up ALT tests are typically scheduled to track changes over time and assess the effectiveness of interventions.

The goal of management is to address the underlying cause of ALT elevation and prevent further liver damage.

Importance of ALT in Liver Health Monitoring

ALT testing plays a crucial role in both diagnosing liver conditions and monitoring liver health over time. Why is ongoing ALT monitoring important?

• Early detection of liver problems: Regular ALT testing can identify liver issues before symptoms appear, allowing for earlier intervention.
• Treatment effectiveness: For patients with known liver conditions, ALT levels help assess how well treatments are working.
• Medication safety: ALT monitoring is essential for patients on certain medications that can affect liver function.
• Progression tracking: In chronic liver diseases, ALT trends over time provide valuable information about disease progression or stabilization.

Regular ALT testing, as part of a comprehensive liver health assessment, is a powerful tool for maintaining overall health and preventing liver-related complications.

ALT in Relation to Other Liver Enzymes

While ALT is a key indicator of liver health, it’s often considered alongside other liver enzymes for a more comprehensive assessment. How does ALT compare to other liver enzymes?

• AST (Aspartate aminotransferase): Often elevated alongside ALT, but less specific to the liver.
• ALP (Alkaline phosphatase): Elevated in conditions affecting bile flow or bone disorders.
• GGT (Gamma-glutamyl transferase): Sensitive to alcohol use and certain medications.

The pattern of elevation among these enzymes can provide clues about the nature and location of liver damage.

ALT Testing in Special Populations

ALT testing and interpretation may require special considerations in certain populations. How does ALT testing differ for specific groups?

Pediatric Patients

ALT reference ranges for children and adolescents differ from those for adults and can vary with age and gender. Interpreting ALT in pediatric patients requires age- and sex-specific reference ranges.

Pregnant Women

During pregnancy, normal physiological changes can affect ALT levels. What should be considered when interpreting ALT in pregnant women?

• Slight elevations in ALT are common and often benign during pregnancy.
• Significant elevations may indicate pregnancy-related liver conditions like HELLP syndrome or acute fatty liver of pregnancy.
• Careful interpretation is crucial to distinguish between normal pregnancy-related changes and pathological conditions.

Elderly Patients

ALT levels tend to decrease with age, and lower thresholds for abnormal results may be appropriate in older adults. Factors like frailty, multiple medications, and comorbidities can complicate ALT interpretation in this population.

Future Directions in ALT Testing and Liver Health Assessment

As our understanding of liver disease evolves, so do the approaches to liver health assessment. What are some emerging trends in ALT testing and liver diagnostics?

• Non-invasive fibrosis markers: Combining ALT with other blood tests and clinical factors to assess liver fibrosis without biopsy.
• Genetic factors: Exploring how genetic variations influence ALT levels and liver disease susceptibility.
• Machine learning algorithms: Developing advanced models that integrate multiple biomarkers, including ALT, for more accurate liver disease prediction and staging.
• Point-of-care testing: Advancing technologies for rapid, bedside ALT testing to facilitate immediate clinical decision-making.

These developments promise to enhance the diagnostic and prognostic value of ALT testing in liver health assessment.

The Role of ALT in Precision Medicine

As healthcare moves towards more personalized approaches, how might ALT testing evolve in the context of precision medicine?

Future applications may include:

• Individualized reference ranges based on genetic profiles and other personal factors.
• Integration of ALT data with other biomarkers and clinical information for tailored risk assessment and treatment planning.
• Longitudinal ALT monitoring strategies customized to an individual’s risk factors and health goals.

These advancements could lead to more precise and effective liver health management strategies.

Conclusion: The Enduring Importance of ALT in Liver Health

ALT testing remains a cornerstone of liver health assessment, offering valuable insights into liver function and potential disease processes. Its interpretation, however, requires a nuanced understanding of various factors that can influence results. As part of a comprehensive liver function panel and considered alongside clinical presentation and other diagnostic tools, ALT continues to play a crucial role in diagnosing, monitoring, and managing liver conditions.

The future of ALT testing looks promising, with ongoing research and technological advancements poised to enhance its diagnostic accuracy and clinical utility. As our understanding of liver disease mechanisms deepens and new biomarkers emerge, ALT will likely remain an essential component of liver health evaluation, evolving to meet the challenges of modern healthcare and the growing burden of liver disease worldwide.

For individuals undergoing ALT testing or those concerned about their liver health, it’s crucial to work closely with healthcare providers to interpret results accurately and develop appropriate management strategies. Regular liver function monitoring, including ALT testing, combined with healthy lifestyle choices, can contribute significantly to maintaining optimal liver health and overall well-being.

ALT | University Hospitals

Does this test have other names?

Alanine aminotransferase, serum glutamic-pyruvic transaminase, SGPT

What is this test?

This test measures the amount of the enzyme alanine aminotransferase (ALT) in your
blood.

ALT, formerly called SGPT, is mostly found in your liver cells. When liver cells are
injured, they release this enzyme into your blood. High levels are a sign of liver
damage.

This test is part of a group of tests commonly referred to as “liver function tests.”
Results of these tests give healthcare providers an overall picture of how well your
liver is working.

Why do I need this test?

You may have this test to see if
you have liver damage or a liver disease, such as hepatitis. Symptoms of liver diseases
include:

• Extreme tiredness or
  weakness

• Loss of appetite

• Yellowing of the eyes and
  skin (jaundice)

• Dark yellow urine or light-colored stool

• Belly (abdominal) pain

• Nausea and vomiting

• Diarrhea

• Headache

You may also have this test to look
for cirrhosis, which causes damage and scarring to the liver. Causes of cirrhosis
include long-term hepatitis infection, excessive alcohol use, obesity, and exposure
to
certain medicines or toxins. Symptoms of cirrhosis include:

• Abdominal swelling from fluid buildup

• Visible blood vessels in the skin

• Itchy skin

• Swelling of the legs, feet,
  or ankles

• Nausea, loss of appetite

• Weight loss

• Feeling tired (fatigue)

What other tests might I have along with this test?

Your healthcare provider may also order other tests of liver health, including:

• Albumin

• Bilirubin

• Alkaline phosphatase
  (ALP)

• Aspartate aminotransferase
  (AST)

• Prothrombin time (PT)

Your healthcare provider may also order other tests that measure:

What do my test results mean?

Many things may affect your lab test results. These include the method each lab uses
to do the test. Even if your test results are different from the normal value, you
may not have a problem. To learn what the results mean for you, talk with your healthcare
provider.

ALT levels are normally less than 40 international units per liter (IU/L). Levels
above 1,000 IU/L may be a sign of:

• Acute viral hepatitis

• Lack of blood flow to the liver

• Injuries from illegal drugs
  or toxins

The ratio of AST to ALT may also provide helpful information to your healthcare provider.
AST levels are normally lower than ALT levels. AST is often higher than ALT in cases
such as:

A number of other medical conditions besides liver disease can also cause liver enzymes
to rise. These include:

How is this test done?

The test requires a blood sample, which is drawn through a needle from a vein in your
arm.

Does this test pose any risks?

Taking a blood sample with a needle carries risks that include bleeding, infection,
bruising, or feeling dizzy. When the needle pricks your arm, you may feel a slight
stinging sensation or pain. Afterward, the site may be slightly sore.

What might affect my test results?

Many medicines can affect your test
results, as can drinking alcohol. ALT levels may also be higher in people who are
obese.

How do I get ready for this test?

Your healthcare provider may ask
you to not eat or drink and to not take certain medicines before your blood tests.
Be
sure your healthcare provider knows about all the medicines, herbs, vitamins, and
supplements you are taking. This includes medicines that don’t need a prescription
and
any illegal drugs you may use.

Australian Health Survey: Users’ Guide, 2011-13

Contents >>
Biomedical Measures >>
Liver function biomarkers >>
Alanine aminotransferase (ALT)

ALANINE AMINOTRANSFERASE (ALT)

Definition

The liver works as the body’s filter, removing toxins from the blood, processing nutrients and regulating its metabolism. When the liver is inflamed or damaged, enzymes including alanine aminotransferase (ALT) leak from the liver cells into the bloodstream. As a result, elevated levels of ALT in the bloodstream can indicate the presence of liver disease, which may have been caused by heavy alcoholism, fatty liver disease (alcohol or non-alcohol related), hepatitis, or a combination of other causes.^1,2

The ALT test measures the amount of ALT circulating in the blood at the time of the test.

Population

ALT results were obtained for selected persons aged 12 years and over, who agreed to participate in the National Health Measures Survey (NHMS) and provided a blood sample. Fasting was not required for this test.

Methodology

A blood sample was collected from participants and ALT levels were measured at the Douglass Hanly Moir (DHM) laboratory.

There is no consensus on the cut off reference values for defining abnormal ALT levels for the Australian population, as there are currently a number of different methods that can be used to measure ALT. As such, cut off reference values for normal and abnormal results were sourced from DHM laboratory reference ranges.

In the NHMS, the following definitions were used for serum ALT:

Cut off points for ALT for females in the NHMS

Cut off points for ALT for males in the NHMS

Further test information about the analysis method and machine used to measure ALT levels is available in Excel spreadsheet format in the Downloads page of this product.

Data items

The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads page of this product.

Interpretation

Points to be considered when interpreting data for this topic include the following:

• ALT results do not confirm a specific diagnosis without consultation with a health professional.
• There are a number of different test methods for measuring ALT, which may produce different results. The data from this topic should therefore be used with caution when comparing ALT results from other studies using a different test method or equation.

Comparability with other surveys

The NHMS is the first ABS survey to collect biomedical data on ALT levels.

ALT data has been collected in other non-ABS surveys. However, caution must be taken when interpreting results due to the differences in scope, assay and the instrument used, and any thresholds applied in the final analysis.

ENDNOTES

1 Everhart J and E Wright 2012. Association of γ-glutamyltransferase (GGT) activity with treatment and clinical outcomes in chronic hepatitis C (HCV). Hepatology: Official Journal of the american Association for the Association for the study of Liver Diseases.
2 Torkadi P, Apte IC and AK Bhute 2013, Biochemical Evaluation of Patients of Alcoholic Liver Disease and Non-alcoholic Liver Disease. Indian Journal of Clinical Biochemistry.

6 Simple Rules for Good Alt Text / Sudo Null IT News

Let’s talk about how to write a good photo description in the alt attribute.

In the first part of , we discussed the basic rules for writing alt text for photos and images. This time, let’s talk about what exactly the description should be in order for it to make sense.

Alternative text is a description of the image in words. This description should help people who read or hear this description, otherwise it is not needed and it is better not to indicate it at all.

Just retell what is in the picture

There is a simple tip to create the perfect description.

Imagine calling a friend and telling them what you see in the picture.

But do not overdo it, as it is better if the description is concise.

Multicolored cat eating food and licking his lips (https://unsplash.com/photos/_FlMYRBExBk)

Creator name and search engine optimization keywords should not be in the image description, but they can be in the article.

Use the context in which the picture is located

The same picture can have a different description in the alt depending on the context. Context is what surrounds the illustration, for example, the text of an article if the image is embedded there.

Simply put,

The description depends on what the user needs to focus on right now.

Look at the picture below and think about what description you would put in the alt.

There are several correct answers:

CSS is awesome .

Good for an article about how CSS works (bad).

White mug with inscription .

If your article is about circles and has nothing to do with web development.

A mess on the developer’s desk: mugs, intertwined wires, cards .

If you are talking about life during a pandemic or regular cleaning of your desk.

White table .

If you are selling tables and think that what is on the table makes no difference. Yes, even a plate.

A white mug with “CSS is awesome” in a square sits on a white table. Awesome goes beyond the square.

This option is suitable if you do not understand the context of the article, but you need to put some picture and write something there. That’s how you can do it too.

The main point in these examples is that you need to focus on what is now more important for the article in this image. To define “now”, you need to understand what is written in the article next to this image. If the article talks about what types of mugs are, then you need to describe the details of the mug in the image, for example “White mug with the inscription “CSS is Awesome””. Everything that is in the background is not important in this case.

Don’t write an alt if the picture doesn’t make sense

There’s nothing wrong with an empty alt if the picture doesn’t make any sense. For example, how to describe my profile picture in the site interface?

For context: the avatar shows the head of a person who lies on the bed and cannot fall asleep due to swarming thoughts.

“Nikolay Shabalin” is a very bad option, since it completely duplicates the text on the right. The avatar is used in the header of the site, so there is no point in describing it.

It’s okay not to describe the picture, but be careful and always remember the context.

Transmit emotions through alt

At first glance, it is not obvious that any avatar can convey some kind of emotion, but in context sometimes there is a sense of them hand over. For example, if the article was about insomnia, then my avatar could be written alt “a person with a bunch of thoughts right before bed.”

Joyful man lying in a hammock at sunset (https://unsplash.com/photos/Kc4MGyzfOTI)

This picture can be described as “A joyful man lies in a hammock at sunset.” Is it necessary to write here that the person is joyful, although we do not even see his face? This is not necessary, but you can write like this if we sell hammocks, we want to complete the picture and say how good he feels in our comfortable hammock, lying in it on the ocean.

You can learn more about the emotional description for images in the blog by Leonie Watson .

Don’t flirt with decor for decor’s sake

We all know that decorative images are usually used without description, although there is such a possibility. To do this, you can use the properties content: “” or, if you use an image in content: url(), then it would be correct to write this:

 content: url("path/to/image.jpg" / "Decorative image description") . 

But it’s better to use this method less often, because most often decorative images are meaningless. But if for some reason you want to convey the emotions of a decorative image, then there is such an opportunity.

Don’t put filenames or the photographer’s name in alt

I often look at what descriptions are filled in the alt attribute and wonder how much fantasy can go wrong. Part of the filled alt text is completely useless, as it does not convey the meaning of the image.

Which description does not fit:

• imgX2 or 7e0273c07fef3b598590d3fdddf7808604f0a191435c2c0c is just a name or a hash of a file with a picture.

• site name or article name – these are probably SEO tricks.

• photographer's name – everything is clear here.

All these options will not help in any way in the main task of alt text – to understand what was in the picture that did not load, or when reading the page with a screen reader.

Summary – how to write a good alt text

A simple clear description is the best solution if it is not too long. The absence of a description is normal, but it should be appropriate. An emotional description is also good if it is inscribed in the context.

Here are the six rules in short:

1. Just tell us what you see in the picture – the shorter the better.

2. Use the context in which the image is located – that is, consider what is around it on the site.

3. Do not write alt if the picture does not carry a separate meaning – for example, an avatar in a profile.

4. Feel free to convey emotions through alt – if someone is happy or sad, write about it, if appropriate.

5. Don’t alt on decorative images like icons.

6. Don’t alt the name of the file or the name of the photographer – that’s not what the alt is for.

Experiment, try and don’t be afraid to make mistakes.

Asset turnover – Alt-Invest

Categories

Open this article in PDF sales to the total assets of the company (Total assets turnover). The formula for calculating the indicator looks like this:

where:
Revenue – sales revenue. In some formulas, it is also referred to as Net Sales Revenue ( Net Sales ), in which case it means that various discounts, refunds and losses are deducted from sales revenue. For most financial statements, these formulations will be identical, since many companies show exactly the net result as revenue in their report.
Total Assets – total assets. Usually, the average between the value at the beginning and end of the reporting period is used.

There is another version of the indicator – the turnover of fixed assets ( Fixed Assets Turnover ). Its formula is:

where Fixed Assets — total fixed assets of the company.

The turnover ratio is calculated for the year, therefore, if the revenue in the calculations is taken for the quarter, then the resulting value must be multiplied by 4. In addition, when using quarterly values, you must make sure that seasonal fluctuations do not distort the result.

Asset turnover in financial analysis

Asset turnover measures a company’s overall ability to generate revenue from the assets it owns. In the version of the TAT indicator, the use of the entire set of assets is analyzed: fixed assets, stocks, other current and non-current assets. The FAT indicator focuses only on buildings, equipment and other fixed assets.

A low turnover may indicate an inefficient business or a significant investment made by the company. Obviously, in each industry, and even in individual segments of the market, the normal level of capital required to ensure production and sales will be different. Therefore, the turnover analysis will be based on a comparison of the company’s performance with its competitors, as well as with its own values ​​for past periods.

But even in cases where the company’s asset turnover is lower than that of competitors, or decreases from year to year, this does not necessarily mean low performance. Here are some reasons why a company’s asset turnover may be low in a normal business:

• the company has invested heavily in business development, but sales are just starting to grow, and the return on investment is expected in the future;
• the company has relied on the automation of production and reducing the share of personnel costs in the cost;
• , the company has chosen a strategy to increase inventory to reduce the cost of its purchases and improve the profitability of sales.

Considering such opportunities, the analyst must evaluate the turnover of the company’s assets in the context of the overall picture of financial results, take into account data on the profitability of its activities, investment history, chosen strategy and plans.

Example of asset turnover calculation

Below is an example of asset turnover calculation. The lines directly involved in the calculation are highlighted:

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