What blood tests are used to assess liver function. How can liver function tests diagnose alcoholic hepatitis. What are the key symptoms and causes of alcoholic hepatitis. What are the different patterns of liver test results and their significance.

Understanding Liver Function Tests: Types and Significance

Liver function tests are crucial diagnostic tools used to assess the health and functionality of the liver. These tests can help identify various liver conditions, including alcoholic hepatitis. Let’s explore the most common liver function tests and their significance.

Hepatocellular Damage Markers

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are two key enzymes that indicate hepatocellular damage when elevated. While both are important, ALT is generally considered more specific for liver disease.

• AST: Elevated levels may indicate hepatocellular damage, but it’s less specific as cardiac and skeletal muscle injury can also cause elevation.
• ALT: More specific for liver damage, its concentration often correlates with increasing body mass index (BMI).
• AST:ALT ratio: A ratio greater than 1 typically indicates hepatocellular injury, while a ratio of 2 or higher is often associated with alcoholic liver disease.

Cholestasis Indicators

Cholestasis, the impairment of bile flow, can be detected through several tests:

• Alkaline phosphatase (ALP): Elevated levels suggest cholestasis, but can also be affected by age, pregnancy, and sex.
• Gamma-glutamyl transferase (GGT): Used to confirm the hepatic origin of elevated ALP.
• 5′ nucleotidase (5’NT): Another test to confirm hepatic origin of ALP elevation, with normal levels being very specific for hepatobiliary disease.

Nonspecific Markers and Synthetic Function Tests

Bilirubin, albumin, and prothrombin time (PT) provide additional insights into liver function:

• Bilirubin: Elevated levels, when fractionated, can indicate cholestasis or hepatocellular damage.
• Albumin: Decreased levels may suggest impaired liver synthesis or other conditions like malnutrition.
• PT: Elevated PT unresponsive to vitamin K supplementation often indicates poor liver function.

Alcoholic Hepatitis: Symptoms and Causes Unveiled

Alcoholic hepatitis is a serious condition characterized by inflammation of the liver due to excessive alcohol consumption. Understanding its symptoms and causes is crucial for early detection and treatment.

Key Symptoms of Alcoholic Hepatitis

Alcoholic hepatitis can present with various symptoms, ranging from mild to severe:

• Jaundice (yellowing of skin and eyes)
• Abdominal pain and tenderness
• Nausea and vomiting
• Fever and fatigue
• Loss of appetite and weight loss
• Mental confusion or changes in behavior

Primary Causes of Alcoholic Hepatitis

The primary cause of alcoholic hepatitis is excessive and prolonged alcohol consumption. However, several factors can increase the risk or severity of the condition:

1. Quantity and duration of alcohol consumption
2. Genetic predisposition
3. Gender (women are more susceptible)
4. Obesity
5. Poor nutrition
6. Presence of other liver conditions (e.g., hepatitis C)

Interpreting Liver Function Test Patterns in Alcoholic Hepatitis

Understanding the patterns of liver function test results is crucial for diagnosing and monitoring alcoholic hepatitis. Let’s examine the typical patterns and their significance.

Hepatocellular Pattern in Alcoholic Hepatitis

In alcoholic hepatitis, we often see a hepatocellular pattern characterized by elevated ALT and AST levels. What’s unique about alcoholic liver disease?

• AST:ALT ratio ≥ 2: This is a hallmark of alcoholic liver disease, distinguishing it from other causes of hepatocellular injury.
• AST elevation predominance: Unlike in other forms of hepatitis where ALT is typically higher, AST is often more elevated in alcoholic hepatitis.

Mixed Pattern in Advanced Cases

As alcoholic hepatitis progresses, a mixed pattern may emerge, showing features of both hepatocellular injury and cholestasis:

• Elevated AST and ALT (hepatocellular pattern)
• Increased ALP and GGT (cholestatic pattern)
• Elevated bilirubin levels

Diagnostic Approach to Alcoholic Hepatitis

Diagnosing alcoholic hepatitis involves a comprehensive approach combining clinical evaluation, laboratory tests, and imaging studies. What steps are typically taken in the diagnostic process?

1. Clinical history and physical examination: Assessing alcohol consumption patterns and looking for signs of liver disease.
2. Liver function tests: Evaluating the pattern of liver enzyme elevations and other markers of liver function.
3. Complete blood count: Checking for anemia, thrombocytopenia, or leukocytosis, which can be associated with alcoholic hepatitis.
4. Imaging studies: Ultrasound, CT, or MRI to assess liver size, texture, and rule out other causes of liver disease.
5. Liver biopsy: In some cases, to confirm the diagnosis and assess the severity of liver damage.

Treatment Strategies for Alcoholic Hepatitis

Managing alcoholic hepatitis requires a multifaceted approach. What are the key components of treatment?

Immediate Interventions

• Alcohol cessation: The most critical step in treating alcoholic hepatitis.
• Nutritional support: Addressing malnutrition, which is common in patients with alcoholic hepatitis.
• Management of complications: Treating ascites, encephalopathy, or bleeding varices if present.

Pharmacological Treatments

In severe cases of alcoholic hepatitis, certain medications may be prescribed:

• Corticosteroids: To reduce inflammation in patients with severe alcoholic hepatitis.
• Pentoxifylline: An alternative for patients who can’t tolerate or have contraindications to corticosteroids.
• N-acetylcysteine: Sometimes used in combination with corticosteroids to improve outcomes.

Long-term Management

Long-term management of alcoholic hepatitis focuses on preventing recurrence and managing underlying alcohol use disorder:

• Alcohol rehabilitation programs
• Regular liver function monitoring
• Management of other health conditions
• Lifestyle modifications, including dietary changes and exercise

Preventing Alcoholic Hepatitis: Key Strategies

Prevention is crucial in reducing the incidence of alcoholic hepatitis. What are the most effective strategies for prevention?

Alcohol Consumption Guidelines

Following recommended alcohol consumption guidelines is essential:

• For men: No more than 2 standard drinks per day
• For women: No more than 1 standard drink per day
• Incorporating alcohol-free days each week

Lifestyle Modifications

Adopting a healthy lifestyle can significantly reduce the risk of alcoholic hepatitis:

• Maintaining a balanced diet rich in fruits, vegetables, and whole grains
• Regular exercise to maintain a healthy weight
• Avoiding other substances that can damage the liver, such as certain medications or illicit drugs

Regular Health Check-ups

Regular medical check-ups can help detect early signs of liver damage:

• Routine liver function tests for those at higher risk
• Discussing alcohol consumption with healthcare providers
• Seeking help for alcohol use disorders early

The Role of Fibrosis Assessment in Alcoholic Hepatitis

Assessing liver fibrosis is crucial in determining the prognosis and guiding treatment decisions in alcoholic hepatitis. How is fibrosis assessed in these patients?

Noninvasive Fibrosis Staging

Several noninvasive methods are available for assessing liver fibrosis:

• Fibrosis scoring systems: Combining clinical and biochemical variables to estimate fibrosis severity.
• Elastography techniques: Using ultrasound or MRI to measure liver stiffness, which correlates with fibrosis.
• Serum biomarkers: Specific blood tests that can indicate the presence and severity of fibrosis.

Importance of Fibrosis Assessment

Why is fibrosis assessment so important in alcoholic hepatitis?

• Prognostic value: The degree of fibrosis can predict long-term outcomes and risk of complications.
• Treatment decisions: Fibrosis stage can influence the choice and intensity of treatment.
• Monitoring: Regular assessment can track disease progression or improvement with treatment.

Understanding the complexities of liver function tests and their patterns in alcoholic hepatitis is crucial for healthcare providers and patients alike. By recognizing the symptoms, causes, and diagnostic approaches to alcoholic hepatitis, we can improve early detection and treatment outcomes. Moreover, emphasizing prevention strategies and the importance of lifestyle modifications can significantly reduce the incidence of this serious liver condition. As research continues to advance our understanding of alcoholic hepatitis, we can hope for even more effective diagnostic tools and treatment options in the future.

The journey to liver health is ongoing, and it requires a collaborative effort between patients, healthcare providers, and researchers. By staying informed about the latest developments in liver function testing and alcoholic hepatitis management, we can work towards better outcomes for those affected by this condition. Remember, the liver has a remarkable ability to regenerate, and with proper care and management, many patients with alcoholic hepatitis can achieve significant improvements in their liver health and overall well-being.

Evaluation of Liver Function | Choose the Right Test

Indications for Testing

Testing may be ordered as part of a routine evaluation or to screen for and monitor liver disease (eg, viral or alcoholic hepatitis). Test selection should be informed by patient history and clinical evaluation. Elevated liver chemistry or function tests should generally be repeated to confirm results before the initiation of exhaustive follow-up testing.  

Laboratory Testing

The table below briefly describes the tests most often included in the evaluation of liver function. Commonly, hepatic function tests are offered in panels that include the recommended first-tier tests for liver disease evaluation. The pattern of abnormal test results should be evaluated to help identify additional testing strategies and determine the underlying cause. Some suggestive patterns are included in the Patterns of Liver Test Results section.

Patterns of Liver Test Results

Hepatocellular Pattern

Elevated ALT and AST concentrations indicate a hepatocellular liver injury.    The differential diagnosis may include viral or autoimmune hepatitis, hemochromatosis, alpha 1-antitrypsin deficiency, or Wilson disease.  If AST elevation is predominant, consider alcohol-related liver damage or cirrhosis.  Although the pattern of AST and ALT may help guide differential diagnosis, additional testing is required for diagnosis. Other liver tests such as bilirubin may also yield elevated results in patients who exhibit a pattern consistent with hepatocellular injury.  

Cholestatic Pattern

Increased ALP and GGT concentrations are indicative of cholestasis.   To determine if ALP elevation is of hepatic origin, GGT should be evaluated.   Cholestatic patterns may be due to hepatobiliary causes such as primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), biliary obstruction, or cholestasis.   

Mixed Pattern

If the pattern of elevation includes features of hepatocellular damage and cholestatic injury, the result is said to be “mixed. ”  A mixed pattern of liver test results accompanied by jaundice is often due to drug-induced liver disease. However, this pattern may also be observed in patients with late-stage acute viral hepatitis or early-stage acute biliary obstruction. 

Liver function tests – Pathology Tests Explained

On This Page
• At a glance
• What is being tested?
• The test
• Common questions
• Related information

At a glance

Also known as

LFT

Why get tested?

Liver functions tests are used to screen for, detect, evaluate and monitor acute and chronic liver inflammation (hepatitis), infection, liver disease and/or damage.

When to get tested?

Periodically to evaluate liver function; whenever you are at risk for liver injury; when you have a liver disease; when you have symptoms such as jaundice when you are taking medications that may affect your liver.

Sample required?

A blood sample drawn from a vein in your arm.

Test preparation needed?

None

                                    

                                                Quick Read patient information sheet

 

What is being tested?

Liver Function Tests (LFTs) is a group of tests that are performed together to detect, evaluate, and monitor liver disease or damage. The liver is one of the largest organs in the body and is located in the upper right-hand part of the abdomen and behind the lower ribs. The liver metabolises and detoxifies drugs and substances that are harmful to the body. It produces blood clotting factors, , and , helps maintain  balances, and stores vitamins and minerals. , a fluid produced by the liver, is transported through ducts directly to the small intestine to help digest fats or to the gallbladder to be stored and concentrated for later use.

Talking Results: what your Liver Function Test results can show

A variety of diseases and infections can cause  or  damage to the liver, causing inflammation, scarring, bile duct obstructions, clotting abnormalities, and liver dysfunction. Alcohol, drugs, some herbal supplements, and toxins can also pose a threat. A significant amount of liver damage may be present before symptoms such as jaundice, dark urine, light-coloured stools, , nausea, fatigue, diarrhoea, and unexplained weight loss or gain emerge. Early detection is essential in order to minimize damage and preserve liver function.

LFTs measure enzymes, proteins, and substances that are produced or excreted by the liver and are affected by liver injury. Some are released by damaged liver cells and some reflect a decrease in the liver’s ability to perform one or more of its functions. When performed together, these tests give the doctor a snapshot of the health of the liver, an indication of the potential severity of any liver injury, change in liver status over time, and a starting place for further diagnostic testing.

The panel usually consists of several tests that are run at the same time on a blood sample. These may include:

• Alanine aminotransferase (ALT) – an  mainly found in the liver; the best test for detecting hepatitis
• Alkaline phosphatase (ALP) – an enzyme related to the  ducts; often increased when they are blocked
• Aspartate aminotransferase (AST) – an enzyme found in the liver and a few other places, particularly the heart and other muscles in the body
• Total bilirubin – measures all the yellow bilirubin pigment in the blood. Another test, direct bilirubin, measures a form combined with another compound in the liver and is often requested with total bilirubin in infants with jaundice.
• Albumin – measures the main  made by the liver and tells whether or not the liver is making an adequate amount of this protein
• Gamma-glutamyl transferase (GGT) – an enzyme found mainly in the liver and is a useful marker for detecting bile duct problems
• Total protein – measures albumin and all other proteins in blood, including  made to help fight off infections

Other tests that can be used to assess liver function include a coagulation screen, together with bilirubin and urobilinogen in urine.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

 

The Test

How is it used?

Liver Function Tests (LFTs) may be used to screen a person for liver damage, especially someone who has a condition, or is taking a drug, that may affect the liver.

LFTs or one or more component tests may be used to help detect liver disease if a person has symptoms that indicate possible liver dysfunction or if a person is being monitored or treated for a known condition or liver disease. A bilirubin test, for instance, may be ordered to evaluate and monitor a jaundiced newborn.

Abnormal tests on a liver function tests panel may prompt a repeat analysis to see if the elevation or decrease persists and/or may indicate the need for additional testing to determine the cause of the liver dysfunction.

The group of tests may also be ordered to monitor liver function and the effectiveness of treatment in someone who has a liver disease.

When is it requested?

LFTs, or one or more components, may be ordered when someone is at risk for liver dysfunction. Some examples include:

• people who have a history of known or possible exposure to hepatitis viruses
• those who are heavy alcohol drinkers
• individuals whose families have a history of liver disease
• people who take drugs that might occasionally damage the liver

LFTs may be ordered when a person has  and  of liver disease. Some of these include:

• Weakness, fatigue
• Loss of appetite
• Nausea, vomiting
• Abdominal swelling and/or pain
• Jaundice
• Dark urine, light coloured stool
• Itching ()

Usually no one single set of liver tests are used to make a diagnosis. Often, several LFTs will be ordered over a few days or weeks to determine if a pattern is present and to help determine the cause of the liver disorder.

When liver disease is detected, it may be monitored on a regular basis over time with the LFTs or with one or more of its components. LFTs may also be ordered regularly to monitor the effectiveness of treatment for the liver disorder.

What does the test result mean?

LFT results are not diagnostic of a specific condition; they indicate that there may be a problem with the liver. In a person who does not have symptoms or identifiable risk factors, abnormal liver test results may indicate a temporary liver injury or reflect something that is happening elsewhere in the body – such as in the skeletal muscles, pancreas, or heart. It may also indicate early liver disease and the need for further testing and/or periodic monitoring.

Results of LFTs are usually evaluated together. Several sets of results from tests performed over a few days or weeks are often assessed together to determine if a pattern is present. Each person will have a unique set of test results that will typically change over time. A doctor evaluates the combination of liver test results to gain clues about the underlying condition. Often, further testing is necessary to determine what is causing the liver damage and/or disease.

The table below shows examples of some combinations of results that may be seen in certain types of liver conditions or diseases.

If a person is taking drugs that may affect their liver, then abnormal test results may indicate a need to re-evaluate the dosage or choice of medication. When a person with liver disease is being monitored, then the doctor will evaluate the results of the liver panel together to determine if liver function in worsening or improving. For example, increasingly abnormal bilirubin, albumin, and/or PT may indicate a deterioration in liver function, while stable or improving results of these tests may indicate liver function preservation or improvement.

For individual tests:

Alanine aminotransferase (ALT)

A very high level of ALT is frequently seen with acute hepatitis. Moderate increases may be seen with chronic hepatitis. People with blocked bile ducts, cirrhosis, and liver cancer may have ALT concentrations that are only moderately elevated or close to normal.

Alkaline phosphatase (ALP)

ALP may be significantly increased with obstructed bile ducts, liver cancer, and also with bone disease.

Aspartate aminotransferase (AST)

A very high level of AST is frequently seen with acute hepatitis. AST may be normal to moderately increased with chronic hepatitis. In people with blocked bile ducts, cirrhosis, and liver cancer, AST concentrations may be moderately increased or close to normal. When liver damage is due to alcohol, AST often increases much more than ALT (this is a pattern seen with few other liver diseases). AST is also increased after heart attacks and with muscle injury.

Bilirubin

Bilirubin is increased in the blood when too much is being produced, less is being removed, due to bile duct obstructions, or to problems with bilirubin processing. It is not uncommon to see high bilirubin levels in newborns, typically 1 to 3 days old.

Albumin

Albumin is often normal in liver disease but may sometimes be low due to decreased production.

Total Protein

Total protein is typically normal with liver disease.

Gamma-glutamyl transferase (GGT)

A GGT test may be used to help determine the cause of an elevated ALP. Both ALP and GGT are elevated in bile duct and liver disease, but only ALP will be elevated in bone disease. Increased GGT levels are also seen with alcohol consumption and often in patients taking some drugs that are metabolized in the liver such as carbamazepine and phenobarbitone.

Prothrombin Time (PT)

A prolonged or increased PT can be seen with liver disease, vitamin K deficiency, and with coagulation factor deficiencies.

Is there anything else I should know?

In order to diagnose a liver disease, a doctor will evaluate the liver panel test results, order follow-up tests such as hepatitis testing, and may order a liver  and/or imaging scans to help confirm a diagnosis and determine the extent of liver damage.

Common Questions

Why does my doctor want to know all of the medications I am taking?

Many over-the-counter drugs and herbal or dietary supplements have the potential to affect the liver. Excessive paracetamol use and the combination of paracetamol and alcohol for instance can cause severe liver damage, as can exposure to toxins such as poisonous mushrooms.

Can I have liver disease if I feel fine?

Yes, early liver disease often causes no symptoms or mild nonspecific symptoms, such as fatigue and nausea.

Can I have abnormal test results and not have liver disease?

Yes, many temporary conditions, such as shock, burns, severe infections, muscle trauma, , pancreatitis, , and pregnancy can cause one or more of the liver function tests to be abnormal.

Why is my family history important?

Some liver conditions, such as haemochromatosis and Wilson’s disease, may be inherited. Early detection of these conditions allows them to be treated and managed appropriately.

What tests may be done in follow up to abnormal liver function tests to help determine the cause of liver injury?

Depending on the results of the liver panel and other factors such as ,  and clinical and family history, a doctor may suspect a particular cause of liver disorder and order follow-up tests. Some examples include:

Last Review Date: October 11, 2022

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By what indicators of a blood test can you understand that your liver is on the verge of failure? Some pathologies can develop over the years, and if they are not detected in time, the consequences can be very deplorable.

April 18, 2022

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The liver is called the main filter organ for a reason: after all, everything that enters our body is absorbed into the bloodstream, and then it passes through the filtration in the liver. Therefore, like no other body, it feels all the consequences of our wrong lifestyle: the habit of eating fatty and high-calorie foods, drinking alcohol, smoking cigarettes. Also, do not forget about the load that the body experiences while taking medications: the liver takes the entire blow from the breakdown of chemical compounds.

Why the liver does not hurt

– This is due to the fact that there are no pain receptors in the liver itself. They are located in the capsule of the liver, which surrounds the organ. When the capsule is stretched due to an increase in the size of the liver itself, this already leads to pain, the doctor explains.

You may experience sudden sharp pain in the liver area due to an injury. For example, this can happen from a strong blow to the stomach. If in this case the capsule ruptures, there is a high probability that internal bleeding will begin.

Sometimes the pain also occurs during physical activity, for example, while running. In people who play sports irregularly, pain in the right hypochondrium is caused by intense filling of the liver with blood – the organ sharply increases in size and the capsule stretches.

Read also

About the most common diseases

– If we talk about the rating, then in the first place I would put fatty degeneration of the liver. With this diagnosis, the organ tissue is replaced by adipose tissue. Many have probably heard about the foie gras dish – this is a goose or duck liver with fatty degeneration, or fatty hepatosis, which is provoked in a bird by a special “diet”. Unfortunately, many people are so accustomed to unhealthy eating that they develop a similar disease, says Maxim Rykov.

If you do not change your menu in time, then fatty degeneration is replaced by what is called the frightening word “cirrhosis”. In this case, the liver tissues are replaced by connective tissue, the organ can no longer fully perform its functions.

Interesting fact

The liver has a very large margin of safety. It can regenerate well, regenerating itself on its own. But until a certain point! With frequent use of alcohol, the safety margin of the liver will be enough for about 15 years. For some people, it may take 5-10 years longer, it all depends on the individual characteristics of the organism.

But this does not mean, , that all other organs have the same margin of safety, primarily the brain and intestines. They can suffer from alcohol much earlier. Therefore, doctors advise drinking as little as possible, and ideally completely abandoning alcohol.

It is important to mention tumor diseases of the liver.

– I mean both metastatic liver damage, when metastases of cancer or tumors appear on it, the primary localization of which falls on another organ, and primary tumors – hepatocellular carcinoma or adenocarcinoma of the liver, which begin to develop directly in the organ.

It should be understood that liver metastasis in malignant tumors is actually an incurable situation. That is, the patient is incurable. With primary liver tumors, the prognosis is also unfavorable; liver and pancreatic cancer are one of the most aggressive forms of cancer. Therefore, it is so important to undergo regular examinations and take tests,” the expert explained.

Not only alcohol and junk food destroy the liver

Many are well aware that the liver suffers from fatty foods, alcohol and frequent medication. However, for some reason, people often forget about cigarettes. Nicotine destroys not only your lungs, but also the liver, because it is absorbed into the blood, and it will inevitably be “driven” through the body’s main filter.

– This is not only about cigarettes, but also about all nicotine-containing products: vapes, electronic cigarettes, sticks, which have been very popular over the past few years. Even though they have a lower burning temperature and no smoke, still has a toxic effect on the liver. Moreover, we still don’t know how electronic smoking will affect your health in 10 or 15 years, says the doctor.

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How to understand that something is wrong with the liver

Some external signs can sometimes give out problems with the liver:

• the skin has acquired a yellowish tint. It can range from pale yellow to bright orange, which is associated with impaired bilirubin metabolism.

• The whites of the eyes can also become yellow , mucous membranes can also change color.

– These are the most important indicators, which very often the patient himself does not pay attention to, even when he looks at himself in the mirror. Most often, this is noticed by a person’s relatives or his entourage,” Maxim Rykov explains.

If you notice that your skin or the whites of your eyes have turned yellow, then this is a good reason to make an appointment with a general practitioner or hepatologist.

As for the pain syndrome, unpleasant sensations appear quite rarely. The pain is usually dull, but sometimes more acute, appears in the right hypochondrium, may increase at night. Most often, the increase is explained by the psychological effect of pain perception, since at night, when a person is not busy with any business, is in peace and quiet, the pain is subjectively perceived as more severe, although its true intensity remains the same.

By the way

There is a myth that fasting and taking warm mineral waters helps cleanse the liver. This is not true. In order for the liver to really cleanse, a person must fast for 1.5 months, drink only pure water without any additives or medicines. Naturally, this is impossible. Therefore, you need to understand that saving the liver is not in fasting, but in leading a healthy lifestyle, trying to eat right and refrain from alcohol and cigarettes.

Many liver diseases can be asymptomatic, so laboratory test results are necessary and informative in the following cases:

• you need to check for abnormal liver function;

• assessment of severity of liver injury required;

• need to monitor the course of liver disease and understand how the treatment is going;

• clarification of the diagnosis is required.

– Some biochemical tests are called liver tests. They can measure the amount of enzymes entering the bloodstream or assess liver function by examining hepatobiliary excretion. Other tests are used to assess the synthesizing function of the liver, says Marina Fursova.

Read also

About informative indicators in analyzes

1. notransferases. They are one of the first to react to the fact that the liver undergoes some changes or suffers from frequent alcohol intake. AST and ALT are considered the two most important indicators of liver damage, although ALT is more specific than AST. So, in some cases, AST is directly compared with ALT and their ratio is calculated, which is can clarify why exactly the organ is damaged. Blood AST is also often compared with other tests such as alkaline phosphatase (AP), total protein, and bilirubin to determine a specific form of liver disease;

2. Biochemical blood test for bilirubin. Bilirubin is a bile pigment produced by the breakdown of hemoglobin proteins, aging red blood cells. It is prescribed for liver diseases, violation of the outflow of bile and diseases of the biliary tract, the appearance of yellowness of the eyes and skin. This indicator is gives the doctor an understanding of how a person’s liver works;

3. Alkaline phosphatase. Elevated levels of this hepatocyte enzyme suggest cholestasis , a condition in which bile cannot flow from the liver into the duodenum. The activity of alkaline phosphatase is sometimes increased in healthy people, this does not necessarily indicate any pathology. In order to correctly interpret the change in the activity of alkaline phosphatase, a comprehensive assessment of the results of other tests, as well as other medical data, is needed;

4. Gamma-glutamyl transpeptidase (GGTP) . This is a protein that is found in the liver and pancreas, its activity in the blood increases with various liver pathologies, as well as with alcohol abuse . It reflects the state of the tissues of the liver and biliary tract;

5. Prothrombin time (PT) and International Normalized Ratio (INR) are significant indicators of the ability of the liver to synthesize fibrinogen and vitamin K, on ​​which blood coagulation depends. In chronic liver diseases, an increase in INR or PT in indicates progression of liver failure . INR or PV levels do not increase in mild hepatocellular dysfunction and are often normal in cirrhosis;

6. Whey proteins. Most whey proteins are synthesized by hepatocytes (liver cells) and help in the diagnosis of specific diseases. They also usually rise in response to damage (eg, inflammation) to various tissues, so the rise may be non-specific and unrelated to liver disease.

See also

“In order to diagnose various liver problems, a blood chemistry test is often sufficient. An increase in the level of ALT, AST and bilirubin will indicate that it is time to make an appointment with a hepatologist,” says Maxim Rykov.

Venous blood test must be taken on an empty stomach. 12 hours before donating blood, exclude physical and emotional overstrain, do not smoke for 30 minutes before the test. On the day of blood sampling, it is necessary to exclude the use of drugs. If this is not possible, then you must definitely tell the doctor how long and what kind of medicines you are taking.

Ultrasound is also considered one of the most accurate diagnostic methods for determining liver diseases – this is a fairly simple and affordable method. It must be understood that of all instrumental methods, it is the results of ultrasound examination that depend on the doctor, since it is even important which sensor the specialist uses, how he applied the gel and how he placed this same sensor on the patient’s body.

Text author:Sofya Khromova

Biochemical blood test

Biochemical blood test (BAC) is one of the most informative tests that gives an idea about the work of the kidneys, liver, gallbladder, pancreas, other organs, lipid, protein and carbohydrate metabolism, the balance of microelements.

Analyzes

Total bilirubin

1 day

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from 125 ₽

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Alanine aminotransferase (ALT)

1 day

from 125 ₽

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LHC can be prescribed by any doctor, because with each disease it is important to see the big picture. For preventive purposes, blood biochemistry is done once a year, during pregnancy – in the 1st and 3rd trimesters with a normal course and more often – with ailments and complaints of a woman about her well-being.

Test indications

• complaints of malaise;
• any disease;
• assessment of the state after therapy;
• preventive examination.

Investigations during biochemical analysis of blood

During a biochemical analysis, the blood sugar, urea, total lipids, low and high density cholesterol, triglycerides, total bilirubin, total protein, AsAt, AlAt enzymes, lipase, amylase, gamma-GTP and other indicators are determined. Each of the indicators may indicate the normal operation of an organ, system, or a deviation from the norm.

It should be remembered that blood biochemistry is a primary diagnosis, an assessment of a person’s overall health. Its results can only be interpreted by an experienced specialist. According to the indicators of the BAC, the doctor prescribes special tests if there are suspicions of a disease or pathology of organs.

Biochemical analysis of blood a large number of tested items. Next, we will talk about the main ones.

Further in the text are the norms of the research, WHICH ARE INTRODUCTORY CHARACTER. In all laboratories, the norms, units of measurement may differ, as well as THEY DEPEND on the sex and age of the patient. BE CAREFUL!

Specific proteins and inflammatory markers

More than 20 plasma proteins are called specific proteins and markers of inflammation, the concentration of which indicates the development of acute inflammation or tissue damage.

C-reactive protein

CRP is one of the most sensitive markers of acute inflammation and tissue damage. It appears in the blood serum and rapidly increases in volume when:

• various inflammations;
• diseases of the gastrointestinal tract;
• parasitic, viral, bacterial infections;
• systemic rheumatic diseases;
• metastases of cancerous tumors;
• tissue damage, including acute myocardial infarction;
• neonatal sepsis;
• meningitis;
• tuberculosis;
• burns;
• taking oral contraceptives, estrogens.

According to the above list, it is clear that the indicator has a low specificity, therefore, with its high rates, narrower studies are immediately prescribed if the reason for the increase is unknown.

The CRP indicator is used to determine the success of therapy: if the treatment gives a result, the protein returns to normal after 6-10 days

Eosinophilic cationic protein (ECP)

ESR rises when:

• atopic bronchial asthma;
• allergic rhinitis;
• atopic dermatitis;
• food allergies;
• helminthiasis;
• acute respiratory infections;
• malignant diseases with activation of eosinophils;
• taking certain medications.

Rheumatoid factor

Rheumatoid factor is a protein produced by the human immune system. An increase in the norm of the Russian Federation may indicate rheumatoid arthritis, Sjögren’s syndrome, chronic infections of a bacterial, viral, parasitic nature, some types of oncology, diseases of the kidneys, liver, and lungs.

Myoglobin

The concentration of myoglobin increases if the myocardium or skeletal muscles are damaged. Normally, its concentration is not determined in the laboratory – so little myoglobin is contained in the blood of a healthy person, from 0 to 70 mcg / l.

Troponin I

Tn I is a heart muscle protein that enters the bloodstream during myocardial infarction. It is one of the most sensitive and specific indicators for damage to the heart muscle. After a heart attack, after about 3 hours, the level of Tn I in the blood rises significantly and remains so for up to 14 days.

Creatine kinase MB

KK-MB is a cell enzyme that is used as a specific and sensitive indicator of myocardial damage.

CK-MB is located almost in its entirety in the heart muscle, therefore its content in the bloodstream is negligibly small. If it increases, then the likelihood of acute heart attack, recurrent heart attack and other pathological processes associated with the heart is high.

NT-proBNP

NT-proBNP is a protein of the left ventricle of the heart. A change in its level may indicate heart failure, its severity. The level of this protein also evaluates the effectiveness of heart failure therapy.

The norm for people under 75 years old is 0-125 pg / ml, over 75 years old – up to 450 pg / ml.

Antistreptolysin-O (ASLO)

ASLO is a marker of streptococcal infection. Its increase is caused by angina, scarlet fever, chronic tonsillitis, acute glomerulonephritis, streptococcal pyoderma.

Procalcitonin

Procalcitonin rises in the blood during bacterial infections, sepsis, septic shock, multiple organ failure, and some other serious conditions.

Electrolytes

Electrolytes include chlorine, sodium, and potassium. They play an important role in metabolic processes, maintain the level of acidity, water balance. The level of electrolytes is the most important characteristic of human health, an indicator of the functionality of the heart and kidneys.

Abnormalities in kidney function, heart disease, diabetes mellitus, pathologies and disorders in the functioning of muscles and the nervous system lead to deviations from the norm. If the electrolyte imbalance is not stabilized by eliminating its causes, the person will experience dizziness, convulsions, and irregular heartbeats. In especially advanced cases, an electrolyte imbalance leads to death.

Lipid metabolism

The LHC shows the level of fats and allows you to assess the risk of occurrence, development of heart and vascular diseases. During testing, the level of triglycerides, cholesterol – total, LDL, HDL is checked.

Triglycerides

Triglycerides grow in diabetes, heart and vascular pathologies, pregnancy; decrease in case of disturbances in the functioning of the thyroid gland, at the terminal stage of liver damage, if a person eats poorly, monotonously.

Cholesterol

• HDL (“good cholesterol”). Participates in the processing and removal of fats from the body. If the values ​​are high, then the risk of formation of vascular plaques decreases. The norm is 1.03–1.55 mmol / l.
• LDL (“bad cholesterol”). Normally – 0-3.3 mmol / l – it is necessary for the body. Exceeding the norm threatens the development of atherosclerosis.
• Total (composed of HDL and LDL). The norm is 5.2 mmol/l. A decrease against the norm leads to psychophysiological disorders, reproductive dysfunction. Elevated levels can cause diabetes, atherosclerosis.

Carbohydrate metabolism

During the LHC, glucose and fructosamine levels are examined. An increase in their level can occur with diabetes mellitus, a decrease in pancreatic tumors, when taking insulin.

• the norm for glucose is 3.3-5.5 mmol / l;
• the norm for fructosamine is up to 285 µmol / l.

Pigments

During the LHC, the level of bilirubin is set – total (yellow), direct, indirect.

• General. Normally – 3.4-17.1 µmol / l, an increase occurs in pathologies, liver diseases, disruption of its work.
• Straight. Normally – up to 7.9 µmol / l, an increase indicates pathologies of the liver, biliary tract.
• Indirect . Its indicators are calculated, depend on direct and total bilirubin. An increase in indirect bilirubin is often associated with anemia, malaria.

Iron

Serum iron is one of the most important indicators of health. It transports and deposits oxygen, participates in hematopoiesis, and is part of many proteins and enzymes. Especially carefully you need to monitor the level of iron in children, adolescents, pregnant and lactating women, the elderly, those who experience high physical exertion, suffer from chronic bleeding.
A decrease in the level of iron occurs with malnutrition, heavy blood loss, non-assimilation of iron, and an increased need for it.

Enzymes

1. Liver tests. The standard set of LHC indicators includes the so-called. “liver tests” – ASAT, ALT. Changes in the norm can signal diseases, pathologies of the liver, heart, inflammation and infections.

• The AST norm is up to 31 U/l in women, up to 37 U/l in men.
• The ALT norm is up to 34 U/l in women, up to 45 U/l in men.

2. Amylase – digestive juice enzyme. An increase in its level occurs in acute, chronic pancreatitis, other diseases (including tumors) affecting the pancreas.

• Amylase rate – 28-100 U / l.

3. Pancreatic amylase – P-type amylase. An increase in the level of P-type amylase occurs when the pancreatic duct is blocked by a tumor, stone, and in some other cases.

4. Creatine kinase (CK) is an enzyme that provides energy for muscle contraction. In the blood, it is present in different isomers. By increasing the concentration of individual isomers, an assumption is made about damage to muscles, myocardium, and oncological diseases.

5. L ipaza — digestive juice enzyme. A change in the norm indicates problems with the pancreas.

6. Vitamins . The standard BAC determines the concentration of vitamin B12. It is necessary, first of all, for hematopoiesis. An increase in the level of B12 occurs with diseases of the kidneys, liver, leukemia, a decrease in vegetarianism, inflammation of the gastrointestinal tract, and parasitic infections. The vitamin norm is from 208 to 963.5 pg / ml. The BAC may include a test for the content of vitamins of group D. Deficiency of this vitamin is experienced by up to 60% of people around the world. Vitamin deficiency is expressed in rickets (children), muscle weakness, pain in the pelvic bones, lower back, legs. With vitamin intoxication (uncontrolled intake of vitamin-containing complexes), headaches, nausea, vomiting, a metallic taste in the mouth, acute pancreatitis, nephro- and arteriolocalcinosis occur.

• The norm for vitamin D2 is 0. 8-7 ng / ml, for vitamin D3 – 2.2-42.6 ng / ml.

Rules for preparing for analysis and passing the LHC

Many factors affect blood counts: food (including drinking water), habits, physical and mental state, bathing, medications, alcohol, smoking, etc. Therefore, to obtain accurate data, several requirements must be met:

• donate blood on an empty stomach, from 8 to 11 am (all laboratory indicators are calculated for this time, they change over the course of the day). Even water is recommended not to drink whenever possible. At least 8 hours should have passed since the last meal, ideally 12 hours;
• the day before, and preferably a few days before, you should give up heavy, fatty, fried foods, strong tea, alcohol, carbonated drinks, and other foods that can change the functioning of the liver, kidneys, pancreas;
• a day before the analysis, avoid physical, psychological overload, do not visit the bathhouse, solarium, do not do x-rays, fluorography, physiotherapy, ultrasound;
• a day before the analysis, refrain from taking medications.