What do liver blood tests reveal about your health. How are liver function tests interpreted. What are the implications of abnormal liver test results. What causes elevated liver enzymes. How to prepare for a liver blood test. When should you be concerned about liver test results.

The Importance of Liver Blood Tests in Assessing Liver Health

Liver blood tests play a crucial role in evaluating the overall health and function of this vital organ. These tests provide valuable insights into the liver’s ability to perform its essential tasks, such as metabolizing nutrients, producing proteins, and filtering toxins from the blood. By analyzing specific enzymes, proteins, and other substances in the bloodstream, healthcare providers can detect potential liver problems early and monitor existing conditions.

What is a Liver Profile?

A liver profile, also known as a liver function test (LFT) or liver panel, is a comprehensive set of blood tests that assess various aspects of liver health. This group of tests typically includes:

• Liver enzyme tests
• Liver protein tests
• Bilirubin tests

Together, these tests provide a comprehensive picture of liver function and can help identify potential liver damage or disease.

Key Components of Liver Blood Tests

Understanding the individual components of liver blood tests is essential for interpreting the results accurately. Let’s explore the main elements of a liver profile:

Liver Enzyme Tests

Liver enzyme tests measure the levels of specific enzymes in the blood that are typically found within liver cells. Elevated levels of these enzymes may indicate liver damage or inflammation. The primary liver enzymes tested include:

• Alanine aminotransferase (ALT)
• Aspartate aminotransferase (AST)
• Alkaline phosphatase (ALP)
• Gamma-glutamyl transpeptidase (GGT)

Are elevated liver enzymes always a cause for concern? While increased levels of liver enzymes can indicate liver damage, it’s important to note that temporary elevations can occur due to various factors, including certain medications, intense exercise, or recent alcohol consumption. Your healthcare provider will interpret the results in the context of your overall health and medical history.

Liver Protein Tests

Liver protein tests assess the levels of proteins produced by the liver, which play crucial roles in various bodily functions. These tests typically measure:

• Albumin: The most abundant protein in the blood, responsible for maintaining fluid balance and transporting hormones and medications
• Total protein: The combined amount of all proteins in the blood
• Antibodies: Proteins that help fight infections

How do liver protein levels reflect liver function? Low levels of albumin or total protein may indicate impaired liver function, as a healthy liver is responsible for producing these essential proteins. Abnormal antibody levels can also provide insights into potential autoimmune liver conditions.

Bilirubin Tests

Bilirubin is a yellow pigment produced when red blood cells break down. The liver is responsible for processing bilirubin and excreting it from the body. Bilirubin tests measure:

• Total bilirubin: The combined amount of all bilirubin in the blood
• Direct (conjugated) bilirubin: The form of bilirubin that has been processed by the liver
• Indirect (unconjugated) bilirubin: The form of bilirubin that has not yet been processed by the liver

Why is measuring bilirubin important? Elevated bilirubin levels can indicate liver dysfunction or other conditions affecting the liver’s ability to process this substance. High levels of bilirubin can lead to jaundice, a yellowing of the skin and eyes.

Interpreting Liver Blood Test Results

Interpreting liver blood test results requires careful consideration of various factors, including the specific tests performed, the individual’s medical history, and the presence of any symptoms. Here’s a general overview of how to interpret common liver test results:

Normal Liver Test Results

Normal liver test results typically fall within the following ranges:

• ALT: 7-56 units per liter (U/L)
• AST: 10-40 U/L
• ALP: 44-147 U/L
• GGT: 9-48 U/L
• Albumin: 3.5-5.0 grams per deciliter (g/dL)
• Total protein: 6.0-8.3 g/dL
• Total bilirubin: 0.1-1.2 milligrams per deciliter (mg/dL)

It’s important to note that these ranges may vary slightly depending on the laboratory and the specific testing methods used.

High Liver Test Results

Elevated liver test results can indicate various liver conditions or damage. Some common causes of high liver test results include:

• Hepatitis (viral, alcoholic, or autoimmune)
• Fatty liver disease
• Cirrhosis
• Liver cancer
• Certain medications
• Alcohol abuse

How significant are mildly elevated liver enzymes? Mild elevations in liver enzymes (less than three times the upper limit of normal) are often not a cause for immediate concern but may warrant further investigation or monitoring. Your healthcare provider will consider the extent of the elevation, your symptoms, and other factors to determine the appropriate course of action.

Low Liver Test Results

Low levels of certain liver proteins or enzymes can also indicate potential liver problems. For example:

• Low albumin levels may suggest advanced liver disease or malnutrition
• Decreased levels of clotting factors (produced by the liver) can indicate severe liver dysfunction

What can cause abnormally low liver enzyme levels? While less common than elevated levels, low liver enzyme levels can occur in conditions such as zinc deficiency, vitamin B6 deficiency, or severe liver damage where the liver is no longer able to produce adequate amounts of enzymes.

Preparing for a Liver Blood Test

Proper preparation for a liver blood test is essential to ensure accurate results. Here are some key steps to follow:

Fasting Requirements

Your healthcare provider may instruct you to fast for 8-12 hours before the test, typically overnight. This means avoiding all food and beverages except water. Fasting is important because certain foods and drinks can affect liver enzyme levels and other test results.

Medication Considerations

Some medications can impact liver test results. Inform your healthcare provider about all medications you’re taking, including over-the-counter drugs and supplements. They may advise you to temporarily stop certain medications before the test or take them into account when interpreting the results.

Lifestyle Factors

To ensure the most accurate results, consider the following lifestyle factors:

• Avoid alcohol for at least 24 hours before the test
• Refrain from strenuous exercise for 24-48 hours prior to testing, as it can temporarily elevate liver enzyme levels
• Wear comfortable clothing with loose-fitting sleeves to facilitate blood drawing

Is it necessary to follow a special diet before a liver blood test? In most cases, no special diet is required beyond the fasting instructions provided by your healthcare provider. However, if you’re undergoing specific tests for liver function, they may provide additional dietary guidelines.

Common Symptoms of Liver Problems

While liver blood tests can detect issues before symptoms appear, it’s important to be aware of common signs that may indicate liver problems. These symptoms can include:

• Jaundice (yellowing of the skin and eyes)
• Abdominal pain or swelling
• Dark urine
• Pale stools
• Chronic fatigue
• Nausea or vomiting
• Loss of appetite
• Itchy skin

When should you seek medical attention for potential liver problems? If you experience persistent symptoms or a combination of these signs, it’s important to consult your healthcare provider promptly. Early detection and treatment of liver issues can significantly improve outcomes.

Causes of Abnormal Liver Test Results

Abnormal liver test results can stem from various factors, ranging from temporary influences to serious liver conditions. Some common causes include:

Hepatitis

Viral hepatitis, particularly hepatitis B and C, can lead to elevated liver enzymes and other abnormal test results. These infections can cause acute or chronic liver inflammation and damage.

Alcoholic Liver Disease

Excessive alcohol consumption can result in alcoholic hepatitis, fatty liver, or cirrhosis, all of which can cause abnormal liver test results.

Non-Alcoholic Fatty Liver Disease (NAFLD)

NAFLD, often associated with obesity and metabolic syndrome, can lead to elevated liver enzymes and other abnormalities in liver function tests.

Medications

Certain medications, including some antibiotics, painkillers, and cholesterol-lowering drugs, can affect liver function and cause temporary elevations in liver enzymes.

Autoimmune Liver Diseases

Conditions such as autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis can cause abnormal liver test results due to the immune system attacking liver cells.

Genetic Disorders

Inherited conditions like hemochromatosis (iron overload) and Wilson’s disease (copper accumulation) can lead to liver damage and abnormal test results.

How can the underlying cause of abnormal liver test results be determined? Identifying the specific cause often requires additional testing, which may include further blood tests, imaging studies (such as ultrasound or CT scans), or in some cases, a liver biopsy. Your healthcare provider will consider your medical history, symptoms, and initial test results to determine the most appropriate diagnostic approach.

Treatment and Management of Liver Conditions

The treatment and management of liver conditions depend on the underlying cause and severity of the problem. Some general approaches include:

Lifestyle Modifications

For many liver conditions, lifestyle changes can significantly improve liver health:

• Limiting or eliminating alcohol consumption
• Maintaining a healthy weight through diet and exercise
• Avoiding unnecessary medications and supplements
• Managing underlying conditions like diabetes and high cholesterol

Medications

Depending on the specific liver condition, medications may be prescribed to:

• Treat viral hepatitis
• Manage autoimmune liver diseases
• Control complications of cirrhosis
• Address underlying metabolic disorders

Monitoring and Follow-up

Regular monitoring of liver function through blood tests and imaging studies is often necessary to track the progression of liver conditions and assess the effectiveness of treatment.

Liver Transplantation

In cases of severe liver failure or end-stage liver disease, liver transplantation may be considered as a last resort.

What role do liver blood tests play in monitoring treatment effectiveness? Liver blood tests are invaluable tools for assessing the response to treatment and monitoring the progression of liver conditions. They can help healthcare providers adjust treatment plans and detect any potential complications early.

In conclusion, liver blood tests are essential diagnostic tools that provide crucial information about liver health and function. By understanding the components of these tests, their interpretation, and the factors that can influence results, individuals can take a more active role in managing their liver health. Regular check-ups and prompt attention to any abnormal results or symptoms can lead to early detection and more effective treatment of liver conditions, ultimately promoting better overall health and well-being.

Liver Profile – What You Need to Know

This material must not be used for commercial purposes, or in any hospital or medical facility. Failure to comply may result in legal action.

WHAT YOU NEED TO KNOW:

What is a liver profile?

A liver profile is a group of blood tests that show how well your liver is working. The liver makes enzymes and bile that help digest food and gives your body energy. It also removes harmful material from your body, such as alcohol and other chemicals.

What blood tests are part of a liver profile?

• Liver enzyme tests measure alanine aminotransferase (ALT), alkaline phosphatase (ALP), and aspartate aminotransferase (AST) enzymes. These tests may also include gamma-glutamyl transpeptidase (GGT).
• Liver protein tests measure albumin and other proteins in your blood. This includes antibodies that help to fight infections.
• Bilirubin tests measure the amount of bilirubin in your blood. Bilirubin is a yellow fluid made in your body when red blood cells break down.

How do I get ready for the test?

Healthcare providers may tell you not to eat or drink anything, except water, after midnight. Several medicines can affect the results of your liver function tests. Ask your healthcare provider if you should wait to take your medicines until after your blood is taken. Wear a short-sleeved or loose shirt on the day of the test. This will make it easier to draw your blood.

What do abnormal test results mean?

Abnormal levels of liver enzymes, proteins, or bilirubin may be a sign of liver damage or disease. You may need another liver profile or other tests to find the cause of your abnormal test results.

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your lab tests. You can then discuss the results with your healthcare providers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright IBM Corporation 2021 Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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Diagnosis of Cirrhosis | NIDDK

How do doctors diagnose cirrhosis?

Doctors diagnose cirrhosis based on your medical history, a physical exam, and the results of tests.

Medical history

Your doctor will ask about your symptoms. He or she will also ask if you have a history of health conditions that make you more likely to develop cirrhosis.

Your doctor will ask about your use of alcohol and over-the-counter and prescription medicines.

Your doctor will ask about your history of health conditions.

Physical exam

Your doctor will examine your body, use a stethoscope to listen to sounds in your abdomen, and tap or press on specific areas of your abdomen. He or she will check to see if your liver is larger than it should be. Your doctor will also check for tenderness or pain in your abdomen.

What tests do doctors use to diagnose cirrhosis?

Blood tests

Your doctor may recommend the following blood tests

• liver tests that can show abnormal liver enzyme levels, which may be a sign of liver damage. Your doctor may suspect cirrhosis if you have
  • increased levels of the liver enzymes alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP)
  • increased levels of bilirubin
  • decreased levels of blood proteins
• complete blood count, which can show signs of infection and anemia that may be caused by internal bleeding
• tests for viral infections to see if you have hepatitis B or hepatitis C
• blood tests for autoimmune liver conditions, which include the antinuclear antibody (ANA), anti-smooth muscle antibody (SMA), and anti-mitochondrial antibody (AMA) tests

Based on the blood test results, your doctor may be able diagnose certain causes of cirrhosis.

Your doctor can use blood tests to tell how serious your cirrhosis is.

Your doctor can use blood tests to tell how serious your cirrhosis is.

Imaging tests

Imaging tests can show the size, shape, texture, and stiffness of your liver. Measuring the stiffness of the liver can show scarring. Your doctor can use stiffness measures to see if the scarring is getting better or worse. Imaging tests can also show how much fat is in the liver. Your doctor may use one or more of the following imaging tests

Liver biopsy

Your doctor may perform a liver biopsy to see how much scarring in is your liver. A liver biopsy can diagnose cirrhosis when the results of other tests are uncertain. The biopsy may show the cause of cirrhosis. Sometimes your doctor may find that something other than cirrhosis has caused your liver to become damaged or enlarged. Your doctor can also diagnose liver cancer based on liver biopsy results.

Liver Function Tests for Chronic Liver Disease

Liver Function Tests

What are some of the most common liver function tests?

A series of special blood tests can often determine whether or not the liver is functioning properly. These tests can also distinguish between acute and chronic liver disorders and between hepatitis and cholestasis.

The most commonly performed blood tests include the following:

• Serum bilirubin test: This test measures the levels of bilirubin in the blood. Bilirubin is produced by the liver and is excreted in the bile. Elevated levels of bilirubin may indicate an obstruction of bile flow or a problem in the processing of bile by the liver.
• Serum albumin test: This test is used to measure the level of albumin (a protein in the blood) and aides in the diagnosis of liver disease.
• Serum alkaline phosphatase test: This test is used to measure the level of alkaline phosphatase (an enzyme) in the blood. Alkaline phosphatase is found in many tissues, with the highest concentrations in the liver, biliary tract, and bone. This test may be performed to assess liver functioning and to detect liver lesions that may cause biliary obstruction, such as tumors or abscesses.
• Serum aminotransferases (transaminases): This enzyme is released from damaged liver cells.
• Prothrombin time (PTT) test: The prothrombin time test measures how long it takes for blood to clot. Blood clotting requires vitamin K and a protein that is made by the liver. Prolonged clotting may indicate liver disease or other deficiencies in specific clotting factors.
• Alanine transaminase (ALT) test: This test measures the level of alanine aminotransferase (an enzyme found predominantly in the liver) that is released into the bloodstream after acute liver cell damage. This test may be performed to assess liver function, and/or to evaluate treatment of acute liver disease, such as hepatitis.
• Aspartate transaminase (AST) test: This test measures the level of aspartate transaminase (an enzyme that is found in the liver, kidneys, pancreas, heart, skeletal muscle, and red blood cells) that is released into the bloodstream after liver or heart problems.
• Gamma-glutamyl transpeptidase test: This test measures the level of gamma-glutamyl transpeptidase (an enzyme that is produced in the liver, pancreas, and biliary tract). This test is often performed to assess liver function, to provide information about liver diseases, and to detect alcohol ingestion.
• Lactic dehydrogenase test: This test can detect tissue damage and aides in the diagnosis of liver disease. Lactic dehydrogenase is a type of protein (also called an isoenzyme) that is involved in the body’s metabolic process.
• 5′-nucleotidase test: This test measures the levels of 5′- nucleotidase (an enzyme specific to the liver). The 5′- nucleotidase level is elevated in persons with liver diseases, especially those diseases associated with cholestasis (disruption in the formation of, or obstruction in the flow of bile).
• Alpha-fetoprotein test: Alpha-fetoprotein (a specific blood protein) is produced by fetal tissue and by tumors. This test may be performed to monitor the effectiveness of therapy in certain cancers, such as hepatomas.
• Mitochondrial antibodies test: The presence of these antibodies can indicate primary biliary cirrhosis, chronic active hepatitis, and certain other autoimmune disorders.

Liver Blood Tests Explained

Liver Blood Tests Explained

Blood tests and Investigations for Liver Function 

Some of the standard or routine blood tests that your doctor will order to check “liver function” are in reality only able to detect liver damage. These tests may not be sensitive enough to accurately reflect whether your liver is functioning at its optimum level. These tests will usually be abnormal in significant liver disease or liver distress; however, they can still give normal readings in some cases of mild liver disease.  

Healthy ranges for Blood tests for Liver Function

ALT              0 – 45 U/L

GGT             0 – 45 U/L

AST              0 – 45 U/L

ALP             30 – 120 U/L

BILIRUBIN      0 – 20 U/L         or 0. 174 to 1.04 mg/dL

ALBUMIN      38 – 55 g/L         or 3.8 to 5.5g/dL 

AFP              20 – 32 g/L        or 2 to 3.2g/dL

ALT (alanine aminotransferase),
is elevated showing inflammation of the liver.

Our ALT shows up high whenever our liver is dealing with any infection or poison or even a hard to digest food such as fried meat. It is common for them to be high in people who have recently had alcohol or paracetamol.  With infections, and these can be other diseases like flu or an septic wound they go up as the liver fights back.  If they are constantly in the 50 to 200 range we term the hepatitis B infection active.  ALT’s range from 0 up to 3000 or so in many acute hepatitis cases.  They change with every meal so it is important not to panic if they go from 20 to 45 after a few months.  All scores below 45 indicate a perfectly healthy score.

GGT (gamma glutamyl transpeptidase)
is elevated in those who use alcohol or toxins.

Our GST shows up high between 50 and 200 if we are often taking paracetamol or using alcohol a lot.  It is often a sign of alcoholism or longer term liver damage, but can be reversed by adopting a alcohol free or toxin free lifestyle.

BILIRUBIN 

If our Bilirubin is elevated, the patient may have a yellow colour skin and eyes, jaundice.  Bilirubin is a bile product made by the liver to digest food and it often is overproduced when we first get Hepatitis B or C, then it back fires into the blood stream causing the yellow effect to eyes and skin.  It can cause itching and skin irritation as it is sweated out. If it goes up during chronic Hepatitis B or C infection it is a sign of poor food and drink or liver disease.  Milk thistle herbal pills are proven to help lower Bilirubin scores so many Hepatitis patients take it.

AFP (Alpha Feta Globulin Protein).
If our AFP is elevated it usually mean excessive inflammation in the liver and/or immune system. Very high levels may be seen in some types of cancers. It is important the many women diagnosed during pregnancy remember it goes up sometimes because of Pregnancy, a score of 40 g/l is not a sign of liver cancer, scores that may indicate a cancer tend to be in the hundreds

AST (aspartate aminotransferase)
is elevated in heart, muscle and liver diseases.

ALP (alkaline phosphatase)
is elevated in many types of liver and non liver disease.

ALBUMIN
falling levels of blood albumin show deteriorating liver function.

Up to 80% of Hepatitis B and C patients usually have normal, perfectly healthy scores for liver function, these are termed inactive or healthy patients.

Viral Hepatitis Liver Tests – the 4 main Results and Stages

Viral Hepatitis Patients tend to present with 4 types of LFT Result, 3 factors most affect the liver results 

Viral Load, 

Time Infected and 

Toxins

Stage 1 – All Normal 

Means hepatitis is having little effect and you are best monitored yearly for activity

Stage 2 – ALT is persistently above 50 but your LFT’s are Normal

Means you have an active hepatitis infection which over decades causes 

Fibrosis without toxins and is best treated at some point and slowed with a liver friendly diet

Your Liver Team should provide a Personalised Care Plan if

Stage 3 – ALT/AST/GGT are 50 to 200 

You are taking liver toxins that worsen viral hepatitis eg alcohol, barbiturates, 

benzodiazepines, anticonvulsants, warfarin, antidepressants, paracetamol, 

or you may also have fatty liver from obesity

Stage 4 – GGT /ALT are 50 to 200 and ALP is above 200

Liver cells are damaged Cirrhosis and Fibrosis have occurred, liver functions 

can fall, tumours can occur.

Understanding Your Blood Tests | Sonora Quest

Your Blood Tests

You and your doctor can learn a great deal about your health by testing a sample of your blood. Laboratory tests help in several ways. Sometimes test results will be abnormal before you have any symptoms, and when you have symptoms, laboratory test results help confirm that a problem does exist.

A normal test result is just as significant as an abnormal result. A normal result does not mean that the test was unnecessary. When a result is normal, it not only helps to rule out disease, but it also establishes a baseline for you. Each person has his or her own baseline “normal”. A person’s own result is the best baseline for monitoring any change that takes place in the future.

What follows is a brief description of the typical tests that may be included in a testing profile. These descriptions will help you to better understand your laboratory test results so that you may have a more meaningful discussion with your doctor. You should not rely on this information for diagnostic treatment. These descriptions are not intended to be a complete listing of all conditions medically relevant to each test. Always consult your doctor regarding your laboratory tests.

Glucose

Glucose is the chief source of energy for all living organisms; however, abnormally high or low blood glucose levels may be a sign of disease. For example, high glucose levels after 12 hours of fasting may suggest diabetes. Low blood glucose, on the other hand, may be seen with certain tumors or with liver disease. A low glucose level may also mean that the blood sample was not handled properly after it was drawn.

Uric Acid

Uric acid levels are useful in the diagnosis of gout. Gout is a condition that occurs and affects men more than women. Diets high in purines (present in sweetbreads, kidney, and liver) may worsen the condition. Patients with gout may develop arthritis and or kidney stones. A number of drugs, particularly diuretics and salicylates (aspirin), may also increase uric acid. Uric acid levels may be increased during kidney failure, with certain tumors, and as a response to stress and alcohol.

Phosphate

Phosphate is closely associated with calcium in bone development and is primarily found in the bones. The remaining phosphate level, which is found in the blood, is very important for muscle and nerve function. Very low levels of phosphate in the blood can be associated with starvation or malnutrition and this can lead to muscle weakness. High levels of phosphate in the blood are usually associated with kidney disease.

Calcium

Calcium is one of the most important elements in the body. Ninety-nine percent of the calcium in the body is in the bones. The remaining one-percent is in body fluids, such as blood, and is very important for the proper function of nerves, enzymes, muscles, and blood clotting. High levels can be caused by bone disease, excess intake of antacids and milk (this is often seen in people with ulcers), excessive intake of vitamin D, and over activity of the thyroid gland. The parathyroid gland is the main regulator of calcium in the body. Tumors of the parathyroid gland may result in very high calcium levels.

Magnesium

This element is found primarily inside the cells of the body. Like calcium, the level in the blood is important. A low magnesium level in the blood may indicate severe malnutrition, severe diarrhea, alcoholism, or excessive use of diuretics. A very low level of magnesium in the blood can cause your muscles to tremble.

Total Bilirubin

Bilirubin is the pigment in the blood that makes your blood plasma or serum yellow. When the bilirubin level in the blood is very high, the whites of your eyes and your skin may become yellow. This is known as jaundice. Bilirubin comes from the breakdown of old red cells in the blood. A high bilirubin level in the blood can be caused by too many red cells being destroyed (hemolysis), by liver disease, or by a blockage of the bile ducts. Fasting can also cause a slight increase in total bilirubin.

Direct Bilirubin

This is a specific form of bilirubin that is formed in the liver and excreted in the bile. Normally, very little of this form of bilirubin is present in the blood, so even a slightly high level of direct bilirubin indicates a problem with the liver cells.

Alkaline Phosphatase

Alkaline Phosphatase is found in all body tissues, but the most important sites are bone and liver. Blood levels increase when bones are growing; thus children have higher levels than adults do. High levels may also be seen in bone and liver disease. Certain drugs may cause high levels too.

Gamma-Glutamyltransferase (GGT)

GGT is primarily found in the liver. Drinking too much alcohol, certain drugs, obstructive liver disease, and bile duct disease can cause high levels of GGT in the blood.

Aspartate-Aminotransferase (AST)

AST is found mainly in the heart, liver, and muscles. High levels of AST in the blood suggest a problem with the heart, liver, or muscles.

Lactate Dehydrogenase (LDH)

LDH is found in all tissues in the body; thus a high level in the blood can result from a number of different diseases. Slightly elevated levels in the blood are common and rarely indicate disease. The most common sources of LDH are the heart, liver, muscles, and red blood cells.

Blood Urea Nitrogen (BUN)

BUN is a waste product derived from protein breakdown in the liver and excreted by the kidneys. When your kidneys are not working well, the level of BUN in the blood will rise. Dehydration and blood loss can also cause a high BUN level. Liver disease, a low protein diet, or too much water intake may cause a low BUN level.

Creatinine

The blood concentration of creatinine depends upon two things – the amount of muscle you have and the ability of your kidneys to excrete the creatinine. A high level of creatinine in the blood usually indicates deterioration in kidney function.

BUN/Creatinine Ratio

When BUN and/or creatinine levels are abnormal, the doctor can determine if the high BUN level is caused by a kidney problem or from something like blood loss in the abdomen.

Total Protein

This is a measure of the total amount of protein in your blood. A low or high total protein does not indicate a specific disease, but it does indicate that some additional tests may be required to determine if there is a problem.

Albumin

Approximately two-thirds of the total protein circulating in your blood is albumin. This important protein keeps water inside your blood vessels. When your albumin level is too low, water can leak out of your blood vessels into other parts of your body and cause swelling. A low level of albumin in the blood can be caused by malnutrition, too much water in the body, liver disease, kidney disease, severe injury such as burns or major bone fractures, and slow bleeding over a long period of time.

Globulin

This is the group of proteins in your blood that helps to fight infections. It is actually comprised of about 60 different important proteins. Some of the proteins in the group play an important role in blood clotting. If your globulin level is abnormal, your doctor may want to measure some of the individual proteins that make up this group.

Albumin/Globulin Ratio

A simple way to tell if the albumin or globulin levels in the blood are abnormal is to compare the level of albumin to the level of globulin in your blood.

Sodium

This element plays an important role in salt and water balance in your body. The adrenal hormone, aldosterone, and the rate of excretion in urine, regulate the blood sodium level. Too much water intake, heart failure, or kidney failure because of fluid retention can cause a low sodium level in the blood. A low level can also be caused by loss of sodium in diarrhea, fluid, and vomit, or by a deficiency of adrenal hormone. Too much intake of salt or not enough intake of water can cause a high level.

Potassium

This element is found inside all cells. Its role is to maintain water balance inside the cells and help in the transmission of nerve impulses. The level of potassium in blood is of critical significance. Low levels may be found in patients on diuretics or in patients not receiving enough dietary potassium. A low potassium level can cause muscle weakness and heart problems. A high level can be found in kidney disease or in overuse of potassium supplements. Some “salt” substitutes contain potassium instead of sodium, and an excessive use of these substitutes can cause dangerously high levels of potassium in the blood. Adrenal hormone disorders can also alter blood potassium level.

Chloride

Chloride is another element that plays a role in salt and water balance. It is almost never the only element that is low or high. Changes in the chloride level are usually associated with changes in sodium or potassium. Borderline low or high levels of chloride usually have very little significance. When there is too much or too little acid in the blood, chloride is an important clue to the cause of the acid abnormality.

Iron

The body must have iron to make hemoglobin and to help transfer oxygen to the muscles. If the body is low in iron, all body cells, particularly muscles in adults and brain cells in children, do not function properly. On the other hand, if there is too much iron in the body, this can cause injury to the heart, pancreas, joints, testicles, ovaries, etc. Iron excess is found in the heredity disease called hemochromatosis, which can be found in about 3 out of every 1000 people.

Total Iron Binding Capacity (TIBC)

Iron is transported in your blood bound to a protein called transferrin. Transferrin transports the iron in your body from the iron storage sites to where it is needed. It also transports the iron when not needed back to the storage sites. A low TIBC suggests malnutrition or iron excess. A high TIBC suggest iron deficiency.

Transferrin Percent Saturation

This percent is obtained by comparing the iron level to the TIBC level. It is a simple way to compare the amount of iron in the blood to the capacity of the blood to transport iron.

Cholesterol

Cholesterol is an essential blood fat, but too high a level of this blood fat is associated with a higher risk of heart disease and clogged blood vessels. The total cholesterol level in blood includes LDL (bad cholesterol) and HDL (good cholesterol).

HDL Cholesterol

High-density lipoprotein (HDL) cholesterol is sometimes described as the “good” cholesterol. One of the important roles of HDL cholesterol in your body is to carry cholesterol away from your arteries to your liver. The more HDL cholesterol you have, the more cholesterol can be carried away and not clog your arteries.

Cholesterol/HDL Cholesterol Ratio

This number is obtained by comparing the total cholesterol level to the HDL cholesterol level: the higher the number, the greater the risk of coronary heart disease. A high HDL cholesterol level will result in a lower ratio, which means a lower risk. This could be true even if the total cholesterol level may be high.

Triglycerides

This is a blood fat largely derived from dietary fat absorption, and to a limited extent, related to a higher risk of heart disease. You must not eat for at least 12 hours to obtain an accurate result for this test.

High Sensitivity CRP

CRP (C-Reactive Protein) is a protein produced in the liver that circulates in the blood. High Sensitivity CRP is a blood test that is able to detect small amounts of CRP. Even low levels of CRP can help indicate your risk for heart disease and help predict risk of a first heart attack up to eight years in advance.

T4 Thyroxine

T4 controls the rate at which energy is used and released by the body. A low level of T4 (hypothyroidism) may cause tiredness, depression, or weight gain even though your appetite is decreased. A high level of T4 (hyperthyroidism) may cause nervousness, irritability or weight loss.

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Liver Function Test (LFT) | OncoLink

Liver function tests (LFT) check how you liver is working. The liver helps clean your blood, makes blood clotting factors, proteins and enzymes, stores vitamins and minerals and makes bile.

LFTs are a group of tests that are looked at to see how healthy the liver is, any causes of illness, and how serious the illness is. LFTs are performed by taking a sample of blood.

The range of values that is considered normal for most people is given with your lab test results. You should be given instructions on how to prepare for the test. Some foods and medications can affect the results of the test. 

Note that liver disease from drinking too much alcohol or a viral infection can cause LFT results that are out of normal range. Your health care team will help interpret the results of this test.

Liver function tests | aidsmap

Key points

• People living with HIV should have regular blood tests to monitor liver function.
• The liver plays an important role in processing drugs used to treat HIV and other conditions.
• Liver problems can be a side-effect of some anti-HIV drugs.

You’ll have a number of routine tests to monitor your health as part of your HIV care. If you’re taking HIV treatment, you’ll also have regular tests to see how well this treatment is working and to make sure you are not developing any unwanted side-effects.

The health of your liver should be regularly checked by your doctor. Having a healthy liver is important to everybody, but it is particularly important for people with HIV. The liver plays a key role in breaking down and processing medicines used to treat HIV and other infections. Liver disease is a significant cause of illness and death in people with HIV.

Some anti-HIV drugs can cause side-effects that affect the liver and if you are taking them your doctor will want to check to see if your liver is suffering any ill-effects because of them.

The health of your liver can also be damaged by a number of things, for example, drinking too much alcohol, using recreational drugs, an unhealthy diet, taking large doses of vitamin A, and some herbal and alternative remedies. Regular liver function tests can help identify problems early.

Progressive damage to the liver can lead to scarring of the liver, which is also known as cirrhosis. If cirrhosis progresses too far, the liver will no longer be able to work properly, possibly leading to problems such as internal bleeding and brain impairment.

Hepatitis

“Regular liver function tests can help identify problems early.”

Some people living with HIV also have the viruses that cause hepatitis A, hepatitis B and hepatitis C. Blood tests are available to see if you have these infections, and you should be tested soon after your diagnosis with HIV, and then at regular intervals if you are at risk of acquiring them. Monitoring the health of the liver can also help detect the presence of these viruses. In some cases, hepatitis B or hepatitis C infection is only detected because of abnormal liver function tests.

Hepatitis A can cause a short illness, while infection with hepatitis B or hepatitis C (or both) can cause long-term, serious liver disease. If you have either or both of them the health of your liver will need to be carefully monitored.

Blood tests

The British HIV Association (BHIVA) recommends that people living with HIV should have regular assessments of their liver function.

The range of tests you’ll have will check levels of enzymes in your liver. These include:

• Alanine aminotransferase (ALT)
• Aspartate aminotransferase (AST)
• Alkaline phosphatase (ALP)
• Gamma glutamyl transferase (GGT)
• Bilirubin
• Albumin.

You should have your liver function checked when you are first diagnosed with HIV, at regular intervals in your first six months of treatment and then at least once a year after that.

Liver problems can be a side-effect of a number of anti-HIV drugs. These include the non-nucleoside reverse transcriptase inhibitor (NNRTI) nevirapine (Viramune and Viramune prolonged-release), some protease inhibitors and, more rarely, efavirenz (Sustiva, also in the combination pill Atripla).

Glossary

liver

An essential organ involved in digestion of food and excretion of waste products from the body.

liver function test (LFT)

A test that measures the blood serum level of any of several enzymes (eg, AST and ALT) produced by the liver. An elevated liver function test result is a sign of possible liver damage.

hepatitis C virus (HCV)

The hepatitis C virus can be spread through sharing contaminated needles, syringes and other equipment to inject drugs, sharing straws to snort drugs, needlestick injuries, and during childbirth. Sexual transmission does occur, primarily between gay men. Hepatitis C can range from a mild illness lasting a few weeks to a serious, lifelong illness. Untreated chronic hepatitis C can cause serious liver damage, cirrhosis, liver cancer, and even death. While there is no vaccine, treatments are available to clear the virus from the body, leading to its cure.

hepatitis A virus (HAV)

The hepatitis A virus is transmitted through contaminated food and water, as well as human faeces. It can be passed on during sex, particularly rimming (oral-anal contact). Symptoms usually last less than two months, although they continue in some people for up to six months. Drug treatment is not needed. A vaccine is available to prevent hepatitis A.

cirrhosis

Severe fibrosis, or scarring of organs. The structure of the organs is altered, and their function diminished. The term cirrhosis is often used in relation to the liver. 

Atazanavir (Reyataz) can increase the amount of bilirubin in your blood. This is not because of liver damage but as a result of interference with the liver handling of bilirubin. In some people, this can cause a yellowing of the skin and the whites of the eyes, but this is not harmful. Although this side-effect is not dangerous, it can be distressing for some people.

A number of medicines used to treat other infections that people with HIV are vulnerable to can also cause liver problems, as can statins, which are used to treat high cholesterol, and drugs used to treat tuberculosis (TB).

You will have more regular liver function tests if you have recently started HIV treatment (after one month and three months), and will be monitored every two weeks for the first two months if you have started treatment with the anti-HIV drug nevirapine (Viramune).

Physical tests of liver function

Your liver is in the upper right-hand side of your abdomen, and your doctor might perform a physical examination to check on its health. This will involve pressing on the liver to see if it is enlarged or painful. These symptoms can indicate that the liver is inflamed, scarred or swollen. Yellowing of the skin and eyes, often called jaundice, may indicate that the liver isn’t working as it should.

The liver infections hepatitis A, hepatitis B and hepatitis C as well as other liver diseases can cause your urine to become very dark and your stools to become pale. You may be asked to provide samples for testing in a lab.

Imaging

If your doctor suspects that your liver has been damaged, then they may request imaging tests such as an ultrasound. A sensor is placed on the belly and uses sound-waves to create an image of the liver. This will show up any abnormalities of the liver and can sometimes show evidence of scarring (cirrhosis).

Another method is transient elastography, often using a machine called FibroScan. This uses echo vibration waves, similar to an ultrasound, to detect hardening or stiffening of the liver.

These procedures are painless and non-invasive.

Liver biopsies

Sometimes, the only reliable way to determine the health of the liver is to test a small sample of liver tissue. This is called a liver biopsy. It is usually performed using local anaesthetic and may involve an overnight stay in hospital, although most people can go home the same day. It can be uncomfortable and cause soreness.

Basic biochemical parameters

Comprehensive laboratory examination, including all the main biochemical parameters of blood and allowing to assess the function of the liver (ALT, AST, total bilirubin), kidney (urea, creatinine), as well as the metabolism of carbohydrates (glucose), lipids (total cholesterol) and proteins (total protein ).

Russian synonyms

Basic biochemical parameters of blood.

Synonyms English

Biochemical profile, Basic biochemical blood tests.

Which biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

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

General information about the study

Basic biochemical blood parameters allow for a comprehensive assessment of the functions of various organs and systems.Together with a general blood test (CBC) and a general urinalysis (OAM), this complex study is included in the “clinical minimum” of analyzes, which is performed at almost any time a patient visits a doctor. The analysis is a screening test and includes baseline indicators that can be used to assess the basic functions of the human body and to suspect the most common diseases.

1. To assess liver function, the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (ALT) and total bilirubin are examined.

ALT and AST – enzymes that catalyze the transfer of amino groups between amino acids (transaminases). Although these enzymes can also be found in many other tissues and organs (heart, skeletal muscles, kidneys, brain, erythrocytes), changes in their concentration in the blood are more often associated with liver diseases, which explains their name – hepatic transaminases. ALT is a more specific marker of liver disease than AST. In viral hepatitis and toxic liver damage, as a rule, the same increase in ALT and AST levels is observed.With alcoholic hepatitis, liver metastases and liver cirrhosis, a more pronounced increase in AST is observed than ALT. It should be noted that there is no direct relationship between the degree of liver damage and the level of hepatic transaminases.

Bilirubin is a pigment formed during the breakdown of hemoglobin and some other heme-containing proteins in the liver, spleen and bone marrow. Total bilirubin is a collection of unbound (indirect, albumin-associated) and glucuronic acid-bound (direct) bilirubin.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 and the diagnosis of biliary obstruction. With an increase in the level of total bilirubin, it is advisable to conduct a study of direct bilirubin and calculate the value of indirect bilirubin, as well as to study the concentrations of such markers of biliary obstruction as alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGTP).

2.Serum creatinine and urea are tested to assess renal function.

Creatinine is the end product of the metabolism of creatine phosphate, an energy substrate formed in the muscles. Creatinine is freely filtered in the renal glomeruli and is used as an indicator of the glomerular filtration rate (GFR) and overall renal function. Increases in serum creatinine are indicative of decreased GFR and impaired renal function, but can also occur with dehydration and muscle damage.It should be noted that a change in the level of creatinine is not an early sign of kidney disease: an increase in its level above the upper limit of the norm is observed with a decrease in GFR already by 50%. This is especially important when examining elderly patients in whom a progressive decrease in GFR is not accompanied by a deviation of the creatinine level from the norm due to a decrease in its production in the body of an elderly person. For this reason, serum creatinine is not recommended as the sole measure of renal function.The optimal indicator for assessing renal function is GFR, which can be obtained either from the calculation using the serum creatinine concentration (as well as gender, age, race and body size), or using the Rehberg test.

Urea is the end product of protein metabolism, formed in the liver and excreted by the kidneys. This indicator is traditionally used in conjunction with creatinine to assess kidney function, but it can also indicate liver disease.

3.Glucose is an integral indicator of carbohydrate metabolism and one of the diagnostic criteria for diabetes mellitus (DM). Regular fasting blood glucose measurement will help diagnose diabetes in time and prevent its complications.

4. Total cholesterol – an integral indicator of lipid metabolism and one of the criteria for the diagnosis of atherogenic dyslipidemia. Regular measurement of cholesterol levels will help diagnose lipid metabolism disorders in time and prevent cardiovascular diseases such as myocardial infarction.Currently, it is recommended to start measuring the level of total cholesterol from the age of 35 years in men and 45 years in women or earlier in the presence of several risk factors for cardiovascular diseases (for example, a history of familial hypercholesterolemia, the presence of a relative with early coronary heart disease). It should be noted that the most accurate information on lipid metabolism will be obtained when performing a lipidogram, which includes, in addition to total cholesterol, other indicators, including the main fractions of blood lipoproteins.

5. Total protein – an integral indicator of protein metabolism. Of greater importance is a decrease in total protein, which can be observed with malnutrition (anorexia, starvation), the presence of chronic infectious (tuberculosis), inflammatory (rheumatoid arthritis) and oncological diseases, as well as impaired liver function (cirrhosis of the liver), kidneys (nephrotic syndrome) and intestinal absorption function (protein-losing enteropathies).

This comprehensive analysis includes basic biochemical parameters and allows one to suspect underlying diseases.Additional laboratory tests may be required for more accurate health information.

It should be noted that the deviation of any indicator from the norm does not always indicate the presence of a disease, and the result of the analysis should be interpreted in conjunction with all available data about the patient.

The most accurate information about the patient’s health will be obtained when assessing baseline indicators over time, that is, when comparing repeated analyzes.Repeated analyzes are recommended to be performed using the same test systems, that is, in the same laboratory.

What is the research used for?

• For a comprehensive assessment of the patient’s health;
• for the timely detection of major diseases.

When is the study scheduled?

• At the annual examination of the patient;
• when a patient seeks medical help.

What do the results mean?

Reference values ​​

For each indicator included in the complex:

In the meantime, there is no need to know about it. ”
Download an example of the result

Important notes

• The results of the study are evaluated taking into account additional clinical, instrumental and laboratory data.

Also recommended

[40-039] Lipidogram

[02-011] Rehberg’s test (clearance of endogenous creatinine)

Who orders the research?

General practitioner, general practitioner.

Literature

1. Johnson CA, Levey AS, Coresh J, Levin A, Lau J, Eknoyan G. Clinical practice guidelines for chronic kidney disease in adults: Part II. Glomerular filtration rate, proteinuria, and other markers. Am Fam Physician. 2004 Sep 15; 70 (6): 1091-7.
2. McPhee S. J., Papadakis M. CURRENT Medical Diagnosis and Treatment / S. J. McPhee, M. Papadakis; 49 ed. – McGraw-Hill Medical, 2009.

diagnostic methods, biochemical parameters, interpretation of results

The liver is an organ adapted to high loads.Up to 1.5 liters of blood is pumped through it every minute. Liver diseases occur with a serious infection of the body, a stably unhealthy lifestyle, pathologies of other vital organs. Diagnosis of liver diseases is quite difficult and, as a rule, requires a large number of laboratory tests.

In the list of tests shown for suspected liver disease, in the first place is a biochemical blood test. It allows you to identify cirrhosis and hepatitis.In special cases, the doctor may prescribe immunological tests, tests for tumor markers and histological studies.

Biochemical analysis for liver diseases: indicators and norms

A blood test for biochemistry is the main laboratory test, in addition to urine and feces tests, which helps diagnose liver cirrhosis, hepatitis, metabolic disorders. Based on this study, additional tests for tumor markers may be prescribed.

Let’s consider each of the indicators determined in the course of the research.

Enzymes

A number of enzymes necessary for the normal functioning of the body are synthesized in the liver. Tests for liver enzymes can be part of a biochemical blood test or carried out separately if serious deviations from the norm (reference values) are detected. When diagnosing, it is necessary to take into account the general clinical picture, since the studied indicators may indicate pathologies of other organs – for example, the heart.

Aspartate aminotransferase (AsAt) is an enzyme involved in the exchange of amino acids.Reference values:

• young children – 36 U / l;
• girls 12-17 years old – 25 U / l;
• boys 12-17 years old – 29 U / l; 90,030 90,029 men – 37 U / l; 90,030 90,029 women – 31 U / l.

Exceeding the norm is observed with damage to liver cells (hepatocytes) or heart muscle. At high concentrations of AsAt for several days and / or a sharp increase in the number of enzymes, urgent hospitalization is required in order to identify necrotic foci, which may even be a consequence of myocardial infarction.In pregnant women, a slight excess of the norm is possible without any pathologies.

Alanine aminotransferase (AlAt) participates in the formation of glucose from proteins and fats. Normal indicators:

• newborns – 5–43 U / l; 90,030 90,029 children under 1 year old – 5–50 U / l; 90,030 90,029 children under 15 years old – 5–42 U / l; 90,030 90,029 men under 65 years old – 7-50 U / l; 90,030 90,029 women under 65 years of age – 5–44 U / l;
• elderly people after 65 years – 5–45 U / l.

The limits of the norm are quite wide, on different days the indicator can vary within 10-30%. With serious liver pathologies, the value exceeds the norm by several times.

Alkaline phosphatase (ALP) . Participates in the reactions of elimination of the remainder of phosphoric acid from its organic compounds. It is found mainly in the liver and bones. Blood norm:

• for women – up to 240 U / l;
• for men – up to 270 U / l.

An increased indicator may indicate, in addition to diseases of the skeletal system, liver cancer or tuberculosis, cirrhosis, infectious hepatitis.

Lactate dehydrogenase (LDH). Required for glycolysis reactions (release of energy through the breakdown of glucose). The rate varies depending on age:

• children of the first year of life – up to 2000 U / l;
• up to 2 years old – 430 U / l;
• from 2 to 12 years old – 295 U / l; 90,030 90,029 adolescents and adults – 250 U / l.

Exceeding the norm can be observed with damage to liver cells.

Glutamate dehydrogenase (GDH) .Participant in the exchange of amino acids. Deviations from the norm are observed with severe lesions of the liver and biliary tract, acute intoxication.

Norm:

• in the first month of life – no more than 6.6 U / l;
• 1–6 months – no more than 4.3 U / l;
• 6–12 months – no more than 3.5 U / l;
• 1-2 years – no more than 2.8 U / l;
• 2-3 ​​years – no more than 2.6 U / l;
• 3–15 years – no more than 3.2 U / l;
• boys and men – no more than 4 U / l;
• girls and women – no more than 3 U / l.

Sorbitol dehydrogenase (SDH) . A specific enzyme, the detection of which in the blood indicates acute liver damage (hepatitis of various etiologies, cirrhosis). Together with the indicators of other enzymes, it helps in the diagnosis of the disease.

Gamma Glutamyl Transferase (GGT) . Contained in the liver and pancreas, it is actively released into the bloodstream with liver pathologies and alcohol intoxication. After giving up alcohol in the absence of hepatic pathologies, the level of GGT returns to normal in a month.

Reference values:

• the first six months of life – no more than 185 U / l;
• up to 1 year – no more than 34 U / l;
• 1-3 years – no more than 18 U / l;
• 3–6 years – no more than 23 U / l;
• 6–12 years old – no more than 17 U / l; 90,030 90,029 boys under 17 years old – no more than 45 U / l; 90,030 90,029 girls under 17 years old – no more than 33 U / l; 90,030 90,029 men – 10–71 U / l; 90,030 90,029 women – 6–42 U / l.

Fructose monophosphate aldolase (FMF). Normally, it can be found in blood in trace amounts. An increase in FMFA is characteristic of acute hepatitis and occupational intoxication of workers in hazardous industries.

Any enzyme is a protein molecule that accelerates one specific biochemical reaction in the body at a certain temperature and acidity of the environment. By the totality of the analysis data for enzymes, one can judge about metabolic disorders associated with certain pathologies. An enzyme test is a very informative method for diagnosing the state of the liver.

Proteins, fats and electrolytes

In addition to the level of enzymes for the diagnosis of liver pathologies, other biochemical parameters of the blood are of great importance.

Total protein . Normally, the concentration of total protein in the blood is 66–83 g / l. The liver actively synthesizes various protein molecules, therefore, deviations from the norm can occur when the liver cells – hepatocytes – do not work properly.

Albumin . The main protein in blood plasma is synthesized in the liver.The concentration in a healthy adult is normally 65–85 g / l. A decreased level may indicate cirrhosis, hepatitis, liver tumor, or the presence of metastases in the organ.

Bilirubin . Yellow pigment, a breakdown product of hemoglobin. Total bilirubin in the blood normally ranges from 3.4–17.1 µmol / l, direct – 0–7.9 µmol / l, indirect – up to 19 µmol / l. Exceeding the norm may indicate pathological processes in the liver.

Cholesterol and its fractions .It can enter the body both with food and be synthesized by liver cells. Normal cholesterol levels, depending on age and gender, can range from 2.9-7.85 mmol / l. Deviations from the norm are observed in a number of diseases, including an increase in values ​​typical for those suffering from alcoholism and cirrhosis of the liver.

Triglycerides . Similarly, cholesterol enters the bloodstream as a result of digestive processes or is synthesized in the liver.Normal rates vary greatly depending on gender and age. The limiting values ​​are in the range of 0.34–2.71 mmol / L. Elevated triglyceride levels can occur with cirrhosis or viral hepatitis. Decreased levels may be associated with malnutrition and various extrahepatic pathologies.

Ammonia . It is formed during the breakdown of amino acids and is found in the blood when hepatic metabolism is impaired due to severe liver damage.

Norm:

• for children in the first days of life – 64–207 μmol / l;
• up to two weeks – 56–92 μmol / l;
• further up to adolescence – 21-50 μmol / L;
• in adolescents and adults – 11–32 μmol / l.

Iron . Acute hepatitis is accompanied by an increase in the level of iron in the blood, cirrhosis of the liver – by a decrease.

Normal indicators:

• in children in the first year of life – 7.16-17.9 μmol / l;
• in the period 1-14 years – 8.95-21.48 μmol / l;
• in adult women – 8.95-30.43 μmol / l;
• in adult men – 11.64-30.43 μmol / l.

Urea . Normal blood urea levels:

• in the first month of life – 1.4–4.3 mmol / l;
• up to 18 years old – 1.8–6.4 mmol / l;
• up to 60 years old – 2.1-7.1 mmol / l;
• after 60 years – 2.9-8.2 mmol / l.

Liver problems are evidenced by a reduced level of urea, this happens in cirrhosis, acute hepatic dystrophy, hepatic coma, hepatitis.

Tests for proteins, fats and electrolytes can help clarify the diagnosis in case of suspected liver disease.

Prothrombin index

Prothrombin is a protein produced in the liver and is a precursor of thrombin, which is necessary for the formation of blood clots. The prothrombin index reflects the state of the blood coagulation system and the liver itself (in relation to protein synthesis). The most modern and informative is the prothrombin index according to Quick. The reference values ​​are 78-142%. An increase in the level of prothrombin can be observed in malignant liver tumors, a decrease is noted when taking certain medications (for example, heparin), vitamin K deficiency, and also due to hereditary factors.

Liver diseases provoke a whole complex of changes in blood biochemistry, and their direction depends on the type of pathology. There are no liver pathologies that would affect only one parameter. However, some values ​​change more, others less, and when evaluating the tests, the doctor focuses on the most pronounced shifts and on the mutual proportions of individual indicators.

Immunological tests for autoimmune liver damage

Autoimmune liver damage includes autoimmune hepatitis, biliary cirrhosis, sclerosing cholangitis.Laboratory markers of these diseases are AMA (antimitochondrial antibodies), SMA (antibodies to smooth muscle), anti-LKM1 (autoantibodies to microsomes 30 ​​type 1 ) (antinuclear antibodies).

The results of the research are presented in credits. The titers of the content of AMA, PCA, SMA and anti-LKM1 in the blood should normally be less than 1:40, the ANA titer – up to 1: 160. In small amounts, these antibodies can also be present in healthy people.

An increased AMA titer is observed in viral or autoimmune hepatitis, as well as oncological diseases and infectious mononucleosis. In 70% of cases, SMA grows with autoimmune or viral hepatitis, malignant neoplasms. The concentration of LKM1 antibodies is high in autoimmune hepatitis, less often in viral hepatitis C and D. However, the result may be incorrect if the patient took phenobarbital, thienam, carbamazepine and other anticonvulsants.

Research for markers of cancer and hepatitis

Markers of liver cancer are AFP (alpha-fetoprotein), CEA (cancer embryonic antigen), ferritin .AFP is specific for primary hepatocarcinoma, its concentration in blood serum also increases in the presence of liver metastases in cancers of other organs. The CEA test allows distinguishing between these two cases; this antigen appears in the blood in increased concentrations precisely with metastatic liver damage. Increased ferritin is characteristic of liver carcinoma and liver metastases: in 76% of all patients with tumor metastases in the liver, its concentration exceeds 400 μg / l.

AFP can increase with liver cirrhosis, CEA – with hepatitis, ferritin – with damage and decay of liver cells.Therefore, for the diagnosis of liver cancer, it is necessary to correlate all three indicators.

Norms:

• AFP for men and non-pregnant women – 0.5-5.5 IU / ml. In pregnant women, AFP can fluctuate within the normal range of 0.5–250 IU / ml, gradually increasing and reaching its maximum before childbirth.
• CEA – up to 5.5 ng / ml.
• Ferritin in women – 13–150 mcg / l; in men – 30–400 mcg / l.

When receiving the results of the analysis for tumor markers, the patient should not panic, the diagnosis of liver cancer is carried out on the basis of the complete clinical picture.Histological analysis may be required.

Histological analysis of liver tissue

Until recently, histological analysis could only be performed invasively, with microscopic examination of the harvested tissues. However, there are already patented methods that provide more complete information by calculation. Although they are not inherently histological, their high information content, comparable only to histology, classifies them into this category of research.

• Conventional biopsy . The method of puncture sampling of liver tissue through the intercostal space for further research. Differs in high information content in relation to severe liver diseases. The disadvantage of this method is that a small part of the tissue is taken, which may not be affected by pathological processes. In addition, biopsy is contraindicated and cannot be performed frequently.
• FIBROTEST® .A set of computational tests, comparable to biopsy in terms of information content. Non-invasive method based on data from blood tests and anamnesis. Allows you to get an accurate quantitative and qualitative assessment of fibrosis and necroinflammatory hepatic changes at any stage, regardless of localization. The possibility of errors in the local examination of the material by biopsy is excluded.
• FIBROMAX® . Additional set of design tests for FIBROTEST®. Allows you to determine the degree of steatosis of any etymology.
  Modern medicine generally follows the trend of decreasing invasiveness, therefore FIBROTEST® and FIBROMAX® are the future in the diagnosis of hepatic pathologies.

When deciding to see a doctor with symptoms of liver pathologies, you should be aware of the full range of studies that you may be prescribed. Their number will be greatly reduced with early medical attention.

How to tell if your liver is not healthy? | Healthy life | Health

The most common sign of liver disease is pain or heaviness in the right hypochondrium.Unpleasant sensations and a feeling of constriction or overcrowding in the liver area may accompany subtle pulling pains and tingling sensations. Other symptoms may include increased fatigue, weakness, and enlargement of the gland. More alarming symptoms that should prompt you to see a doctor and get tested are bitterness in the mouth, heartburn, nausea, and vomiting.

Since most liver pathologies at first do not have obvious symptoms, doctors recommend not to wait for the deterioration of the state of health, but to determine the disease in time by passing a biochemical blood test.“The first thing to do is go to the clinic once a year and have a biochemical blood test. It will have six indicators: ALT, AST, GGT, ALP and two bilirubins. You can do an ultrasound, but most likely you will not see an existing disease, or if you have delayed the process, you will already see cirrhosis. Therefore, in the early stages of the disease, it makes no sense to do ultrasound, ”says gastroenterologist-hepatologist Sergei Vyalov .

A biochemistry test should be taken on an empty stomach, and the last meal should be eight hours before blood sampling for analysis.

What will a biochemical blood test show?

An increase in ALT will indicate the development of such serious diseases as viral hepatitis, toxic liver damage, cirrhosis of the liver, and liver cancer. Decrease in ALT levels – for necrosis or cirrhosis.

An increase in AST in the blood indicates the development of viral, toxic or alcoholic hepatitis, liver cancer, and a decrease in AST levels indicates a ruptured liver and vitamin B6 deficiency.

An increase in GGT can occur in acute viral or chronic hepatitis and toxic liver damage.

An increase in alkaline phosphatase (ALP) will indicate toxic hepatitis, necrosis, cirrhosis or liver cancer.

Elevated total bilirubin is a symptom of jaundice or hepatitis. An increase in the bound bilirubin will also indicate jaundice, which has developed due to a violation of the outflow of bile from the liver.

See also:

Hepatic profile

Photo: Shutterstock / FOTODOM

• Doctors
• Updated: June 18, 2020

Hepatic profile is a set of specific blood tests that allows you to timely diagnose diseases of the liver and gallbladder.

Hepatic profile – a set of specific blood tests, which allows you to diagnose diseases of the liver and gallbladder in a timely manner.

What are the indications for a hepatic profile?

• liver diseases;
• cholecystitis;
• jaundice.

What do the liver profile indicators mean?

1) Total protein – an indicator that reflects the total amount of proteins in the blood. A decrease in the content of total protein in plasma is observed in severe liver diseases (due to a decrease in protein synthesis by hepatic cells).

Normal values ​​for total protein: 66-83 g / l.

2) AST (AST, aspartate aminotransferase) is one of the main enzymes synthesized in the liver. Normally, the content of this enzyme in blood serum is low, since most of it is found in hepatocytes (liver cells).

Normal AST values:

90,028 90,029 women – up to 31 U / l;

90,029 men – up to 37 U / l.

3) ALT (ALT, alanine aminotransferase) – an enzyme synthesized in the liver.Most of it is found and works in liver cells, so the normal concentration of ALT in the blood is low.

Normal ALT values:

90,028 90,029 women – up to 34 U / l;

90,029 men – up to 45 U / l.

4) Total bilirubin – yellow blood pigment, which is formed as a result of the breakdown of hemoglobin, myoglobin and cytochromes.

Normal values ​​of total bilirubin: 3.4-17.1 μmol / l.

5) Direct bilirubin (conjugated bilirubin, bound) – fraction of total blood bilirubin.

Normal values ​​of direct bilirubin: 0-7.9 μmol / L.

6) Indirect bilirubin (unconjugated bilirubin, free) – the difference between the indices of total and direct bilirubin.

Normal values ​​for indirect bilirubin: <19 μmol / L.

7) Gamma-GT (gamma-glutamyltransferase) is an enzyme found mainly in the cells of the liver and pancreas.

Normal gamma-GT values:

• men <55 U / L
• women <38 U / L

8) Alkaline phosphatase – an enzyme widely distributed in human tissues.The hepatic and bone forms of alkaline phosphatase, the activity of which is determined in the blood serum, are of the greatest clinical importance.

Normal values ​​of alkaline phosphatase: 30-120 U / L.

9) Cholesterol (total cholesterol) is the main blood lipid that enters the body with food and is also synthesized by liver cells.

Normal cholesterol levels: 3.2-5.6 mmol / l.

What preparation is needed for the research?

The day before blood sampling, it is necessary to exclude the intake of alcohol, for 1 hour – smoking.It is advisable to take blood on an empty stomach in the morning. At least 12 hours should elapse between the last meal and blood collection. Juice, tea, coffee are not allowed. You can drink water. It is necessary to exclude increased psycho-emotional and physical stress.

What are the deadlines for the analysis?

1 day.

Sources

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• Stolte B., Nonnemacher M., Kizina K., Bolz S., Totzeck A., Thimm A., Wagner B., Deuschl C., Kleinschnitz C., Hagenacker T. Nusinersen treatment in adult patients with spinal muscular atrophy: a safety analysis of laboratory parameters. // J Neurol – 2021 – Vol – NNULL – p .; PMID: 33899154 ​​
• Sanyal AJ., Ling L., Beuers U., DePaoli AM., Lieu HD., Harrison SA., Hirschfield GM. Potent suppression of hydrophobic bile acids by aldafermin, an FGF19 analogue, across metabolic and cholestatic liver diseases.// JHEP Rep – 2021 – Vol3 – N3 – p.100255; PMID: 33898959
• Wang S., Shi H., Liu T., Li M., Zhou S., Qiu X., Wang Z., Hu W., Guo W., Chen X., Guo H., Shi X., Shi J., Zang Y., Cao J., Wu L. Mutation profile and its correlation with clinicopathology in Chinese hepatocellular carcinoma patients. // Hepatobiliary Surg Nutr – 2021 – Vol10 – N2 – p. 172-179; PMID: 33898558
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Increased blood ALT – CMD

ALT (glutamatpyruvate transaminase; GPT, L-alanine: 2 oxoglutarate aminotransaminase, EC 2.6.1.2.) Belongs to the enzymes of the class of transaminases that play a key role in the synthesis and catabolism of amino acids (transamination or transamination reaction) and the provision of cells with energy. ALT catalyzes the transamination reaction between alanine and a-ketoglutarate, which leads to the formation of pyruvate and glutamate.The reaction coenzyme is pyridoxine, vitamin B6.

ALT is an intracellular enzyme, its content in the blood serum of healthy people is significantly lower than in many organs and tissues, its greatest activity is detected in the liver, skeletal muscles, myocardium. An increase in ALT activity in the blood indicates damage or destruction of the enzyme-rich cells.

The most significant increase in ALT activity (exceeding the upper limit of the norm by more than 15 times) is noted with necrosis of liver cells (acute viral hepatitis, toxic hepatitis).In acute viral hepatitis, a multiple increase in the activity of ALT in the blood occurs much earlier than the development of jaundice. A slightly smaller increase in ALT activity (exceeding the upper limit of the norm by 5-10 times) is found in various liver diseases (chronic hepatitis, cholangitis, liver tumors), acute pancreatitis, burns, taking hepatotoxic drugs, acute myocardial infarction, etc.

An important indicator is the ratio of the activity of AST / ALT enzymes (de Ritis coefficient); it is advisable to calculate its values ​​only with increased activity of one or both enzymes.An increase in the coefficient of more than 1.4 is noted in cirrhosis, severe alcoholic and toxic liver damage, which is evidence of deep necrosis of hepatocytes with damage to the mitochondrial cell apparatus and the release of the mitochondrial AST fraction. In uncomplicated viral hepatitis or non-alcoholic liver damage, the coefficient is less than 1.0.

Indications for research

• Liver diseases;
• donor screening;
• examination of persons in contact with patients with viral hepatitis in the focus of infection.

Research methods. Spectrophotometric (kinetic) methods based on the recommendations of the International and National Federations of Clinical Chemistry. The addition of pyridoxal-5-phosphate to the reaction mixture provides the maximum catalytic activity of ALT. The enzyme activity depends on the temperature and the presence or absence of pyridoxal-5-phosphate in the reaction mixture.

Increased values ​​

• Acute and chronic liver diseases;
• taking hepatotoxic drugs;
• acute and chronic pancreatitis;
• acute myocardial infarction, acute myocarditis;
• trauma, skeletal muscle necrosis, myopathy, myositis;

90,029 heatstroke;

• erythrocyte hemolysis, hemolytic diseases;
• renal failure.

Reduced values ​​

• Vitamin B6 deficiency;
• obstructive jaundice;
• terminal stage of liver failure.

ALT (ALT, alanine aminotransferase)

ALT (alanine aminotransferase, ALAT) is an intracellular enzyme from the group of transferases, a subgroup of transaminases, which catalyzes the conversion of a-keto acids into amino acids by transferring amino groups. Normally, only a small part of this enzyme is lost into the blood.The enzyme is present mainly in the cytoplasm of hepatocytes, but it is also contained in the cells of skeletal muscles and myocardium. The biochemical activity of ALT in the liver is almost 10 times higher than in the myocardium and skeletal muscles, therefore, an increase in the level of ALT in the blood is considered mainly as an indicator of damage to the liver parenchyma. When liver cells are damaged, the integrity of their membrane is disrupted and ALT enters the bloodstream. ALT has a greater diagnostic sensitivity in diseases of the hepatobiliary system than AST.

If the biochemical blood test ALT (ALAT) showed an increase in ALT activity 50 times or more, then this can mainly be due to acute impairment of hepatic perfusion, acute necrosis of hepatic cells caused by exotoxins, including paracetamol and carbon tetrachloride, viral hepatitis, infectious mononucleosis. An increase in the concentration of ALT in the blood is diagnostically significant, since its level increases even before the appearance of other clinical symptoms of liver diseases (jaundice, etc.)etc.). In viral hepatitis, an increase in enzyme activity occurs at a very early time – in the prodromal period (observed in 50% of patients – 5 days, in 90% – 2 days before the clinical manifestation of the disease). High ALT and AST values ​​are also observed in toxic hepatitis, especially in severe cases. A moderate increase in transaminases is observed with alcoholic liver damage. Depending on the stage of the cirrhotic process, the levels of ALT and AST can be either at the upper limit of the norm, or in 4-5 times increase from the upper limit (the level of AST is higher than ALT).In patients with primary or metastatic liver carcinomas, an increase in the activity of transaminases by 5-10 times is observed, however, there are cases when their level remains within the normal range, mainly in the early stages of malignant organ infiltration. The level in the blood test ALT (ALAT), exceeding more than 15 times the upper limit of the norm, is always an indicator of acute hepatocellular necrosis of toxic, viral or circulatory origin.

An increase in the level in the analysis of ALT is also observed in myocardial infarction, since this enzyme is also contained in the heart muscle, however, its increase in comparison with AST is insignificant, since the activity of ALT in cardiomyocytes, in contrast to AST, is low.In uncomplicated myocardial infarction, ALT (ALAT) levels in the blood test remain within normal limits or there is a slight increase. An increase in serum ALT concentration in myocardial infarction may indicate the development of congestion in the liver.

General practitioner, surgeon, infectious disease specialist, endocrinologist, hematologist, therapist, gastroenterologist.

Biochemical blood test – to pass at the Unified Medical Center in St. Petersburg

A biochemical blood test is one of the most important methods of laboratory diagnostics, with the help of which a doctor can get a visual picture of the patient’s body condition, give recommendations, prescribe medications or draw conclusions about the effectiveness of the treatment being carried out.This analysis is carried out in the diagnosis of almost all diseases and in order to identify the absence of any diseases. In the event of any health problems and for preventive purposes, experts prescribe it in the first place. Having received the results, the specialist will be able to assess:

• Functioning of internal organs (pancreas, kidneys, liver and other organs).
• The content of trace elements in the blood.
• Metabolism (carbohydrates, lipids and proteins) in the body.

How is blood taken for biochemical analysis?

The doctor collects samples from the patient in a sitting or lying position. A strong tourniquet is placed above the elbow, and the area of ​​the future puncture is treated with special antiseptics. A needle is carefully inserted into the vein at the bend of the elbow, after which the doctor takes the required amount of blood. The obtained biological material is poured into a test tube and enters the laboratory for further examination.

To obtain a reliable result, it is recommended to give up tea, juices, alcohol, coffee and food 12 hours before the procedure, giving preference only to pure water. Eating fatty foods as well as fasting can also skew the study results. Most often it is recommended to do this analysis in the morning, like many others. At the Unified Medical Center, you can take tests during the day, always on an empty stomach. Medication, exercise and stress can all affect the results of both tests.

Biochemical blood test: norm, results

When carrying out a diagnostic procedure, doctors will be able to find out the characteristics of several parameters at once and compare them with generally accepted norms. The combination of different indicators gives the most complete picture.

Delivery of a biochemical blood test in St. Petersburg

Specialists of the Unified Medical Center offer patients to undergo blood biochemistry in adults and children. The presence of our own laboratory makes it possible to obtain ready-made results already on the day of treatment, without the need to stand in long queues and spend a lot of time waiting.