What are liver function tests and why are they performed. How do various liver enzymes indicate potential liver damage or disease. What should patients expect during the testing process and how are results interpreted.

The Importance of Liver Function Tests in Diagnosing Hepatic Health

Liver function tests play a crucial role in assessing the health and functionality of one of our body’s most vital organs. These tests measure levels of specific enzymes and proteins in the blood that can indicate liver damage or disease. By understanding what liver function tests entail and how to interpret their results, patients and healthcare providers can work together to diagnose and manage liver conditions effectively.

What exactly is a liver function test?

A liver function test is not a single test, but rather a panel of blood tests that collectively evaluate various aspects of liver health and function. These tests measure levels of enzymes, proteins, and other substances that are produced or processed by the liver. Abnormal levels can indicate liver damage, disease, or impaired function.

Common Reasons for Ordering Liver Function Tests

Healthcare providers may recommend liver function tests for various reasons, including:

• Screening for liver diseases like hepatitis
• Monitoring known liver conditions
• Evaluating unexplained symptoms that could be liver-related
• Assessing liver function before starting certain medications
• Monitoring patients with risk factors for liver disease

Individuals with certain risk factors may undergo liver function tests more frequently. These risk factors include:

• Heavy alcohol consumption or alcohol use disorder
• Family history of liver disease
• Obesity, especially when combined with diabetes or hypertension
• Use of medications known to affect liver function
• Presence of other conditions like gallbladder disease or anemia

Key Components of Liver Function Tests and Their Significance

Liver function tests typically include several specific tests, each providing unique insights into liver health:

Alanine Transaminase (ALT) Test

ALT is an enzyme primarily found in liver cells. Elevated levels in the blood can indicate liver cell damage or inflammation. Is ALT the most liver-specific enzyme? While ALT is considered highly liver-specific, other enzymes like AST are also important in assessing liver health.

Aspartate Transaminase (AST) Test

AST is another enzyme found in liver cells, but it’s also present in other tissues. High AST levels may suggest liver damage, but interpreting results requires consideration of other test values and clinical context.

Alkaline Phosphatase (ALP) Test

ALP is an enzyme found in liver, bile ducts, and bone. Elevated levels can indicate liver damage, bile duct obstruction, or bone disorders. How does ALP differ from other liver enzymes? Unlike ALT and AST, which primarily indicate liver cell damage, ALP can also point to issues with bile flow or bone metabolism.

Albumin and Total Protein Test

The liver produces albumin and other proteins. Low levels of these proteins in the blood may indicate chronic liver disease or malnutrition. Why is albumin important in liver function? Albumin plays a crucial role in maintaining blood volume and transporting various substances throughout the body.

Bilirubin Test

Bilirubin is a byproduct of red blood cell breakdown. The liver typically processes and eliminates bilirubin from the body. High levels can cause jaundice and may indicate liver dysfunction or other conditions affecting bilirubin metabolism.

Gamma-glutamyltransferase (GGT) Test

GGT is an enzyme found in liver and bile duct cells. Elevated levels can suggest liver or bile duct damage, often related to alcohol consumption or certain medications.

Prothrombin Time (PT) Test

This test measures blood clotting time, which can be affected by liver function since the liver produces clotting factors. Prolonged clotting time may indicate severe liver damage.

Preparing for Liver Function Tests: What Patients Should Know

Proper preparation is essential for accurate liver function test results. Patients should:

• Inform their healthcare provider about all medications, including over-the-counter drugs and herbal supplements
• Follow any fasting instructions provided by their doctor, which may include avoiding food for 8-12 hours before the test
• Avoid alcohol consumption for at least 24 hours before the test
• Discuss any concerns or questions with their healthcare provider prior to the test

The Liver Function Testing Process: From Blood Draw to Results

Understanding the liver function testing process can help alleviate patient anxiety and ensure smooth procedure execution.

How is a liver function test performed?

The test involves a simple blood draw, typically from a vein in the arm. A healthcare professional will:

1. Clean the skin at the injection site
2. Insert a small needle into the vein
3. Collect a blood sample in one or more vials
4. Apply pressure to the site and bandage it after removing the needle

The entire process usually takes just a few minutes. Patients may feel a brief sting or pinch when the needle is inserted, but discomfort is generally minimal.

How long does it take to get liver function test results?

Result turnaround time can vary depending on the testing facility. In clinics with on-site laboratories, results may be available within a few hours. For tests sent to external labs, it may take a few days to receive results. Urgent cases can sometimes be expedited.

Interpreting Liver Function Test Results: Understanding the Numbers

Interpreting liver function test results requires medical expertise, as normal ranges can vary between laboratories and depend on factors like age and gender. However, understanding some basic principles can help patients engage in informed discussions with their healthcare providers.

What do normal liver function test results look like?

Test results typically include:

• The specific tests performed
• The patient’s values for each test
• The laboratory’s reference range for normal values

Values falling within the reference range are generally considered normal. However, it’s important to note that “normal” can vary between individuals and laboratories.

How are abnormal results interpreted?

Abnormal results don’t necessarily indicate liver disease. Factors to consider include:

• The degree of elevation or decrease in specific markers
• Patterns of abnormalities across multiple tests
• Changes in values over time
• The patient’s overall health, symptoms, and risk factors

Healthcare providers may order additional tests or follow-up liver function tests to confirm or clarify initial findings.

Potential Risks and Considerations in Liver Function Testing

While liver function tests are generally safe and low-risk procedures, patients should be aware of potential considerations:

Are there any risks associated with liver function tests?

The risks of liver function tests are minimal and primarily related to the blood draw process. These may include:

• Slight pain or discomfort at the needle insertion site
• Bruising or soreness that typically resolves within a few days
• Very rare occurrences of infection at the injection site
• Lightheadedness or fainting in individuals sensitive to blood draws

Patients should inform their healthcare provider if they experience persistent pain, swelling, or signs of infection at the injection site.

Can medications affect liver function test results?

Yes, certain medications can influence liver function test results. It’s crucial for patients to provide a complete list of all medications, including over-the-counter drugs and supplements, to their healthcare provider. Some medications that may affect results include:

• Acetaminophen (paracetamol)
• Certain antibiotics
• Statins used to lower cholesterol
• Some herbal supplements

Healthcare providers will consider medication use when interpreting test results.

Beyond the Numbers: Comprehensive Liver Health Assessment

While liver function tests provide valuable information, they are just one component of a comprehensive liver health assessment. Healthcare providers consider multiple factors when evaluating liver health and determining the need for further investigation or treatment.

What additional factors are considered alongside liver function tests?

A thorough liver health evaluation may include:

• Patient’s medical history and risk factors
• Physical examination findings
• Symptoms reported by the patient
• Results from other relevant blood tests
• Imaging studies such as ultrasound, CT, or MRI of the liver
• In some cases, liver biopsy for definitive diagnosis

This comprehensive approach allows healthcare providers to accurately diagnose liver conditions and develop appropriate treatment plans.

Understanding liver function tests empowers patients to actively participate in their healthcare. By knowing what these tests measure, how they’re performed, and what the results might indicate, individuals can engage in more informed discussions with their healthcare providers and take proactive steps towards maintaining optimal liver health.

Liver Function Test

Written by Matthew Hoffman, MD

• What Is a Liver Function Test?
• Why Are Liver Function Tests Done?
• Types of Tests and What They Measure
• How to Prepare for a Liver Function Test
• What Happens During a Liver Function Test?
• Liver Function Test Results
• Liver Function Test Risks
• More

A liver function test is one of a group of tests that check levels of certain enzymes and other proteins in your blood.

Some of the tests look for enzymes that you’d find in your blood only when your liver is damaged or has a disease. Others check that the organ is working the way it should.

Your liver does all kinds of work that’s crucial for your health. It helps break down food, clean your blood, make proteins, and store energy. If something goes wrong with it, you might have a number of symptoms, from yellow skin to slurred speech. That’s when you might need a liver test.

You might have this test to check for a liver disease such as hepatitis (an illness in which your liver swells and can cause serious issues). General symptoms of liver problems include:

• Lack of appetite
• Nausea or vomiting
• Weakness or feeling very tired
• Yellowish eyes or skin (jaundice)
• Dark urine or light-colored poop (less common)
• Swelling in your belly (less common)

Often, however, you don’t notice any symptoms.

Your doctor may order a liver test if you’re more likely to have liver damage or disease, like if you:

• Drink heavily or have an alcohol use disorder
• Have a family member with liver disease
• Are very overweight, especially if you also have diabetes or high blood pressure
• Take medicine that can harm your liver
• Have gallbladder disease or anemia

The liver test can also help your doctor learn whether an illness is getting worse or how well treatment is working.

There are a number of liver tests, with lots of complex names. Some common ones include:

• Alanine transaminase (ALT) test. ALT is an enzyme that helps break down proteins and is found mainly in your liver. High levels in your blood could mean you have liver damage.
• Alkaline phosphatase (ALP) test. ALP is an enzyme in your liver, bile ducts, and bone. You might have high levels if you have liver damage or disease, a blocked bile duct, or bone disease.
• Albumin and total protein test. Your liver makes two main proteins: albumin and globulin. Low levels might mean damage or disease. Keep in mind that your immune system also makes globulin.
• Aspartate transaminase (AST) test. AST is another enzyme in your liver. High blood levels could be a sign of damage or disease.
• Bilirubin test. Your body makes bilirubin when it breaks down red blood cells. Usually, your liver cleans bilirubin out of your body. If you have high levels in your blood, a problem called jaundice, you may have liver damage.
• Gamma-glutamyltransferase (GGT) test. High levels of the GGT enzyme could point to liver or bile duct damage.
• Prothrombin time (PT) test. This test measures how long it takes your blood to clot. If it takes a long time, that could be a sign of liver damage. Medications that thin your blood, such as warfarin (Coumadin), can also lead to a longer PT. You probably won’t have this test until you have had other liver tests.

Make sure to tell your doctor about any medicines you’re taking, including over-the-counter medications and herbal supplements. They may tell you to stop eating the night before the test.

Your doctor uses a thin needle to take a small amount of blood, usually from your arm near your elbow. You’ll feel a pinch or stinging when the needle goes in.

If there is liver damage, you’ll probably have these tests more than once over a few days or weeks. Your doctor can look at how levels change to be sure of your condition.

If you get your test at a clinic that has a lab on-site, you can get results in a few hours. If not, it might take a few days.

The results usually show normal values for the specific test, along with your numbers. Keep in mind that what’s normal can vary with different labs. It also depends on whether you’re male or female.

If your results aren’t normal, you’ll probably get more tests.

By itself, a liver test can’t tell for sure that you have a certain illness. Your doctor can help you understand what your results mean.

Liver function tests are generally safe, with few risks. You may have some soreness or a bruise where the blood is taken. Call your doctor if it doesn’t get better after a couple of days.

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Liver Function Test

Written by Matthew Hoffman, MD

• What Is a Liver Function Test?
• Why Are Liver Function Tests Done?
• Types of Tests and What They Measure
• How to Prepare for a Liver Function Test
• What Happens During a Liver Function Test?
• Liver Function Test Results
• Liver Function Test Risks
• More

A liver function test is one of a group of tests that check levels of certain enzymes and other proteins in your blood.

Some of the tests look for enzymes that you’d find in your blood only when your liver is damaged or has a disease. Others check that the organ is working the way it should.

Your liver does all kinds of work that’s crucial for your health. It helps break down food, clean your blood, make proteins, and store energy. If something goes wrong with it, you might have a number of symptoms, from yellow skin to slurred speech. That’s when you might need a liver test.

You might have this test to check for a liver disease such as hepatitis (an illness in which your liver swells and can cause serious issues). General symptoms of liver problems include:

• Lack of appetite
• Nausea or vomiting
• Weakness or feeling very tired
• Yellowish eyes or skin (jaundice)
• Dark urine or light-colored poop (less common)
• Swelling in your belly (less common)

Often, however, you don’t notice any symptoms.

Your doctor may order a liver test if you’re more likely to have liver damage or disease, like if you:

• Drink heavily or have an alcohol use disorder
• Have a family member with liver disease
• Are very overweight, especially if you also have diabetes or high blood pressure
• Take medicine that can harm your liver
• Have gallbladder disease or anemia

The liver test can also help your doctor learn whether an illness is getting worse or how well treatment is working.

There are a number of liver tests, with lots of complex names. Some common ones include:

• Alanine transaminase (ALT) test. ALT is an enzyme that helps break down proteins and is found mainly in your liver. High levels in your blood could mean you have liver damage.
• Alkaline phosphatase (ALP) test. ALP is an enzyme in your liver, bile ducts, and bone. You might have high levels if you have liver damage or disease, a blocked bile duct, or bone disease.
• Albumin and total protein test. Your liver makes two main proteins: albumin and globulin. Low levels might mean damage or disease. Keep in mind that your immune system also makes globulin.
• Aspartate transaminase (AST) test. AST is another enzyme in your liver. High blood levels could be a sign of damage or disease.
• Bilirubin test. Your body makes bilirubin when it breaks down red blood cells. Usually, your liver cleans bilirubin out of your body. If you have high levels in your blood, a problem called jaundice, you may have liver damage.
• Gamma-glutamyltransferase (GGT) test. High levels of the GGT enzyme could point to liver or bile duct damage.
• Prothrombin time (PT) test. This test measures how long it takes your blood to clot. If it takes a long time, that could be a sign of liver damage. Medications that thin your blood, such as warfarin (Coumadin), can also lead to a longer PT. You probably won’t have this test until you have had other liver tests.

Make sure to tell your doctor about any medicines you’re taking, including over-the-counter medications and herbal supplements. They may tell you to stop eating the night before the test.

Your doctor uses a thin needle to take a small amount of blood, usually from your arm near your elbow. You’ll feel a pinch or stinging when the needle goes in.

If there is liver damage, you’ll probably have these tests more than once over a few days or weeks. Your doctor can look at how levels change to be sure of your condition.

If you get your test at a clinic that has a lab on-site, you can get results in a few hours. If not, it might take a few days.

The results usually show normal values for the specific test, along with your numbers. Keep in mind that what’s normal can vary with different labs. It also depends on whether you’re male or female.

If your results aren’t normal, you’ll probably get more tests.

By itself, a liver test can’t tell for sure that you have a certain illness. Your doctor can help you understand what your results mean.

Liver function tests are generally safe, with few risks. You may have some soreness or a bruise where the blood is taken. Call your doctor if it doesn’t get better after a couple of days.

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Liver test up to 50% off

Description of analysis

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

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

Research material
— Blood serum

includes 8 studies

• Enzyme of liver cells, increases when they are damaged

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

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

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

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

• Metabolic product of liver proteins, excreted by kidneys

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

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

Order other complexes suitable for you

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

• Current complex

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

• Another

  Biochemical blood test (advanced) – 20 studies

How to prepare

In advance

Do not take a blood test immediately after x-ray, fluorography, ultrasound, physiotherapy.

The day before

24 hours before blood sampling:

• Limit fatty and fried foods, do not take alcohol.

• Avoid strenuous exercise.

From 8 to 14 hours before donating blood, do not eat, drink only clean still water.

Delivery day

Before blood sampling

• 60 minutes without smoking,
• 15-30 minutes to be in a calm state.

Result

• Electronic result

  At the post office and in your personal account when ready

  View example

• Expert interpretation of results

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

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

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

• Doctor’s consultation

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

  See example

Liver function, complex of analyzes (liver tests)

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

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

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

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

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

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

Complete laboratory examination of the liver

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

Synonyms Russian

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

English synonyms

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

What biomaterial can be used for research?

Venous blood.

How to properly prepare for an examination?

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

General information about the study

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

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

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

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

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

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

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

• Bilirubin is a pigment formed during the breakdown of hemoglobin and some other heme-containing proteins in the liver, spleen and bone marrow. It exhibits toxicity to the nervous system and must be eliminated from the body in the bile or urine. Excretion of bilirubin is a multi-step process in which the liver plays a major role. There are two main fractions of bilirubin: direct and indirect. When bilirubin binds to glucuronic acid, conjugated bilirubin is formed in the liver. Since this type of bilirubin can be determined directly with a direct laboratory test, it is also called direct bilirubin. Bilirubin that has not undergone conjugation with glucuronic acid is called unbound. In laboratory conditions, it is not possible to investigate the level of unbound bilirubin: its concentration is calculated based on the concentrations of total and bound bilirubin. For this reason, this type of bilirubin is also called indirect. Total bilirubin consists of both fractions. An increase in the level of bilirubin can be observed in many liver diseases, but the greatest value of this marker lies in the differential diagnosis of jaundice. Hemolytic (prehepatic) jaundice is characterized by an increase in total and indirect bilirubin. For hepatic jaundice, an increase in both fractions (direct and indirect bilirubin) and total bilirubin is typical. Obstructive (subhepatic) jaundice is characterized by an increase in total and direct bilirubin.

• Alkaline phosphatase, ALP, is an enzyme found in the membrane of the biliary pole of hepatocytes, as well as in bone tissue and intestinal cells. The concentration of total alkaline phosphatase is increased in almost 100% of cases of extrahepatic obstruction of the biliary tract. As a rule, complete obstruction is accompanied by a significant increase in total alkaline phosphatase (more than 3-5 times). With intrahepatic obstruction, the level of total alkaline phosphatase also increases, but not so sharply (less than 3 times). It should be noted that an increase in total alkaline phosphatase can also be observed in other diseases, such as bone diseases, myocardial infarction and sarcoidosis. Therefore, in order to confirm that liver disease is the cause of the increase in the level of total alkaline phosphatase, it is advisable to conduct an additional study – an analysis for gamma-HT.

• Gamma-glutamyl transpeptidase, gamma-GT is also a membrane-bound liver enzyme that catalyzes the transfer of the gamma-glutamyl group of glutathione to other molecules. Gamma-HT is currently the most sensitive marker of liver disease. An increase in gamma-HT levels is the earliest sign of liver damage. An increase in the concentration of gamma-HT can be observed in all liver diseases, but the greatest value of this marker is in the diagnosis of biliary tract obstruction. With obstruction of the biliary tract, the concentration of gamma-HT increases by 5-30 times. The study of the level of gamma-HT allows you to make sure that the increase in total alkaline phosphatase is caused precisely by liver disease, and not by other causes, primarily diseases of the skeletal system. As a rule, with obstruction of the biliary tract, there is a parallel increase in the level of gamma-HT and total alkaline phosphatase. High levels of gamma-HT are characteristic of liver metastases and alcoholic cirrhosis. In viral hepatitis, there is a moderate increase in the level of gamma-HT (2-5 times). It should be noted that an increase in total ALP and gamma-HT is also observed in obstruction of the biliary tract caused by diseases of the pancreas (cancer of the pancreatic head).

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

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

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

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

What is research used for?

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

When is the test scheduled?

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

What do the results mean?

Reference values ​​

For each indicator included in the complex:

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

Important notes

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

Also recommended

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

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

[42-028] Efficacy of treatment with PEG- interferon and Ribavirin

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

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

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

[13-069] Extended serology of autoimmune liver diseases

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

Who appoints a study?

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

Literature

1. McPhee S.