What are liver function tests. How do they measure liver health. What do abnormal results indicate. When should you get a liver function test. How to prepare for liver function tests. What are common liver diseases and their symptoms.

Understanding Liver Function Tests: A Comprehensive Guide

Liver function tests, also known as liver chemistries, are crucial blood tests that provide valuable insights into the health and functionality of your liver. These tests measure various proteins, enzymes, and substances in your blood, offering a comprehensive overview of liver performance. By understanding these tests and their results, you can take proactive steps towards maintaining optimal liver health.

What Are Liver Function Tests?

Liver function tests are a panel of blood tests that evaluate different aspects of liver health. They measure levels of specific enzymes, proteins, and other substances that are produced or processed by the liver. These tests can detect liver damage, assess liver function, and monitor the progression or treatment of existing liver conditions.

The Purpose and Importance of Liver Function Tests

Liver function tests serve multiple purposes in healthcare. They are essential for:

• Screening for liver diseases such as hepatitis
• Monitoring potential side effects of medications
• Assessing the severity of existing liver conditions
• Evaluating overall liver health
• Detecting early signs of liver damage

These tests are particularly important because liver problems can often develop without noticeable symptoms in their early stages. Regular liver function tests can help detect issues before they become more serious.

When Are Liver Function Tests Recommended?

Your healthcare provider may recommend liver function tests in various scenarios:

1. To check for liver damage from infections like hepatitis B or C
2. To monitor the effects of certain medications on liver health
3. To track the progression of existing liver diseases
4. If you’re experiencing symptoms of liver disorders
5. If you have a family history of liver disease
6. If you have certain medical conditions like diabetes or high blood pressure
7. If you consume alcohol frequently
8. If you have gallbladder disease

Common Liver Function Tests and Their Significance

Several tests are typically included in a liver function panel. Each test provides specific information about different aspects of liver health. Understanding these tests can help you better interpret your results.

Alanine Transaminase (ALT) Test

The ALT test measures the level of an enzyme involved in protein metabolism. Elevated ALT levels in the blood can indicate liver damage. Did you know that approximately 10% of people in the United States have elevated ALT levels? This highlights the importance of regular liver function testing, especially for those at risk of liver disease.

Aspartate Aminotransferase (AST) Test

AST is an enzyme found in various body parts, including the liver, heart, and muscles. While not as specific to liver function as ALT, elevated AST levels can suggest liver problems, especially when measured in conjunction with ALT. The ratio of AST to ALT can provide additional insights, with a high AST:ALT ratio potentially indicating alcoholic liver disease.

Alkaline Phosphatase (ALP) Test

ALP is an enzyme present in the liver, bile ducts, and bones. An ALP test is often used to evaluate the bile duct system of the liver. Elevated ALP levels may indicate issues with bile flow or liver damage.

Albumin Test

Albumin is the main protein produced by the liver. It plays crucial roles in tissue nourishment and the transport of hormones and vitamins throughout the body. An albumin test assesses how well the liver is producing this essential protein. Low albumin levels may suggest impaired liver function or other health issues.

Bilirubin Test

Bilirubin is a waste product from the breakdown of red blood cells. The liver processes bilirubin before it’s excreted in stool. High bilirubin levels in the blood can indicate liver damage or certain inherited conditions that affect bilirubin processing.

Interpreting Liver Function Test Results

Interpreting liver function test results requires understanding the typical ranges for each test and what deviations from these ranges might indicate. It’s important to note that “normal” ranges can vary slightly between laboratories and based on factors such as age and sex.

Here’s a general guide to interpreting liver function test results:

• ALT: Elevated levels may indicate liver damage
• AST: High levels, especially in combination with high ALT, suggest liver problems
• ALP: Elevated levels may point to bile duct issues or liver damage
• Albumin: Low levels can indicate impaired liver function
• Bilirubin: High levels may suggest liver damage or certain genetic conditions

Is it possible to have abnormal test results without liver disease? Yes, certain medications, intense exercise, and other factors can temporarily affect liver function test results. This is why it’s crucial to discuss your results with your healthcare provider, who can interpret them in the context of your overall health and medical history.

Preparing for Liver Function Tests

Proper preparation is key to ensuring accurate liver function test results. While specific instructions may vary depending on the tests being performed, here are some general guidelines:

• Fasting: Some tests may require you to fast for 8-12 hours before the blood draw
• Medication: Inform your doctor about all medications you’re taking, as some may affect test results
• Alcohol: Avoid alcohol consumption for at least 24 hours before the test
• Exercise: Avoid strenuous exercise for 24 hours before the test, as it can temporarily elevate some enzyme levels

Always follow your healthcare provider’s specific instructions for test preparation. Can you eat or drink anything before a liver function test? In most cases, water is allowed and even encouraged to stay hydrated, but it’s best to confirm this with your doctor.

Recognizing Liver Disease Symptoms

While liver function tests are crucial for detecting liver problems, it’s also important to be aware of potential symptoms of liver disease. Early recognition of these symptoms can lead to prompt diagnosis and treatment.

Common symptoms of liver disorders include:

• Fatigue and weakness
• Unexplained weight loss
• Jaundice (yellowing of skin and eyes)
• Abdominal pain or swelling
• Nausea or loss of appetite
• Dark urine or pale stools
• Itchy skin

If you experience any of these symptoms, especially in combination, it’s important to consult your healthcare provider. They may recommend liver function tests to investigate the cause of your symptoms.

Lifestyle Factors Affecting Liver Health

Your lifestyle choices can significantly impact your liver health. By understanding these factors, you can make informed decisions to protect and support your liver function.

Diet and Nutrition

A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support liver health. Certain foods are particularly beneficial for the liver:

• Leafy greens like spinach and kale
• Cruciferous vegetables such as broccoli and Brussels sprouts
• Berries and other antioxidant-rich fruits
• Nuts and seeds, particularly walnuts and flaxseeds
• Fatty fish high in omega-3 fatty acids

Conversely, excessive consumption of processed foods, saturated fats, and added sugars can contribute to liver problems like fatty liver disease.

Alcohol Consumption

Alcohol can have a significant impact on liver health. Excessive alcohol consumption is a leading cause of liver disease. But how much alcohol is too much? The general guideline is to limit alcohol intake to no more than one drink per day for women and two drinks per day for men. However, for optimal liver health, consider reducing alcohol consumption further or abstaining entirely.

Exercise and Physical Activity

Regular physical activity can help maintain a healthy weight and reduce the risk of fatty liver disease. Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. This can include activities like brisk walking, swimming, cycling, or strength training.

Medication and Supplement Use

Some medications and supplements can affect liver function. Always follow prescribed dosages and inform your healthcare provider about all medications and supplements you’re taking. Be particularly cautious with acetaminophen, as excessive use can lead to liver damage.

The Role of Liver Function Tests in Preventive Healthcare

Liver function tests play a crucial role in preventive healthcare by enabling early detection of liver problems. Regular testing can help identify issues before they progress to more serious conditions.

Frequency of Testing

How often should you get liver function tests? The frequency of liver function testing depends on various factors, including your age, overall health, and risk factors for liver disease. Generally:

• Adults with no known risk factors may have liver function tests as part of routine check-ups every few years
• Those with risk factors or existing liver conditions may need more frequent testing, possibly every 6-12 months
• Individuals taking medications that can affect the liver may require regular monitoring as advised by their healthcare provider

Always follow your healthcare provider’s recommendations for the frequency of liver function tests based on your individual health profile.

Integrating Liver Health into Overall Wellness

Maintaining liver health is an essential component of overall wellness. By incorporating liver-friendly habits into your daily routine and staying vigilant about potential liver issues, you can support your liver’s vital functions and overall health.

Consider these strategies for integrating liver health into your wellness routine:

• Stay hydrated by drinking plenty of water throughout the day
• Incorporate liver-supporting foods into your diet
• Limit alcohol consumption and avoid tobacco use
• Maintain a healthy weight through balanced nutrition and regular exercise
• Practice safe behaviors to prevent viral hepatitis, such as getting vaccinated and using protection during sexual activity
• Manage stress through relaxation techniques like meditation or yoga
• Get adequate sleep to support your body’s natural detoxification processes

By prioritizing liver health and understanding the importance of liver function tests, you can take proactive steps towards maintaining overall health and preventing liver-related complications. Regular check-ups, including liver function tests when appropriate, can provide valuable insights into your liver health and help you make informed decisions about your lifestyle and healthcare.

Advanced Liver Function Tests and Emerging Technologies

While the standard liver function tests provide valuable information, advancements in medical technology have led to the development of more sophisticated tests for assessing liver health. These advanced tests can offer more detailed insights into liver function and disease progression.

Fibroscan (Transient Elastography)

Fibroscan is a non-invasive imaging test that measures liver stiffness, which can indicate the presence and extent of liver fibrosis or cirrhosis. How does Fibroscan work? It uses ultrasound technology to send a mechanical pulse through the liver, measuring the speed at which the pulse travels. Stiffer liver tissue indicates more advanced liver disease.

Magnetic Resonance Elastography (MRE)

MRE is another non-invasive imaging technique that combines magnetic resonance imaging (MRI) with sound waves to create a visual map of liver stiffness. This test can be particularly useful in detecting early stages of liver fibrosis and monitoring disease progression over time.

Liquid Biopsy

Liquid biopsy is an emerging technology that analyzes blood samples for circulating tumor DNA, cell-free DNA, and other biomarkers. While primarily used in cancer diagnostics, this technology shows promise for liver disease detection and monitoring. Can liquid biopsy replace traditional liver biopsies? While it may not entirely replace liver biopsies yet, it offers a less invasive alternative for monitoring liver health and disease progression in some cases.

Metabolomics and Proteomics

These cutting-edge approaches involve analyzing the metabolites and proteins in blood or urine samples to gain a comprehensive understanding of liver function and metabolism. These techniques can potentially detect liver disease at earlier stages and provide more personalized treatment approaches.

As research in liver health continues to advance, these and other emerging technologies may become more widely available, offering even more precise and comprehensive assessments of liver function. However, it’s important to note that many of these advanced tests are still being studied and may not be routinely available or necessary for all patients. Your healthcare provider can guide you on which tests are most appropriate for your specific situation.

Understanding liver function tests and staying informed about advancements in liver health assessment can empower you to take an active role in maintaining your liver health. Regular check-ups, a healthy lifestyle, and open communication with your healthcare provider are key to ensuring optimal liver function and overall well-being. Remember, your liver plays a crucial role in your body’s health, and taking care of it is an investment in your long-term health and quality of life.

Liver Function Tests: Purpose, Procedure, and Results

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

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

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

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

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

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

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

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

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

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

Common liver function tests include:

Alanine transaminase (ALT) test

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

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

Aspartate aminotransferase (AST) test

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

• heart
• brain
• pancreas
• liver
• muscles

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

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

Alkaline phosphatase (ALP) test

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

Albumin test

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

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

Bilirubin test

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

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

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

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

Symptoms of a liver disorder include:

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

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

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

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

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

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

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

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

Potential risks of a liver function test

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

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

Was this helpful?

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

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

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

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

Other diagnostic tests

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

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

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

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

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

Liver Function Tests: Purpose, Procedure, and Results

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

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

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

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

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

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

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

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

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

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

Common liver function tests include:

Alanine transaminase (ALT) test

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

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

Aspartate aminotransferase (AST) test

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

• heart
• brain
• pancreas
• liver
• muscles

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

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

Alkaline phosphatase (ALP) test

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

Albumin test

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

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

Bilirubin test

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

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

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

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

Symptoms of a liver disorder include:

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

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

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

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

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

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

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

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

Potential risks of a liver function test

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

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

Was this helpful?

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

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

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

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

Other diagnostic tests

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

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

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

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

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

Blood tests to check the liver / Gastrohepatocenter EXPERT

Many patients are interested in: how to check the liver and what tests to take before consulting a hepatologist?

If you do not know where to start the examination, then the doctors of the GastroHepatoCenter EXPERT recommend that you contact a hepatologist for a free conversation, who will prescribe a list of indicators that is suitable for your case. This will help you save your resources:

• time – you pass all the necessary indicators in 1 visit to the clinic
• money – you will not hand over what is not needed at the moment.

However, for those who are being screened for prevention or suspected of having liver disease, we have prepared a list of essential blood tests that may be helpful for your doctor to see.

Indications

Comprehensive laboratory analysis of the liver condition is required:

• for symptoms : yellowness of the skin and sclera of the eyes, bitterness in the mouth, nausea, heaviness in the right hypochondrium, chronic fatigue
• with risk factors : overweight or sudden weight loss, sedentary lifestyle, regular consumption of alcohol and heavy meals (suspicion of fatty liver disease)
• if possible infection with viral hepatitis B, C, D is suspected 0013 with heredity factor and suspected genetic disorder of iron and copper metabolism
• with suspected autoimmune diseases – this also applies to other organs (thyroid gland, hematopoietic system, etc.)
• for preventive examination .

Prevention of liver diseases is of particular importance, because it has no nerve endings and does not hurt. Therefore, diseases of this organ occur without obvious symptoms.

Basic blood tests for the liver

Among the tests to check liver function, biochemical and virological indicators are key:

1. Liver enzymes – AST, ALT analysis . These enzymes are released from liver cells (hepatocytes) when they are damaged. Depending on the activity of the course of the disease, they can even exceed the norm by 50 times.
2. GGTP enzymes, alkaline phosphatase . The activity of these enzymes increases in violation of the outflow of bile and congestion (cholestasis). GGTP is also sensitive to alcohol consumption.
3. Bilirubin total, direct, indirect . Bilirubin is an intermediate product of hemoglobin processing. One of the stages of hemoglobin metabolism occurs in the liver. If the metabolic process is disturbed due to damage to hepatocytes, excess bilirubin is released into the blood. It is he who gives the icteric color to the skin, mucous membranes and sclera of the eyes.
4. Screening for viral hepatitis . Unfortunately, many people do not know that they are infected with viral hepatitis or know, but cannot even guess how the infection occurred. Therefore, an analysis for antibodies to hepatitis C and B is carried out for all patients who seek help from a hepatologist. With a positive analysis, further virological examination is carried out.
5. CBC . This is a mandatory analysis for all diseases, showing the state of the body as a whole and the presence of an inflammatory or other pathological process.

In addition, the doctor may prescribe an assessment of the level of copper and iron in the blood with genetic studies (if Wilson-Konovalov’s disease and hemochromatosis are suspected), pancreatic amylase and glucose to assess pancreatic function, screening for autoimmune disorders and others.

The cost of tests for liver diseases

Biochemistry of the liver and blood for hepatitis, the prices for which are listed below, are given strictly on an empty stomach 10-12 hours after the last meal.

In case of any liver disease, the examination should be supplemented by liver ultrasound with elastography. This will give the doctor information about the anatomical features of the organ, its size, location, stage of fibrosis / cirrhosis, and the state of the biliary tract.

To clarify the activity of the course of the disease, the doctor may prescribe fibrotest / fibromax. This is one of the most informative tests for the liver, giving additional information about the stage of fibrosis and steatosis.

Consult a hepatologist with the results of the examination.

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Detailed 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.
• Exclude physical and emotional overexertion within 30 minutes prior to the study.
• Do not smoke for 30 minutes prior to examination.

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 external pathways of blood coagulation (fibrinogen, prothrombin, factor V, VII and X). The liver is the main source of synthesis of these factors, and diseases of this organ can be accompanied by a violation of the coagulation mechanism and lead to increased bleeding. Clinically significant disorders of blood coagulation are observed in the late stages of liver disease.
• Cholesterol can be synthesized in almost any cell of the body, however, most of it (up to 25%) is synthesized in the liver, from where this compound enters the systemic circulation as part of very low density lipoproteins (VLDL) or into the gastrointestinal tract as part of bile acids. Hypercholesterolemia is a characteristic feature of hepatic cholestasis observed in cholelithiasis, primary sclerosing cholangitis, viral hepatitis, primary biliary cirrhosis, and some other diseases. Hypocholesterolemia has less clinical significance. Different fractions of cholesterol are associated with different effects on human health. Thus, low-density lipoprotein cholesterol (LDL-C) is a well-known risk factor for heart disease, while HDL-C is considered one of the protective factors.

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

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

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

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

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

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

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

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

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

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

What is research used for?

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

When is the test ordered?

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

What do the results mean?

Reference values ​​

For each indicator included in the complex:

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

Important Notes

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

Also recommended

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

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

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

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

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

[13-068] Antibodies to antigens of autoimmune liver diseases 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 prescribes the study?

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

Literature

1. McPhee S.J., Papadakis M. CURRENT Medical Diagnosis and Treatment / S. J. McPhee, M. Papadakis; 49 ed.