What does increased blood alt mean? ALT and AST in the blood: liver tests for liver enzymes

When cells are destroyed as a result of damage to any organ, ALT enters the blood, representing an important diagnostic indicator.

What is alanine aminotransferase needed for and where is it found?

Alanine aminotransferase plays an important role in the body, participating in the metabolism of amino acids, in particular the essential amino acid alanine. It, in turn, plays a role in providing energy to the central nervous system, strengthening the immune system, regulating metabolism and producing lymphocytes.

Where is ALT found:

ALT analysis, rules and standards

The ALT indicator is included in the biochemical blood test along with other transaminases. The test must be taken on an empty stomach, in the morning. Eliminate alcohol for a week. At least eight hours must pass after dinner. All this is important to obtain reliable data. Taking some medications affects the ALT level, which is why when taking oral contraceptives, aspirin, paracetamol, warfarin, be sure to tell your doctor about this.

A blood test is taken from a vein

Reasons for increased ALT

An increase in ALT in the blood occurs as a result of cell destruction. What diseases lead to this?

Hepatitis is an acute or chronic inflammatory process in the liver of an infectious or nutritional-toxic nature. Viral hepatitis develops when infected with hepatitis viruses (A, B, C, D, E and F). Moreover, the disease can be asymptomatic for a long time. For example, viral hepatitis C is therefore called the “gentle killer”, since for a long time, damaging liver cells, it does not show itself in any way. Cirrhosis eventually develops. Alimentary-toxic hepatitis develops under the influence of substances that destroy liver cells. In particular, it is caused by long-term alcohol consumption.

This is the effect of large doses of alcohol on the liver

Liver cirrhosis is the outcome of all liver lesions, when destroyed cells are replaced by connective tissue, and it can no longer perform its functions. All this leads to liver failure and severe complications.

It is worth noting that, in addition to ALT, acute hepatitis is accompanied by an increase in other transaminases (AST, GGTP), and the level of bilirubin also increases.

Pancreatitis is damage to the pancreas with necrosis of its tissue. The reasons for the development are abuse of fatty foods and alcohol or stones in the bile ducts. Patients with chronic pancreatitis need to check this indicator throughout their lives to prevent exacerbation.

The predominant increase in ALT over AST will be with liver damage, and if vice versa - with heart damage.

Myocarditis is an inflammatory heart disease characterized by damage to the heart muscle. In this situation, the blood test is also characterized by increased concentrations of ALT and AST.

Burns, frostbite, multiple organ failure, extensive trauma - all these conditions are accompanied by a significant increase in ALT.

Also, oncological processes in the above-mentioned organs are the reasons when ALT is elevated.

When ALT is low

Reduced ALT levels are possible with a deficiency of folic acid and certain vitamins. In liver cirrhosis, a decrease in ALT is a poor prognostic sign, indicating a complete absence of remaining healthy cells.

Pregnancy

During pregnancy, in the first trimester, a slight increase in ALT is possible. There is nothing scary about this, it is physiological and related to the pregnancy itself. If ALT increases significantly and characteristic symptoms appear, you should urgently consult a doctor for examination.

Symptoms

Symptoms of increased alanine transaminase in the blood are varied. The clinical picture is determined by the affected organ and the disease that led to it.

From the liver

A characteristic symptom of liver cirrhosis is “head of the jellyfish”, a combination of ascites and varicose veins of the abdominal wall

If the liver is damaged, pain in the right hypochondrium, nausea, and vomiting are possible. Yellowness of the skin and icterus of the sclera are possible. With a viral etiology, there may be hyperthermia. When cirrhosis has developed, rashes like spider veins appear on the body, and an enlarged abdomen due to ascites (accumulation of fluid in the abdominal cavity).

Varicose veins (esophagus, stomach), which can be complicated by bleeding. Multiple organ failure gradually develops.

From the pancreas

Pancreatitis is manifested by severe pain in the abdomen, in the navel, swelling, repeated vomiting, weakness, and subsequent clouding of consciousness.

From the side of the heart

The main symptom of myocardial infarction is severe, burning pain behind the sternum, which can spread to the left arm, jaw, and under the shoulder blade.

A painless form of heart attack is possible, or an atypical one, when the pain is localized in the abdomen, or severe shortness of breath develops. In addition to pain, heart rhythm disturbances and a drop in blood pressure are possible. Concerned about severe weakness, fear of death, chills.

If there is an oncological process in the affected organ, severe weight loss in a short period of time, weakness, and increased fatigue are possible.

Diagnostics

Diagnosis of the disease and the causes of increased ALT is carried out by doctors using all available research methods. In many cases, on an emergency basis, since among them there are life-threatening diseases that lead to disability.

A correctly interpreted biochemical blood test can lead to the right diagnostic path. Thus, there is the concept of the de Retis index, which is the ratio of increased AST and ALT. Its norm is 0.91-1.75.

If it exceeds two, then the reason is in the heart muscle. If it is less than one, then the liver is affected.

In the hospital, a full examination is carried out, which also includes MRI or X-ray CT, extensive blood and urine tests. Invasive methods are also used, such as puncture biopsy and angiography of cardiac vessels. All this allows you to quickly make a correct diagnosis and begin treatment.

Treatment

In order to reduce ALT levels, it is necessary to cure the disease that led to this, after which the ALT level will return on its own.

An approximate set of products for patients with liver and pancreas diseases

Severe diseases such as pancreatic necrosis, extensive myocardial infarction, severe hepatitis complicated by multiple organ failure are treated in the intensive care unit.

The treatment of each disease is specific and there is no point in describing it. A few words can be advised to people taking medications that affect the liver, as well as abusing alcohol. In such cases, it would be useful to periodically take a course of hepatoprotectors (Carsil, Essentiale) and at least somehow protect the liver cells from damage, thereby lowering ALT.

For many diseases, such as pancreatitis, hepatitis, diet is very important. Reduce consumption or completely eliminate everything fatty, spicy, smoked, salty and alcohol. To prevent exacerbations, a healthy lifestyle should become your goal in itself!

Hello! Can two out of three hepatitis vaccinations test positive for hepatitis B? ALT-23, AST-50. Thanks for the answer.

My alt is 180, what does this mean?

And I have AST 1566 and ALT 1555. Viral hepatitis has been ruled out, I don’t drink alcohol, I play sports, I lead a healthy lifestyle, there are no gallstones.

Good afternoon I have ALT 134, what does this mean and what tests need to be done? AST is normal

Good afternoon I have Ast-63.71 Alt-82.57, ultrasound of the abdominal cavity is normal, MRI is normal, pain in the right hypochondrium, doctors cannot diagnose anything, what examinations need to be done!? Thanks for the answer!

I have AST 38.4, Alt-46.9, vaccinated against hepatitis B in 2011. I don't drink, I don't smoke, I play sports. What is this?

Good afternoon, I have A-ALT-42 U/L, A-AST-32U/L, what could this be? What examination do I need to do?

Good afternoon, according to my blood biochemistry tests: A-ALT- 42 U/L, A-AST- 32 U/L, what could this mean? Tell me what kind of examination I need to do?

I have AST-39.9, ALT-59.7, total bilirubin 12.4. What could this be, how should I get examined? Please answer.

Good afternoon My ALT is 45.8; AST-34.8; Bilirubin - 9.8. I lead a healthy lifestyle, but I take the statin ROZISTARK (rosuvastatin), 0.5 ml every day. Due to this, my total cholesterol is 4.92 (when I don’t use this drug, my cholesterol rises to 7). What should I do, please advise. The ultrasound did not find anything special in the liver. Maybe you need to buy a statin, for example. in Switzerland (there is such a possibility), maybe there is a “cleaner” drug there? Without statins, cholesterol will rise again, especially since there has already been a mini-stroke.

alt-46.6, ast-28.1. What could it be?

This slight increase most likely overloaded the liver, watch your diet, and do the test again after 2 weeks.

On the 2nd day after surgery to remove the gallbladder, they took a blood test, ALT and AST were more than 150, bilirubin was 0.03 higher (the drainage had not yet been removed because there was some fluid, ultrasound showed). At the hospital they said that the tests were almost normal, and the gastroenterologist said that I practically had hepatitis (before the operation the tests were normal), all organs were not inflamed. Is the doctor right? What could this be from?

Good afternoon. I have Alat 50 and Asat 24.2, cholesterol 7.95 and triglycerides 3.79. Cholesterol is clear, but what do the other indicators tell us? Thank you.

Elevated ALT levels in the blood - the main causes

ALT – alanine aminotransferase. It is a specific enzyme involved in the production and breakdown of proteins. It is synthesized by cells of various organs: liver, spleen, kidneys, lungs, heart muscles. Normally, a small amount enters the blood. Blood ALT testing is a common diagnostic test.

Diagnosis based on ALT analysis

The level of alanine aminotransferase is detected as part of a general biochemical blood test. Complaints for which a blood test for ALT is prescribed are:

• Increased fatigue;
• Decreased appetite;
• The appearance of weakness in the body;
• Pain on the right side of the abdomen;
• Change in urine color;
• Yellowness of the skin;
• Pain in the heart area;
• Urge to feel sick.

Possible diseases with elevated ALT levels

It is mandatory to detect aminotransferase levels in patients suffering from obesity, diabetes mellitus, and liver disease.

Important! Blood donation is carried out in the morning on an empty stomach. It is not recommended to drink alcohol or fatty foods the day before the test.

You should also refrain from taking strong medications. The results of the study may be affected by a person’s psycho-emotional state and physical stress.

Exceeding the normal threshold

In medical research, the upper limit of normal ALT is important. The limit for adult men is 45 units/l, for women 34 units/l. An increase in ALT in a blood test indicates an inflammatory process in the body. Below are the diseases that cause this pathology.

1. Pancreatitis. Severe damage to the pancreas. Occurs due to the appearance of a tumor blocking the enzyme ducts. As a result, the accumulated digestive enzymes begin to digest the pancreas itself. Possible death;
2. Hepatitis. Liver disease. Characterized by inflammation of organ tissue. It is divided into several types. Hepatitis C is considered the most dangerous. The latter often becomes chronic and can cause cirrhosis of the liver. Common causes of hepatitis are: toxic damage to liver cells (for example, alcohol), viral infection;
3. Myocardial infarction. The most severe heart disease. It is characterized by the death of some parts of the heart muscle due to a critical decrease in blood circulation. The pathology has many causes. The main ones: smoking, hypertension, obesity, diabetes, sedentary lifestyle.

There are reasons for exceeding the ALT norm in a blood test that are not related to the diseases listed:

• Chemotherapy;
• Injuries accompanied by damage to the muscles of the body;
• Taking potent drugs;
• Physical and emotional stress;
• Eating fatty fried foods
• Taking drugs.

Important! The main recommendations aimed at reducing the likelihood of the occurrence of these diseases will be: proper nutrition, avoidance of drug use (including alcohol, nicotine), moderate physical activity, and reduction of stressful situations in life.

De Rittis coefficient

One of the most important research methods is considered to be a comparison of the ALT level with the level of AST - aspartate aminotransferase. The latter is also an endogenous enzyme involved in the synthesis of amino acids. Aminotransferases have similar threshold levels in the blood. The diagnosis of a particular pathology depends on the balance of ALT and AST. The AST/ALT ratio is characterized by the de Rittis coefficient.

Important! The normal value of the de Rittis coefficient is 1.33-1.75 units/l.

A decrease in the norm below 1 unit/l will mean viral liver damage. An increase in the coefficient to 2 U/L or higher, subject to an increased albumin content, indicates myocardial infarction.

Normal ALT/AST levels in the body:

• Alalnine aminotransferase: men – up to 45 units/l, women – up to 34 units/l;
• Aspartate aminotransferase: men – up to 41 units/l, women – up to 31 units/l.

Independent interpretation of analyzes

Often, patients, having read enough medical information, try to independently decipher a blood test for ALT levels. Having received the results in the laboratory, some people, seeing a deviation of the indicators from normal values, independently diagnose themselves with serious diseases.

Doctors know that exceeding ALT threshold values ​​is not always a sign of pathology. Results from different laboratories may vary. It depends on the equipment, on the research methods, on the materials used in the analysis. Also, other factors can influence the results, be it the patient’s poor lifestyle, taking medications, emotional state, and others.

Only a doctor can correctly decipher the research results. He also prescribes medication.

To date, doctors do not use ALT analysis as a means of accurate diagnosis. An excess of ALT in a blood test only indicates the possibility of a disease. To make a final diagnosis, additional studies are used and specialized specialists are involved: urologists, cardiologists and others.

Normalization of ALT levels with folk remedies

After the examination, the patient with high ALT levels is prescribed medications. But for prevention, the doctor may recommend herbal medicine. Below are examples of using folk remedies to reduce alanine aminotransferase levels.

• Milk thistle decoction. To prepare, pour a teaspoon of chopped herbs into a glass of boiling water, wrap it and let it brew for 20 minutes. Then filter the infusion. Take the decoction in small sips, half an hour before meals, twice a day, for three weeks;
• Herbal collection. Immortelle, St. John's wort and celandine are mixed. The proportion of herbs is accordingly. The collection is poured with 1 liter of hot water, wrapped and infused for 12 hours. Then you need to strain the infusion. Take half a glass 4 times a day for two weeks;
• Dandelion infusion. To prepare, take 200 grams of crushed dandelion flowers. Pour in 100 ml of vodka. The product is infused for 24 hours. Take 2 tablespoons three times a day for three weeks;
• Decoction of corn silk. To prepare the product, take dried crushed stigmas. Pour 200 ml of boiling water and leave for a minute. Take the infusion twice a day, a glass. The course of treatment can be six months.

Important! Folk remedies are not a cure! They are used to prevent diseases and generally strengthen the body.

The level of development of modern medicine allows us to accurately diagnose most known diseases. One of the generally accepted research methods is a biochemical blood test. It contains many indicators, one of which is the level of alanine aminotransferase.

Exceeding the normal level of ALT indicates the possibility of developing serious diseases in the body. But only a doctor can accurately determine the disease. We strongly recommend not to engage in self-diagnosis, much less self-medication. If alarming symptoms appear, contact the clinic immediately. They will conduct all the necessary examinations and help you cope with the problem.

How to get rid of varicose veins

The World Health Organization has officially declared varicose veins one of the most dangerous mass diseases of our time. According to statistics for the last 20 years, 57% of patients with varicose veins die in the first 7 years after the disease, of which 29% die in the first 3.5 years. The causes of death vary - from thrombophlebitis to trophic ulcers and the cancerous tumors caused by them.

The head of the Phlebology Research Institute and academician of the Russian Academy of Medical Sciences spoke in an interview about how to save your life if you have been diagnosed with varicose veins. Watch the full interview here.

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Increased ALT in the blood: causes and treatment

Alanine aminotransferase (ALT) is a special substance involved in amino acid metabolism. It is usually found in organs such as the liver, heart, and kidneys.

The penetration of this enzyme into the bloodstream is evidence of the presence of a pathological process. What this means and what ailments it is associated with will be discussed later in the article.

In most cases, alanine aminotransferase is elevated in diseases affecting the liver. However, the possibility of pathology of other vital organs cannot be ruled out.

The concentration of ALT in the blood is an important diagnostic indicator that determines the location and severity of the pathology.

Basic functions of ALT

This enzyme is important for health. Thanks to it, metabolic processes are carried out, which helps strengthen the immune system, provide the body with the necessary energy reserves, and also produce lymphocytes.

All processes occur inside cells with a small release of the enzyme into the bloodstream.

Due to the destructive process occurring in the cells of the liver and other organs affected by the disease, ALT enters the blood in large quantities. Its presence, exceeding acceptable values, becomes an important indicator for the diagnosis of certain diseases.

The presence of alanine aminotransferase is typical for such organs as:

• the liver, where its concentration is highest;
• heart muscle;
• lungs;
• kidneys;
• pancreas.

This becomes a prerequisite for a thorough examination of these particular organs when high ALT levels are detected in a biochemical blood test.

Indications for analysis

An increase in the level of ALT in the blood signals not only pathology in the listed organs. It also indicates the possibility of other diseases.

That is why blood biochemistry is assessed. The analysis reveals deviations, becomes an integral part of preventive measures, and an effective way to diagnose serious diseases of the liver, myocardium and pancreas.

Carrying out this study becomes mandatory when monitoring pathological changes in the liver that occur as a result of taking medications, hepatitis and poisoning with toxic substances.

A biochemical blood test is prescribed if the following symptoms occur:

• intense pain in the right hypochondrium;
• yellowness of the skin and eye sclera;
• lightening of stool and dark urine;
• lack of appetite;
• general weakness.

Timely detection of elevated ALT levels makes it possible to eliminate such signs by making an accurate diagnosis and prescribing an adequate course of treatment.

Other symptoms

In addition to the manifestations listed above, indicating a high level of ALT in the blood, there are symptoms that appear depending on the damage to a particular organ:

1. Liver. The ailments are accompanied by painful manifestations under the right ribs, changes in skin color and yellowness of the eyes. Viral hepatitis occurs against a background of elevated body temperature. Cirrhosis is characterized by the accumulation of fluid in the abdominal cavity, and so-called spider veins appear on the skin.
2. Heart. The main symptom of myocardial infarction is intense pain in the chest area, radiating to the subscapular area, left arm and jaw. The heart rhythm is disturbed, shortness of breath occurs, and blood pressure drops. There is general weakness and chills.
3. Pancreas. Nausea, repeated vomiting, sharp or aching pain in the stomach, bloating, weakness.

If an oncological process occurs, in addition to these signs, sudden weight loss and loss of strength are observed.

Diagnostics

Detection of high levels of enzymes in combination with the listed manifestations makes it possible to quickly diagnose diseases, which significantly increases the effectiveness of treatment.

For testing, blood from a vein is taken in the morning on an empty stomach. The reliability of the results depends on the preliminary preparation of the patient by following simple rules:

• last meal no later than 8 hours before collection of biomaterial;
• eliminating alcohol and quitting smoking;
• limiting physical activity.

If you use medications, you should inform your doctor.

Only if these requirements are met will the tests be accurate, which will make it possible to make an accurate diagnosis.

Analysis transcript

It should be noted that when interpreting the results, the values ​​of an enzyme such as AST are also taken into account. According to the Ritis coefficient scale, which considers the ratio of these enzymes, indicators up to 1.65 conventional units are taken as the norm.

Exceeding these values ​​by 2 times indicates pathological changes in the heart muscle. Indicators below 1.0 indicate liver damage.

However, with hepatitis of viral origin, a decrease in these values ​​is observed, and liver damage due to alcohol poisoning provokes a significant increase in them.

A comprehensive examination of a patient with a high level of enzymes involves the use of MRI, X-ray CT, a general analysis of urine and blood, and a number of other measures.

ALT norms

In adults and children, there is a significant difference in indicators that are considered within normal limits. The table shows that the permissible concentration of this substance depends not only on age, but also on gender:

For a child from 1 year to 3 years

The indicated values ​​are approximate, but small fluctuations up or down are allowed - from 1 to 3 units.

Factors influencing performance

The reasons for increased ALT are quite varied. But most often they indicate liver pathology and are a kind of marker of its condition. In addition, high values ​​are found even with minor diseases of other organs, when they are accompanied by cell destruction.

1. Types of hepatitis. At the same time, the chronic and viral forms do not cause a significant deviation of ALT from the norm.
2. Mechanical jaundice. High rates are also observed extremely rarely.
3. Cirrhosis. Characterized by the absence of pronounced symptoms for a long time.
4. Fatty liver disease - steatosis. This condition is characterized by a slight increase in blood levels. However, if the pathology develops into steatohepatitis, alanine aminotransferase increases significantly, and the level of direct and total bilirubin also increases.
5. Malignant neoplasms in the liver. They often result from hepatitis. Biochemical analysis to determine ALT indicators allows not only to diagnose the disease, but also to draw a conclusion about the need for surgical intervention. ALT values ​​increase significantly after chemotherapy.
6. Pancreatitis. With an exacerbation of the inflammatory process in the pancreas, ALT increases. Indicators can increase 3-6 times.
7. Myocarditis (damage to the heart muscle). In addition to an increase in enzyme levels, shortness of breath becomes a striking symptom.
8. Myocardial infarction. Pathology is indicated by a 5-fold increase in ALT values. An increase in time indicates progression of deterioration.
9. Alcoholism. There is an increased concentration of ALT, which increases after drinking alcohol.
10. Muscular dystrophy. ALT values ​​can increase 8-9 times.

Extremely high rates are provoked by acute hepatitis: exceeding the norm at once.

Other reasons

In addition to diseases, physiological reasons also act as factors causing upward deviations in ALT values. Among them:

• exceeding permissible physical activity;
• drinking alcohol before the examination;
• stressful situations;
• eating fatty, fried, spicy foods.

Increased rates are observed during pregnancy. A slight deviation is considered natural.

Uncontrolled use of medications significantly affects the results of the analysis. Therefore, if possible, you should refrain from using them before performing the analysis.

How to bring the indicators back to normal

The exceptional information content of the results of blood biochemistry on ALT, which allows diagnosing a wide range of pathological conditions, does not provide grounds for independently drawing conclusions and making decisions.

This prerogative should be left to qualified doctors.

The fundamental principle in an integrated approach to eliminating the problem is further examination in order to determine the root cause of the deviation from the norm. Having found out which disease served as the trigger for the increase in values, the doctor will choose the right treatment tactics.

Diseases with a particularly severe clinical course require a course of treatment in a hospital setting.

These include:

• pancreatic necrosis;
• extensive myocardial infarction;
• acute and infectious hepatitis;
• cirrhosis;
• oncology.

The treatment of each of them is specific and requires strict adherence to the doctor’s recommendations.

Drug treatment

Among the most effective medications used specifically to lower enzymes in the blood, hepatoprotectors should be noted:

Drugs in this group prevent further destruction of liver cells and other organs. At the same time, they restore cells damaged by the pathological process.

Other measures

In addition to taking hepatoprotectors, choleretic agents and drugs that improve digestive processes, it is recommended to adhere to the following diet:

• meals should be small and frequent;
• Fatty, fried and spicy foods should be excluded from the diet;
• smoked meats and sausages are prohibited;
• It is not recommended to use marinades or get carried away with pickles;
• food should be steamed, baked, simmered or boiled;
• limit the consumption of strong tea and coffee;
• exclude alcohol and smoking.

About the use of traditional methods

As auxiliary agents, it is allowed to use decoctions and infusions of chamomile, thyme, St. John's wort, and peppermint.

However, you should consult your doctor before using them.

The greatest harm comes from self-medication and irresponsible attitude towards one’s health.

To avoid serious consequences caused by late contact with a specialist, you should do a blood test 1-2 times a year. This will allow you not to miss the onset of the destructive effects of liver, pancreas and heart diseases on the body.

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When is a blood test for ALT prescribed and what is it?

For some diseases, people are prescribed a blood test for the ALT enzyme, and not everyone understands what it is. The abbreviation ALT (AlAT) stands for alanine aminotransferase, which is a special endogenous enzyme component. Blood enzymes are synthesized exclusively inside cells. The substance is contained in small quantities in the blood. With an increased level of transaminase in the blood during a biochemical analysis, it becomes clear that there are some pathologies or abnormalities in the body. Often, a high level of the enzyme indicates destructive processes in some organs (most often the liver) and the development of serious diseases. To find out the reasons why the enzyme level has increased, a biochemical blood test for enzymes is performed.

The enzyme is found in almost all organ tissues. These are kidneys, heart muscle, liver, muscle tissue. The main function of the enzyme is to participate in amino acid metabolic processes. The analysis is carried out regardless of age: the blood can determine the level of the enzyme in a child and an adult.

What is revealed through analysis

The largest amount of enzyme is found in liver tissue. Blood biochemistry makes it possible to detect pathological changes even in the early stages, when the disease does not manifest itself in any way. ALT is the most accurate indicator in identifying pathologies.

The amount of alanine aminotransferase is determined in a general biochemical blood test. An increased enzyme content helps to detect even jaundice without obvious signs on the body. Doctors prescribe a blood test for AST (AST - aspartate aminotransferase), ALT when taking medications for a long time, to exclude the possibility of developing drug-induced hepatitis. The study is necessarily prescribed for increased fatigue, weakness, loss of appetite, frequent nausea and vomiting, pain in the liver due to its enlargement, dark urine and light-colored stool. All these symptoms may indicate developing liver pathologies.

At the same time, there is an increase in the level of AST and ALT in the blood. In infancy, when studying a child's AST biochemical blood test, doctors may see an increase in the amount of the enzyme. This condition may be associated with jaundice and does not pose any visible threat to the baby.

Biochemical studies can be used as both a diagnostic method and a method of analysis during the treatment period to determine how effectively the therapy affects the pathology and at what stage the disease is. People who suffer from alcohol addiction or are at risk (if they have diabetes or are overweight, who are in contact with patients with hepatitis), an ALT test is mandatory. A study is carried out on venous or capillary blood. In order for the results to be reliable, the patient should not consume spicy foods or alcoholic beverages for 10 hours before donating blood.

Normal ALT levels

The amount of alanine aminotransferase differs between children and adults. The child’s indicators are as follows: for a newborn up to 4 days, the AST norm, the ALT norm is up to 48 U/l; from 4 days to 6 months – 55; from 6 months to 1 year – 53; 1-3 years – 32; 3-6 years – 28; 11 years – 38. In childhood, minor fluctuations in indicators may be allowed.

This is explained by physiological growth. By the age of 18, ALT levels stabilize and approach normal levels. Adults: men – 41; women – 32 U/l.

A deviation in a biochemical blood test is not always considered a pathology. This may be caused by infectious diseases. In some cases, blood thinning medications cause large amounts of the enzyme. Therefore, before conducting an examination, a person should definitely tell their doctor about concomitant diseases and medications used. In a child, an elevated level of the enzyme may indicate that an acute viral disease is beginning. The decoding of ALT in the blood during a biochemical analysis is carried out by a doctor, and not by laboratory personnel.

If the test showed an increase in enzymes

An increased level of alanine aminotransferase by 4 times means that a person may develop a myocardial infarction. With hepatitis, the amount of enzyme in the blood test increases in men and women. With muscular dystrophy, ALT in the blood increases 7 times; acute form of pancreatitis, gangrene contribute to an increase of 4-6 times.

If the level of ALT is elevated, this indicates that serious pathologies are developing or already present in the body.

In inflammatory diseases of the liver, for example, in hepatitis of various types, the number of enzymes is limited to one. Hepatitis can be detected using an analysis 8-9 days before the appearance of external symptoms. A disease that is caused by viruses or alcohol poisoning increases the level of the enzyme alone. The development and division of cancer cells in the liver significantly increases the level of the enzyme. A biochemical blood test is carried out not only as a diagnostic method, but also as a method for making decisions about surgical intervention. If the enzyme level is too abnormal, surgery is not performed because more serious complications may occur.

People diagnosed with pancreatitis have to undergo such a biochemical blood test several times a year. At the same time, lipase increases in the blood (one of the digestive enzymes that is involved in the breakdown of fats). With the help of this study, relapses of the disease are prevented and the progress of therapy is monitored. The main symptoms of damage to the heart muscle are the appearance of shortness of breath in a person, rapid fatigue and an increased amount of enzyme in the blood. Pathology is diagnosed using AST determination.

Liver cirrhosis is insidious in that it may not manifest itself for a long time. If a person feels chronic fatigue, fatigue, or pain occurs in the liver area, he should go to the hospital and undergo a test to determine the level of ALT in the blood. In this way, it is possible to diagnose the disease at an early stage and prevent cancer and death. With cirrhosis, the indicator increases by one.

The enzyme level decreases to normal only when the true cause of increased enzyme production is identified and appropriate measures are taken. If the disease is detected in a timely manner and after undergoing adequate therapy, the indicators will return to normal.

In some cases, ALT can be lowered with the help of medications; they are prescribed only by doctors and taken at a certain dosage under the supervision of a specialist. Medicines have contraindications, so they should not be used without a doctor’s prescription. Such medications are used to reduce enzyme levels in cases where the rules were violated before taking the test. Medicines do not eliminate the causes of increased enzyme levels; they only reduce them for a short period.

False analysis

In some cases, if a person does not follow the rules for taking the test, the result may be false. To prevent this, you must:

• do not take medications a week before the test (barbiturates, statins, antibiotics provoke an increase in ALT levels);
• do not eat fast food;
• do not drink alcohol;
• try to remain calm and not give in to stress;
• do not violate the sterility of the procedure;
• the test is not performed one week after insertion of a cardiac catheter or other operations.

In order for the result to be reliable, before taking the test, a person should definitely consult a doctor and study the prohibited points in detail. You need to donate blood for an ALT test on an empty stomach.

Increased ALT in pregnant women

For females, the normal level of enzyme content in the blood is 32 U/l. In the first trimester of pregnancy, this figure may increase slightly, but this does not indicate pathological changes. In the second and third trimester of pregnancy, the ALT level should already be normal.

If the level of the enzyme in the blood is elevated during 6-9 months of pregnancy, this may indicate that preeclampsia is present. This pathology is a complication and manifests itself precisely in the last months of pregnancy. In this case, the woman experiences frequent dizziness, nausea, pressure surges, and possible tachycardia. The higher the enzyme level, the more severe the pathology. This fact is explained by the fact that the liver has too much load, which the body cannot cope with on its own, therefore the condition manifests itself by an increase in the level of the enzyme in a biochemical blood test.

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Alanine aminotransferase (ALAT) is an enzyme whose elevated levels in the blood may indicate liver damage. The ratio of AlAt and AsAt (aspartate aminotransferase) indicators makes it possible to carry out differential diagnosis of various diseases of internal organs.

Localization and role of the AlAt enzyme in the human body

The enzyme is present in all cells of the body, but its greatest concentration is found in the heart, liver and kidneys. It is localized in smaller quantities in the tissues of the spleen, pancreas and lungs. Synthesized inside cells, this biologically active substance is involved in the formation of a large number of different amino acids. It is involved in nitrogen and energy metabolism. In the blood of a healthy person, alanine aminotransferase is present in minimal concentration.

An increase in ALT levels in the blood may indicate cell death in various organs, but primarily it indicates liver pathology. The study is indicated for patients who experience nausea, yellowing of the skin, pain in the right hypochondrium, weakness, loss of appetite, and changes in the color of excrement. The test should also be taken by people who have had hepatitis, have a predisposition to liver disease or are overweight, and also use alcohol or medications that have a negative effect on the liver.

Determining the activity of this substance is very important for diagnosing hepatitis in the early stages. ALT is elevated already in the first, pre-icteric, stage of the disease, the duration of which is 10–350 days, depending on the form of the disease. If there is a suspicion of serious damage to the liver tissue, the patient may be prescribed an analysis for alanine aminotransferase in conjunction with a number of other studies: AST, LDH, GGT, bilirubin, etc. It is important to conduct a comprehensive study, since not only the quantitative content of alanine is decisive -aminotransferases in plasma, but also the ratio of the concentrations of various enzymes.

So, if AsAt exceeds the AlAt value, this indicates the presence of a cardiac pathology in the patient, and if on the contrary, then specialists have every reason to believe that the patient suffers from liver disease. Both intracellular enzymes increase equally when the patient has muscle injuries.

Since elevated alanine aminotransferase can indicate various pathologies, its specific concentration should be taken into account when assessing the results obtained. Thus, with fatty liver degeneration, its content increases 2–3 times, with cirrhosis - 4–5 times, with alcoholic hepatitis - no more than 6 times, with carcinoma - 5–10 times. In viral hepatitis, its level correlates with the degree of cell destruction and can exceed normal levels by 50–100 times.

You should know!
In some patients, ALT may be elevated due to the use of a number of dietary supplements. Taking these drugs often leads to liver damage. Frequent consumption of fast food has a similar effect. When nutrition is normalized, the enzyme level returns to reference values.

In biochemical analysis, alanine aminotransferase is measured in units per liter (U/L).

Normal concentration of alanine aminotransferase in the blood

The enzyme norm in men over 17 years of age is 41 U/l, and in women of the same age - 31 U/l. During pregnancy, indicators often increase, but too strong an increase in ALT concentration may indicate the presence of pathologies.

In newborns, the content of the substance does not exceed 17 U/l, but it gradually increases and by 6 months reaches 56 U/l. Then the concentration of alanine aminotransferase begins to decrease, and by 3 years it reaches 33 units, by 6 years - 29 units. In teenage boys, its content averages 27 U/l, and in girls - 24 U/l.

The analysis can be prescribed by a general practitioner, hematologist, infectious disease specialist, endocrinologist, gastroenterologist or surgeon. For a reliable interpretation of the results, you may need to consult an oncologist, hepatologist and urologist (if the patient has any complaints in their profile).

Alat is elevated: causes of imbalance

There are a number of reasons for increased ALT, but the main one is liver disease: malignant tumors, viral and alcoholic hepatitis, fatty hepatosis, toxic lesions caused by taking various medications (antibiotics, oral contraceptives, psychotropic drugs, immunosuppressants, steroids, etc.) .

In some cases, the content of this enzyme increases in cardiac disorders, pancreatitis, myositis, extensive burns, muscular dystrophy and hemolytic diseases. ALT can increase due to a lack of alpha1-antitrypsin and carnitine (a substance related to B vitamins).

Results may also be elevated for physiological reasons. In particular, with intense physical activity, intramuscular injections and consumption of food with harmful additives. Significantly affects the content of this substance and medication intake. Therefore, before taking the test, you should consult with your doctor about temporarily canceling them. If it is not possible to stop taking the medication, then the influence of this factor should be taken into account when assessing the results of the study.

When ALT levels exceed the norm by 2-3 times, doctors call this condition a slight increase; an increase in ALT up to 20 times the reference values ​​is called moderate. When the concentration increases by more than 20 times, experts begin to sound the alarm. The main ways to lower enzyme levels are to treat the diseases that cause its growth, stop taking toxic drugs and alcohol, and normalize your diet.

Important to know!
In order for the results of the study to be as reliable as possible, it is necessary to refrain from eating for 12 hours before the analysis, and also to avoid smoking and overexertion (physical and emotional) half an hour before taking the biomaterial.

AlAt lowered: why?

ALT decreases in acute and chronic liver diseases accompanied by extensive tissue necrosis. In this case, the decrease in enzyme concentration is due to a significant reduction in the number of cells that synthesize it. Also, alanine aminotransferase deficiency occurs with vitamin B6 deficiency. In such a situation, to normalize the level of the enzyme, it is necessary to compensate for the lack of vitamins, change the diet and begin treatment of those diseases that caused the imbalance.

If ALT is within normal limits, this does not mean the absence of liver pathologies. To make an accurate diagnosis, this test must be combined with other tests. Blood should be tested for the content of this substance if you have a genetic predisposition to liver disease, obesity, diabetes, taking certain medications, or if you have contact with people suffering from viral hepatitis.

How to find out the level of alanine aminotransferase in the blood?

Laboratory tests are carried out in public clinics upon referral from a doctor. The results are ready in 2-3 days, but often to get answers you need to go to the doctor who ordered the study, which requires additional time. This can be difficult for busy people. The most convenient option is to go to a private diagnostic and treatment institution, where you can get tested at a convenient time and without a referral from a specialist.

We recommend paying attention to one of the leading Russian private laboratories -. Medical offices of this network operate in 290 settlements in Russia and neighboring countries. The results of tests carried out in these research laboratories are recognized by all medical institutions in the country.

The turnaround time for a biochemical test for alanine aminotransferase (AlAt) is 1 business day. For an additional fee, the analysis can be completed in 2 hours. For non-transportable patients, blood is drawn at home. The client can receive the research results at the company's office, by courier, by email, fax or telephone. The cost of analysis in Moscow and the Moscow region is 260 rubles, in St. Petersburg - 170 rubles, and in other cities of the country - 130–160 rubles.

Wednesday, 03/28/2018

Editorial opinion

The problem of interpreting the results of a biochemical study should rest entirely on the shoulders of a specialist. Keep in mind that the ALT indicator itself does not have significant diagnostic value. Specialists are primarily interested in the proportional ratio of AsAt and AlAt. In addition, deviations in the concentration of alanine aminotransferase from acceptable levels may be a physiological norm, taking into account the physical training carried out the day before and the injuries received in the process.

Cells of the liver, heart and some other organs produce special enzymes involved in metabolic processes. Normally, they practically do not enter the bloodstream and are not detected during analysis or are contained in very small quantities. However, diseases that cause destruction of the cellular structure of tissues contribute to the release of these enzymes into the bloodstream. The most significant substances in the diagnosis of pathological processes are abbreviated as AlAt and AsAt.

This is the abbreviated name for one of the main enzymes that ensures the metabolism of amino acids - alanine aminotransferase. Produced primarily by hepatocytes - liver cells. It is synthesized in smaller quantities in skeletal and cardiac muscle tissue and the pancreas. Usually, alanine aminotransferase is not detected in the blood of a healthy person during a laboratory biochemical study or is detected in very small quantities. At the same time, ALT is increased in men due to accelerated amino acid metabolism (in women it occurs less intensively).

Most often, a comprehensive laboratory analysis is carried out to determine the concentration of another substance - aspartate aminotransferase (abbreviated AsAt). It is produced by the same cells and also participates in amino acid metabolism. The content of the enzyme in the blood plasma also changes in certain diseases of the liver and heart muscles, indicating necrotic processes.

But the main diagnostic value is the ratio of these two enzymes, the value of which is called the de Ritis coefficient and allows you to reliably establish the localization of the pathological process. If the reference (acceptable) indicators are exceeded and the coefficient value is less than 0.91 or more than 1.75, we can assume liver problems in the first case or heart pathology in the second.

Norm AsAt and AlAt in a biochemical blood test

The concentrations of these enzymes change over time, which is the norm in childhood. For example, infants have higher levels than adults due to the nature of the birth period. Due to the massive release of red blood cells into the blood and their subsequent transformation into bilirubin, jaundice, characteristic of newborns, develops and, accordingly, an increase in the amount of ALT.

For AsAt and AlAt, the norms for children of different ages and adults can be found in the table:

As can be seen from the table, normal indicators constantly fluctuate in childhood and adolescence, and from the age of 12 they also differ according to the gender of the subject. In addition, a slight increase in ALT levels is normal in women in the blood during early pregnancy. However, in the last trimester, an increase in enzyme concentration indicates gestosis, which threatens the health of the mother and fetus.

Aspartate aminotransferase is also determined in different quantities according to gender and age. In adult men, the upper limit of normal is 37 units per liter, in women - 31. The highest level is observed in children in the first days of life (up to 97 units / l), by one year it decreases to 82, and by six - to 36. For adolescents 12 -17 years old are considered normal values ​​not exceeding 29 and 25 U/l for boys and girls, respectively.

A blood test shows elevated ALT and AST – what does this mean, what are the reasons?

An increase indicates pathological destruction of hepatocytes, heart cells, and pancreas. Normally, they enter the blood in minimal quantities, as a result of natural tissue renewal and the death of old cells. Extensive organ damage and massive cell death lead to a sharp increase in their volume in the bloodstream. Thus, an increase in ALT levels in the blood serum is typical for the following diseases and conditions:

• hepatitis, liver cirrhosis, fatty degeneration;
• acute pancreatitis;
• extensive burns, shock;
• viral infections;
• lymphoblastic leukemia;
• shocks of various etiologies;
• hematopoiesis disorders;
• muscular dystrophy;
• mononucleosis.

Increased AST in the blood or aspartate aminotransferase appears in the blood plasma in large quantities during necrotic processes in the body. Exceeding the maximum permissible values ​​by several times (from 2 to 20) is a sign of diseases of the following organs:

• Heart – coronary insufficiency, myocardial infarction, pulmonary thrombosis, angina attacks, postoperative condition, rheumatic carditis.
• Gallbladder and liver - cholestasis, cholangitis, amebiasis, liver cancer, hepatitis, cirrhosis.
• Pancreas – acute inflammation or phlegmon.
• Skeletal muscles - damage or dystrophy;

The plasma concentration of the enzyme also increases with systemic and infectious pathologies such as vasculitis, mononucleosis, and hemolytic syndrome.

Could the increase in alanine aminotransferase and aspartate aminotransferase levels be caused by other reasons not related to diseases? Yes, enzyme levels increase in women at the beginning of pregnancy, which is the norm. The same phenomenon can be observed when using certain medications: antibiotics, antitumor and sedative drugs, barbiturates, oral contraceptives and others. The level of physical activity, intake of sports nutrition, and alcoholic beverages also influence the growth of indicators.

Who needs research

A referral for a biochemical blood test, AsAt and AlAt, is mandatory for all donors before the blood collection procedure, as well as for persons with identified pathologies of the liver, heart, and pancreas.

The results of this study are also used for hepatitis and cirrhosis, as they make it possible to determine the degree of organ damage. In addition, it is necessary to control the amount of enzymes during treatment with certain antibiotics, as well as after toxic compounds enter the body.

The basis for a biochemical blood test is also a deterioration in general health in the form of constant weakness, fatigue, and loss of appetite. Common symptoms such as abdominal pain, nausea and vomiting, yellowing of the whites of the eyes, dark urine and digestive problems are reasons to consult a doctor immediately for a referral for an examination.

How to prepare for analysis for AlAt, AsAt

You need to donate blood from a vein for testing, which is done in public clinics upon referral or on a paid basis in private laboratories. A test for AlAt and AsAt in the blood is taken in the morning and strictly on an empty stomach: at least 12 hours must pass after the last meal. On the day of visiting the laboratory, you should not smoke or drink any liquids other than water. You should absolutely not drink alcoholic beverages for the entire week before your test.

In addition, the result may distort the use of any medications - antimicrobial, contraceptive, choleretic, sedatives and others. So the question of their cancellation or temporary suspension of treatment should be discussed with your doctor in advance. The analysis period is 24 hours, which means you can get the results the very next day. For an additional fee, the process can be accelerated: a rapid test is completed in just 2 hours.

Analysis transcript

The results of the study must be provided to your doctor. The specialist pays attention to the quantitative indicators of the content of both enzymes, the degree to which the maximum permissible value is exceeded and their ratio. For example, the concentration of ALT allows one to draw conclusions about the nature of liver diseases. Thus, hepatitis A, B, C cause 20 times the excess of the norm, and alcoholic ones – 6 times. With fatty degeneration, an increase of 2 or 3 times is observed.

As for oncological diseases (liver cancer, in particular), then you should pay attention to aspartate aminotransferase and its concentration.

With carcinoma, it increases several times, and progresses over time. At the same time, alanine aminotransferase values ​​increase slightly. In the later, inoperable stages of cirrhosis, the opposite phenomenon is observed.

Of particular importance is the so-called de Ritis coefficient - the numerical ratio of increased values ​​of AlAt and AsAt, especially if the localization of the pathological process has not yet been precisely established. With liver damage, there is usually an increased ALT in the blood, and the level of aspartate aminotransferase decreases. If the myocardium is damaged, the opposite proportion occurs. Normally, the de Ritis coefficient ranges from 0.91 to 1.75, that is, when hepatocytes are destroyed, it is significantly less than 1, and during a heart attack, it is more than 2.

In addition, the concentration of enzymes is reduced. For AlAt and AsAt in a blood test, this is typical in the case of repeated sessions of hemodialysis, liver rupture, necrosis or cirrhosis, as well as in cases of severe deficiency of B-group vitamins in the body or taking anticoagulants. In any case, decoding should be done by a specialist, taking into account third-party factors that could affect the final result of the study, since it is not always determined by pathological reasons. It is unacceptable to draw conclusions and make diagnoses on your own without special education.

How to lower ALT in the blood?

If quantitative deviations of indicators from the norm have been identified, first of all it is necessary to exclude the influence of factors such as taking dietary supplements and alcohol, and excessive physical activity. A diet that includes too much fatty and “heavy” food also needs to be adjusted. Often it is food that provokes inflammation of the pancreas, and diet promotes recovery.

When drug therapy becomes the cause, the doctor must adjust the course or replace the drug with a less toxic one. At the same time, the effectiveness of such a measure must be continuously monitored through regular analyses. If the concentration of enzymes has changed due to liver disease or another pathological process, it must be identified and treated. For this, a full examination with hospitalization in a hospital is usually prescribed.

Among the many enzymes that are indicators of hepatocellular disorders, the most useful and necessary are alanine aminotransferase (ALAT) and aspartate aminotransferase (AST). Thanks to them, the reactions of transfer of the gamma groups of alanine and aspartate to the gamma group of ketoglutarate are accelerated. As a result of this process, pyruvic and oxaloacetic acids are formed.

Both ALT and AST are cellular enzymes of the kidneys, liver, and heart. But alanine aminotransferase, first of all, is located in the liver and is considered its most basic indicator, and aspartate aminotransferase is found in many (in addition to those listed above) organs and tissues, including skeletal muscles, brain, etc. That is why the key enzyme AST is less characteristic as an indicator of liver function, and it takes part in amino acid metabolism.

If liver, heart, and kidney cells are destroyed, alanine aminotransferase (ALAT) enters the blood. An increase in this cellular enzyme in the blood indicates hidden diseases. When studies show that the blood level of ALT is high, quite serious diseases may develop, such as:

And an increase in aspartate aminotransferase in the blood can lead to

If the total AST and ALT levels are elevated, the following are possible:

Extensive hepatic necrosis,

Toxinogenic liver damage,

Severe viral hepatitis,

Prolonged vascular collapse.

In almost all human diseases, blood tests show that both AST and ALT are elevated, that is, the level of both enzymes in these cases is almost the same and indicates the presence of pathology. But there is still one difference. If ALT is elevated to a greater extent than aspartate aminotransferase, this indicates the incubation period for the development of infectious hepatitis. If there is more AST in the blood, this is most often a heart problem.

In a healthy person, the content of these cellular enzymes should be at the level of:

In men, up to 41 units per liter (U/L);

In women, up to 31 units per liter (U/L).

To determine the level of these enzymes of protein metabolism, a biochemical blood test is taken. The norm for ALT in it will be 28-190 nmol/(s l) or 0.1-.68 µmol/(ml h), and for AST - 28-25 nmol/(s l) or 0.1-.45 µmol /(ml h). This norm for both cases is given for the Reitman-Frenkel method (colorimetric research method).

Typically, blood tests for alanine aminotransferase are carried out to find out about the condition of the liver, and for aspartate aminotransferase - to see the condition of the myocardium (heart muscle). If the analysis shows their increased content in the blood, it means that processes of destruction and cell death are occurring in these organs. So, if AST exceeded its level in the blood by 2-20 times, then the development of myocardial infarction is quite possible. If ALT is elevated, a pathological process occurs in the liver.

If alanine aminotransferase and aspartate aminotransferase levels in the blood are low, experts know that there is a lack of pyridoxine (vitamin B6) in the body. This usually happens during pregnancy, with frequent hemodialysis and renal failure.

Unfortunately, where these enzymes come from in the blood serum of a healthy person is still unknown, so the mechanism of their clearance (an indicator of the speed of purification of plasma, other biological fluids and tissues from any substances due to their redistribution, biotransformation, and excretion from the body) is also unclear.

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Norms and changes in blood tests for ALT and AST

Biochemical blood tests for ALT and AST are most often prescribed in the diagnosis of liver diseases. In some cases, the doctor prescribes these studies to the patient when diagnosing pathologies of the cardiovascular system and skeletal muscles. What do the designations AlAT and AST mean, and what can deviations of these indicators from the norm indicate?

Biochemical blood test for ALT

Alanine aminotransferase (AlAT) is an intracellular enzyme from the group of aminotransferases that takes part in the metabolism of amino acids.

The largest amount of alanine aminotransferase is found in liver and kidney cells. A slightly lower content of this enzyme is found in the cells of the heart muscle, skeletal muscles, spleen, pancreas, lungs, and red blood cells. ALT activity in the blood serum of men is slightly higher than that of women.

There are certain indications for conducting a blood test to determine the level of alanine aminotransferase:

• diagnosing liver diseases;
• control of patients with different types of hepatitis;
• examination of contact persons in the outbreak of viral hepatitis;
• donor examination.

The ALT level in a blood test depends on age. In addition, the activity of this enzyme is slightly higher in men than in women.

The value of the ALT norm in a blood test for children under six months is less than 60 U/L, up to one year – less than 54 U/L, up to six years – less than 30 U/L, up to 12 years – less than 38 U/L. For boys under 18 years of age, this figure should normally not exceed 27 U/l, for girls under 18 years of age – 24 U/l. For adult men, the normal value of ALT in the blood is less than 41 U/L, for adult women – less than 31 U/L.

An increase in the value of alanine aminotransferase in a blood test is observed in the following pathologies:

• viral hepatitis;
• toxic liver damage;
• cirrhosis;
• primary or metastatic liver cancer;
• fatty hepatosis;
• obstructive jaundice;
• severe pancreatitis;
• hypoxia, shock (usually in an asthmatic state);
• myocarditis, extensive myocardial infarction;
• myodystrophy, myositis;
• right heart failure;
• severe burns;
• chronic alcoholism;
• some hemolytic diseases;
• taking hepatotoxic drugs (immunosuppressants, antibiotics, anabolic steroids, psychotropic drugs, antitumor drugs, contraceptives, sulfa drugs, salicylates).

Biochemical blood test for AST

In most cases, the doctor prescribes blood tests for ALT and AST at the same time.

Aspartaminotransferase (AST) is an enzyme that is involved in the metabolism of amino acids. Its greatest amount is found in the cells of the liver, cardiac myocardium, nerve tissue, and muscles. This enzyme is also found in the cells of the pancreas, kidneys, and lungs. In case of damage and pathologies of the above organs, AST is released into the bloodstream, and therefore its content in the blood test increases.

Indications for prescribing a blood test for AST are the following situations:

• diagnosing liver pathologies;
• diagnosis of myocardial infarction and some other diseases of the heart muscle;
• diagnosing pathologies of skeletal muscles.

The norm of AST in the blood of children under 12 months should be no higher than 60 U/L, up to nine years - no higher than 55 U/L, in adult men - less than 41 U/L, in adult women - less than 31 U/L.

The level of aspartaminotransferase in the blood increases with the following diseases and conditions:

• toxic, viral, alcoholic hepatitis;
• primary and metastatic liver cancer;
• acute pancreatitis;
• cholestasis;
• severe attack of angina, myocardial infarction;
• pulmonary artery thrombosis;
• angiocardiography, cardiac surgery;
• rheumatic carditis in the acute stage;
• myopathies (chronic muscle diseases);
• skeletal muscle injuries;
• heatstroke;
• burns.

A slight increase in AST is observed with excessive muscle load.

A decrease in the level of this enzyme in the blood indicates a deficiency of vitamin B6 in the body and severe liver pathologies (liver rupture).

How to properly take blood tests for ALT and AST?

In order to avoid false deviations from the norm in blood tests for ALT, as well as AST, it is necessary to properly prepare for donating blood.

The day before blood sampling, you need to exclude fried, fatty, spicy foods, and alcoholic beverages from your diet. It is recommended to avoid increased physical activity.

Blood is taken for analysis in the morning on an empty stomach; at least eight hours must have passed since the last meal.

You should not donate blood for these studies immediately after fluorography, radiography, ultrasound, rectal examination, or physiotherapeutic procedures.

If the patient is taking any medications, he must notify the doctor prescribing the test. Some medications can significantly distort test results.

A competent interpretation of a biochemical blood test for ALT, as well as AST, can only be done by a qualified doctor.

http://ymadam.net/zdorove/sdaem-analizy/analiz-krovi-na-alat-i-asat.php

What do blood tests for ALAT and AST show?

2 Norms of indicators

Norm number of units per 1 liter of blood:

• ALT - in men up to 40 units/l, and in women up to 32 units/l;
• AST - in men from 15 - 31 units/l, and in women from 20 - 40 units/l.

What is a biochemical blood test? When a study is carried out in laboratory conditions, this is a biochemical analysis. It is a guideline for the attending physician, since it shows a complete picture of the work of all vital organs:

• liver,
• pancreas,
• kidney,
• gallbladder, etc.

This analysis considers the following indicators:

• blood glucose levels;
• bilirubin;
• ASAT and ALAT;
• gamma - GT;
• alkaline phosphatase;
• cholesterol;
• LDL (bad fats);
• triglycerides;
• total protein;
• albumen;
• potassium;
• sodium;
• chlorine;
• createnine;
• urea and uric acid;
• C-reactive protein (CRP);
• iron.

If there is a deviation from the norm of one or another indicator, it becomes clear to the doctor what exactly needs to be regulated or treated.

3 Preparation for submitting material for research

If the patient is taking any medications, then most likely, shortly before the test, the doctor will stop the drug that can change the accuracy of the blood test. Donate blood in the morning on an empty stomach (last meal 12 hours before).

To prepare for the analysis you need:

1. 1. Avoid alcohol the day before donating blood.
2. 2. Give up cigarettes within an hour.
3. 3. Chewing gum should also not be chewed.
4. 4. You can’t drink any liquids either.

For analysis, blood is taken from a vein. The answer will be in one day. Deciphering the analysis without medical knowledge is impossible, so consultation with a doctor is necessary.

In most cases, elevated ALAT levels are associated with liver pathology. This is a sign that there is a disease of this organ. It should be noted that in a biochemical blood test, the level of this enzyme is higher than normal 1 or 4 weeks before the onset of symptoms of the disease. And in the acute period of the disease, the indicators increase almost 10 times.

In 1 minute, the liver can cleanse or neutralize up to a million molecules of toxic substances, and in about an hour - up to 100 liters of blood. Sometimes, for some reason, the cells are damaged, the contents of the cells come out and enter the blood. If such indicators are high in a biochemical blood test, this will mean that cell destruction is occurring in the body.

4 Why does the ALAT enzyme increase in the blood?

There can be many reasons for increasing the amount of ALAT enzyme:

• excess fat deposited in liver cells;
• hepatitis, jaundice;
• cirrhosis;
• taking medications, for example Paracetamol or antibiotics;
• chemical poisoning;
• tumor, cancer or metastases;
• myocardial infarction, heart surgery;
• muscle injuries;
• alcohol addiction.

If the body does not have enough vitamin B6, the level of this enzyme in the blood will decrease.
The liver is a unique organ that can recover in 3 months if treated.

ACAT, like the previous enzyme, transports (transfers) amino acids from molecule to molecule. It contains vitamin B6. As a result of the work of enzymes, glucogens are formed (sugars, but not from carbohydrates), which support the body during exercise, fasting, when energy is needed, i.e. this enzyme is a participant in energy exchange.

The difference between these two enzymes is that an increased level of ASAT in the blood warns primarily of heart disease, more precisely, of myocardial infarction. The largest share of the ACAT enzyme is found in muscle tissue - the myocardium and muscles. In other organs their concentration is lower.

When taking the test, a person’s age and gender matter. Since muscles play a leading role in this analysis, men have more muscle mass than women, and accordingly, the indicators will be high. In children, the rates will be higher due to the active development of the muscular skeleton.

Indicators will be changeable in pregnant women. Increased levels of the hormone estrogen affect the liver, so increases in ALT and AST in pregnant women are considered normal. But if high levels are accompanied by toxicosis, then urgent treatment is required, because it can be dangerous for both the baby and the mother. If a pregnant woman does not eat properly, she may become deficient in vitamin B6, and then a blood test will show a decrease in AST and ALT levels.

5 Why does the AST level deviate from the norm?

The reasons for the increase and decrease in AST levels are almost the same as with ALT, only if with ALAT the condition of the liver is put in the foreground, then in the case of AST - the heart and muscles.

Some of the reasons:

1. 1. Heart - myocardial infarction, coronary insufficiency, heart surgery, angina pectoris, tachycardia, rheumatic carditis, arterial blood clots.
2. 2. Liver.
3. 3. Gallbladder.
4. 4. Pancreas.

After receiving laboratory tests, doctors are left to determine the disease process of the organ in which the disturbances occurred. What is needed to normalize the level of ALT and AST enzymes:

1. 1. Do not drink alcohol, even in small doses.
2. 2. Review medications and, if necessary, change medications.
3. 3. Cure inflammatory processes in the body.
4. 4. Take a course of liver or heart treatment.
5. 5. Change your lifestyle, in particular, review your diet. Avoid unhealthy fats and include healthy foods in your diet.

All treatment should be carried out under the supervision of a doctor in order to properly normalize enzyme levels. Usually, if AST or ALT is abnormal, a hepatologist or cardiologist is consulted.

Medicines that increase the level of these enzymes:

• Heparin;
• antibiotics;
• NSAIDs (non-steroidal anti-inflammatory drugs);
• antifungal;
• anticonvulsants;
• lowering blood sugar;
• fluoroquinolones - antimicrobial drugs;
• nitrofurans - antibacterial drugs;
• stanina - cholesterol-lowering drugs.

If the body lacks vitamin B6, then enzyme activity will be reduced. In this case, it is useful to eat foods rich in this vitamin:

1. 1. Sprouted grains, any.
2. 2. Walnuts.
3. 3. Legumes, soybeans, cereals.
4. 4. Vegetables - carrots, cabbage, spinach, tomatoes.
5. 5. Strawberries, lemon, oranges, cherries.
6. 6. Meat and dairy products, eggs, fish.

Normalizing enzyme levels is not difficult, you just need to take the appropriate test and follow the doctor’s instructions.

And a little about secrets.

A healthy liver is the key to your longevity. This organ performs a huge number of vital functions. If the first symptoms of a gastrointestinal or liver disease have been noticed, namely: yellowing of the sclera of the eyes, nausea, rare or frequent bowel movements, you simply must take action.

http://zdorpechen.ru/diagnostic/biochemistry/alat-i-asat-chto-eto-takoe

ALT or AlAT (alanine aminotransferase) and AST or AST (aspartate aminotransferase) are a combination of complex protein molecules with non-membrane permanent cell elements, otherwise enzymes. Their main purpose is to accelerate the chemical reaction of amino acids (alanine and aspartic), which mediate the connection between protein and carbohydrate metabolism. The production of enzymes in the body occurs endogenously, that is, intracellularly, therefore in the blood of a healthy person the concentration of AST and ALT is insignificant.

General information about ALT

The main location of alanine aminotransferase is hepatocytes (liver cells). In smaller quantities, it is found in the myocardium, pancreas, kidneys and muscle tissues. Aspartate aminotransferase is concentrated to a greater extent in the heart muscle, as well as in the liver, neurons of the brain, and skeletal muscles.

When there is a destructive change in the listed organs, enzymes are released and enter the systemic bloodstream in large quantities. When the enzyme AST or ALT in the blood is elevated, this means a violation of the integrity of organ cells, hence the development of pathological processes.

ALT and AST are closely correlated. A healthy enzyme ratio, otherwise known as the De Ritis ratio, ranges from 0.91 to 1.75. A low coefficient (below one) indicates the presence of liver pathologies. Exceeding the indicator by 2 times indicates destruction of the myocardium.

The concentration of ALT is identified within the framework of blood biochemistry. The enzyme is a marker of the organic state of hepatocytes and liver performance. According to its quantitative content, signs of liver diseases are determined at the preclinical stage, that is, before the appearance of characteristic symptoms of discoloration of the skin and mucous membranes (jaundice).

An increase in the levels of the main enzyme of hepatocytes allows the doctor to assume the presence of:

• hepatitis of various etiologies;
• cancer processes in the liver;
• cirrhosis (all types);
• steatosis (fatty liver);
• fatty hepatosis;
• cholestasis (impaired synthesis and outflow of bile);
• progressive muscular dystrophy;
• toxic liver damage (drug, alcohol, etc.);
• pancreatic diseases;
• cardiac dysfunction.

First of all, pathologies associated with cytolysis (destruction of hepatocytes) come under suspicion. Unsatisfactory results of ALT (ALT) in biochemical analysis require additional verification by laboratory and instrumental methods. Based on blood counts alone, pathology is suspected, but not definitively diagnosed.

Blood biochemistry study parameters

Signs of increasing values

– a method of laboratory study of biofluids in order to identify functional disorders in organs and systems of the body. The study is assigned:

• according to symptomatic complaints of the patient (sustained pain of any localization, digestive disorders, cardiac and respiratory functions, malfunctions of the nervous, endocrine, hepatobiliary system and renal apparatus);
• as part of medical examination;
• for preventive purposes;
• upon contact with patients infected with viral hepatitis;
• to control the therapy of diagnosed diseases.

During the perinatal period, women donate blood for biochemistry several times, which allows timely diagnosis of possible disorders in the body of the expectant mother that negatively affect the development of the child. Particular attention is paid to ALT indicators in a blood test when the patient exhibits symptoms of liver pathologies:

• nausea and heaviness in the epigastric region;
• alternating diarrhea and constipation (constipation);
• loss of interest in food (loss of appetite);
• yellow coating on the tongue and bitterness in the mouth;
• subfebrile (37–38°C) body temperature;
• skin itching (especially in the face);
• change in the shade of excrement to light yellow, dark color of urine;
• pain in the hypochondrium on the right;
• yellowish tint to the whites of the eyes
• chronic flatulence;
• telangiectasia (spider veins) and hematomas of non-traumatic origin;
• swelling.

For diagnosed liver diseases, an analysis for the content of AST and ALT in the blood can be prescribed separately to monitor the dynamics of treatment.

Rules for preparing and submitting analysis

To obtain objective results, a biochemistry analysis should be done after simple preliminary preparation. The patient must comply with the following conditions:

• for 5–7 days, avoid drinking alcohol-containing drinks, because toxic metabolites of ethanol disrupt the synthesis of proteins and enzymes in the liver.
• Eliminate fatty foods and fried foods from your diet in 2–3 days so as not to create additional stress on the liver and pancreas;
• temporarily stop using medications;
• fast before the procedure for at least 8–12 hours.

Why do you need to take the test on an empty stomach? This is due to the fact that any food changes the composition of the blood, and fats make the plasma cloudy. Test results performed on a full stomach will be inaccurate.

ALT reference values

Standard ALT values ​​are classified by gender (men and women) and by age category of the patient. In children, from birth to 6 months, normal levels increase, then change depending on age, and become stable after adulthood.

Reference! The measurement value for alanine aminotransferase is U/L. The coefficient for conversion to the SI system (mmol/l) is 5.6.

The upper limit of children's enzyme levels in the blood should not exceed the following values ​​(in U/l):

Alanine aminotransferase reference values ​​for adults:

When assessing ALT indicators, the obtained AST values ​​are necessarily taken into account. Analysis results are deciphered within 24 hours.

Reasons for deviation from the norm

The enzyme indicator may deviate from the standard values ​​both upward and downward. Both options are unsatisfactory and indicate intense cell destruction. A decreased level of ALT is recorded much less frequently than an increase in the concentration of the enzyme in the blood.

There are two main reasons for the decline in indicators:

• extensive necrosis of hepatocytes as a consequence of advanced chronic liver diseases;
• long-term deficiency in the body of pyridoxine (vitamin B 6).

Vitamin B 6 takes an active part in the production of ALT and AST. With its chronic deficiency, enzymes are synthesized in insufficient quantities. Hyperfermentemia (increased ALT levels) is classified into four degrees:

• light – increase in indicators by 3–5 times;
• moderate – 5–6 times;
• average – more than 6 times;
• high – more than 10 times.

The causes of increased ALT are associated with acute or chronic pathologies of the liver and heart. Myocardial infarction (necrosis of an area of ​​the heart muscle) is presumably diagnosed when the ALT level exceeds the standards by 5 or more times. At the same time, the Ritis coefficient also increases. Acute inflammation of the pancreas results in an increase in enzyme levels by at least 3 times, dystrophy of the muscular system – by 7–8 times.

In viral hepatitis, an increased value of alanine aminotransferase is observed, 20–50 times. There are three main types of viral disease, two additional ones:

• Botkin's disease or hepatitis A;
• serum (hepatitis B);
• post-transfusion or hepatitis C;
• type D and E (diseases associated with the main types).

With toxic (alcoholic) hepatitis, ALT levels can be increased a hundred times. A high level of enzyme in biochemistry results, especially in the absence of pronounced symptoms, is a reason for additional examination. The patient needs to donate blood for an enzyme-linked immunosorbent assay (ELISA) to detect the hepatitis virus.

With incurable cirrhotic liver damage (cirrhosis), the ALT content in the blood can be increased from 225 U/L to 2250 U/L. Results depend on the stage and etiology of the disease. Cirrhosis may have the following etiology:

• viral – formed as a complication of hepatitis A, B, C;
• pharmacological or medicinal – develops with prolonged incorrect use of medications;
• toxic (alcoholic) – occurs as a consequence of chronic alcoholism;
• metabolic-nutritive – formed against the background of chronic pathologies of the endocrine system; cryptogenic (with an unknown nature of origin);
• biliary (primary and secondary) – is a complication of gallbladder diseases;
• autoimmune, the cause of development is a malfunction of the body’s immune system.

The highest ALT level is recorded in viral and alcoholic types of cirrhosis. If there is a suspicion of cirrhotic changes in the liver tissue, the patient urgently needs to undergo an ultrasound of the peritoneal organs.

Other possible causes of elevated enzyme levels include:

• Pancreatic necrosis, otherwise the death of pancreatic cells, as a complication of advanced pancreatitis.
• Cholecystopancreatitis and chronic inflammation of the pancreas. During latent periods of the disease, the level of alanine aminotransferase is slightly increased. A sharp increase in the enzyme in the blood means an exacerbation of the disease.
• Myocarditis (inflammation of the heart muscle). Pathology is diagnosed by comparing ALT and AST levels and calculating the Ritis coefficient.
• Acute and chronic liver diseases (steatosis, steatohepatitis, hepatosis).
• Cancerous degeneration of hepatocytes (more often occurs as a complication of chronic hepatitis and cirrhosis).
• Alcohol, drug or other liver intoxication.
• Chemotherapy course of treatment.
• Heart attack and pre-infarction condition.
• Infection caused by the Epstein-Barr virus (mononucleosis).

If the suspected diagnosis is not confirmed during further examination, false results may mean non-compliance with the preparation conditions (drinking alcohol, eating fatty foods), as well as a state of neuropsychological tension or physical exhaustion at the time of donating blood.

To reduce a high ALT level in the blood, first of all, it is necessary to begin treatment of the underlying disease that affected the test results. Since in most cases, the increased concentration of ALT is due to the development of liver pathologies, drugs of the hepatoprotective group are prescribed:

• Essential phospholipids (complex compounds of alcohols, high molecular weight acids and lipids). Stimulate the regeneration of hepatocytes, stabilize metabolic processes, maintain the balance of proteins, fats and carbohydrates (Essliver, Phosphonciale, Essentiale Forte N, Phosphogliv, etc.).
• Hepatoprotectors-lipotropics. Inhibit or stop fatty infiltration of the liver (Heptral, Betargin, Hepa-Merz).
• Plant hepatoprotectors. Promotes the restoration of liver cells; treatment requires long-term use. The tablets contain natural extracts of medicinal herbs (Liv-52, Silimar, Karsil, Bonjigar, etc.).

Additional therapy is carried out with drugs based on ursodeoxycholic acid (Ursosan, Urdoxa, Ursodez) and lipoic acid, which help neutralize toxins and breakdown products of alcohol. You can lower ALT with diet therapy. A patient with impaired functional abilities of the liver and pancreas is prescribed the “Table No. 5” diet.

A brief table of permitted and prohibited foods for increased ALT in the blood

Important! If ALT levels are too high, any alcoholic drinks are completely excluded from the menu!

Results

Alanine aminotransferase (ALT) is an endogenous enzyme that accelerates the chemical reaction of the amino acid alanine. The main part of ALT is contained in the liver, the rest is localized in the pancreas, myocardium and muscles. In a healthy man, the amount of enzyme in the blood is no more than 45 U/l, in a woman – 34 U/l.

If the levels are significantly elevated, it means that the tissues and cells are pathologically altered and have serious damage, through which alanine aminotransferase enters the bloodstream. ALT levels are determined as part of a biochemical blood test.

In most cases, with an increased enzyme value, liver diseases (hepatitis, hepatosis, cirrhosis, etc.), chronic or acute pancreatitis, and cardiac dysfunction (myocarditis, heart attack) are diagnosed. The diagnosis must be confirmed by a detailed examination, including a number of laboratory tests and hardware diagnostic procedures.