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[11] [12] [13] Levels in the third trimester can be as much as 2-fold greater than in non-pregnant women. [11] As a result, ALP is not a reliable marker of hepatic function in pregnant women. [11] In contrast to ALP, levels of ALT, AST, GGT, and lactate dehydrogenase are only slightly changed or largely unchanged during pregnancy. [11]
The following refer to the "upper reference limit" (URL), also known as the "upper limit of normal" (ULN), which depend on the source and are typically 40-50 U/L (0.67-0.83 μkal/L) for both AST and ALT. While values vary between individuals, the following are typical AST and ALT patterns: [11] [12] [13] [14]
Alanine transaminase (ALT), also known as alanine aminotransferase (ALT or ALAT), formerly serum glutamate-pyruvate transaminase (GPT) or serum glutamic-pyruvic transaminase (SGPT), is a transaminase enzyme (EC 2.6.1.2) that was first characterized in the mid-1950s by Arthur Karmen and colleagues. [1]
FibroTest is independent of ethnic origin, sex, genotype, viral load, transaminases or the presence of comorbidities. The test has been validated in those over the age of 65 years, [12] children, [13] people with chronic kidney disease or kidney transplantation, hemophiliacs, patients with chronic inflammatory disease, and the general population.
The proportion of AST to ALT in hepatocytes is about 2.5:1, but because AST is removed from serum by the liver sinusoidal cells twice as quickly (serum half-life t 1/2 = 18 hr) compared to ALT (t 1/2 = 36 hr), so the resulting serum levels of AST and ALT are about equal in healthy individuals, resulting in a normal AST/ALT ratio around 1.
HELLP syndrome is a complication of pregnancy; the acronym stands for hemolysis, elevated liver enzymes, and low platelet count. [1] It usually begins during the last three months of pregnancy or shortly after childbirth. [1]
Still, the blood values are approximately equal between the arterial and venous sides for most substances, with the exception of acid–base, blood gases and drugs (used in therapeutic drug monitoring (TDM) assays). [6] Arterial levels for drugs are generally higher than venous levels because of extraction while passing through tissues. [6]
It is essential to use age-specific normal reference values, as healthy infants and children usually have levels that would be considered elevated in adults. [4] Additionally, ALP levels are "not well defined" as of 2020, and can vary by sex and by racial group. [5]