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[1] [2] Other terms include transaminasemia, [3] and elevated liver enzymes (though they are not the only enzymes in the liver). Normal ranges for both ALT and AST vary by gender, age, and geography and are roughly 8-40 U/L (0.14-0.67 μkal/L). [ 4 ]
GGT is also elevated in 30% of the hepatitis C patients. GGT can increase by 10 times in alcoholism. GGT can increase by 2 to 3 times in 50% of the patients with non-alcoholic liver disease. When GGT levels is elevated, the triglyceride level is elevated also. With insulin treatment, the GGT level can reduce.
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.
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]
The ratio of aspartate aminotransferase to alanine aminotransferase is usually 2 or more. [13] In most cases, the liver enzymes do not exceed 500. A liver biopsy is not required for the diagnosis, however it can help confirm alcoholic hepatitis as the cause of the hepatitis if the diagnosis is unclear. [3] [14]
Blood testing includes liver enzymes, serology (i.e. for autoantibodies), nucleic acid testing (i.e. for hepatitis virus DNA/RNA), blood chemistry, and complete blood count. [33] Characteristic patterns of liver enzyme abnormalities can point to certain causes or stages of hepatitis.
According to NICE guidelines, statins can continue unless liver enzyme levels double within three months of starting statins. [66] Treatment with pentoxifylline is not recommended. [14] Omega-3 fatty acids may reduce liver fat and improve blood lipid profile but do not seem to improve liver histology (fibrosis, cirrhosis, cancer). [14]
Elevated levels of CDT suggest recent heavy alcohol consumption, especially if other liver-associated enzymes (such as GGT) are elevated. Although recent heavy alcohol use is most commonly associated with elevated CDT, certain rare liver disorders can also increase levels of CDT.