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In medicine, the presence of elevated transaminases, commonly the transaminases alanine transaminase (ALT) and aspartate transaminase (AST), may be an indicator of liver dysfunction. [ 1 ] [ 2 ] Other terms include transaminasemia , [ 3 ] and elevated liver enzymes (though they are not the only enzymes in the liver).
Blood testing usually shows markedly high elevations of both liver transaminase enzymes, AST and ALT, which may exceed 10,000 U/L. [9] It has been found that those who suffer from ischemic hepatitis had significant cardiac disease as well.
AST and ALT levels are almost always less than 500. The elevated AST to ALT ratio is due to deficiency of pyridoxal phosphate, which is required in the ALT enzyme synthetic pathway. Furthermore, alcohol metabolite–induced injury of hepatic mitochondria results in AST isoenzyme release.
Associated symptoms are fever, hepatomegaly, jaundice, and anorexia. [50] AST and ALT blood levels are both elevated, but at less than 300 IU/liter, with an AST:ALT ratio > 2.0, a value rarely seen in other liver diseases. [51] In the United States, 40% of cirrhosis-related deaths are due to alcohol. [32]
[70] [71] Generally, AST and ALT are elevated in most cases of hepatitis regardless of whether the person shows any symptoms. [32] The degree of elevation (i.e. levels in the hundreds vs. in the thousands), the predominance for AST vs. ALT elevation, and the ratio between AST and ALT are informative of the diagnosis. [32]
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When GGT levels is elevated, the triglyceride level is elevated also. With insulin treatment, the GGT level can reduce. Other causes of elevated GGT are: diabetes mellitus, acute pancreatitis, myocardial infarction, anorexia nervosa, Guillain–Barré syndrome, hyperthyroidism, obesity and myotonic dystrophy. [6]
Signs and symptoms of alcoholic hepatitis include jaundice (yellowing of the skin and eyes), ascites (fluid accumulation in the abdominal cavity), fatigue and hepatic encephalopathy (brain dysfunction due to liver failure). [3] Mild cases are self-limiting, but severe cases have a high risk of death.