Alat increased by 9 units. Blood test alat and asat are elevated what does this mean

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 him, metabolic processes, which helps strengthen immune system, providing the body with the necessary energy reserves, as well as the production of 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 in large quantities penetrates the blood. Its presence, exceeding acceptable values, becomes an important indicator for the diagnosis of certain diseases.

The presence of alanine aminotransferase is characteristic of 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 detected in biochemical analysis high blood ALT levels.

Indications for analysis

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

This is why blood biochemistry is assessed. Analysis reveals deviations and becomes an integral part preventive measures, 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 feces and dark urine;
• lack of appetite;
• general weakness.

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 the background elevated temperature bodies. Cirrhosis is characterized by the accumulation of fluid in abdominal cavity, 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, acute 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

Revealing high level 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;
• avoiding alcohol and quitting smoking;
• limiting physical activity.

In case of use medications The doctor should be notified.

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. From the table it is clear that permissible concentration of this substance depends not only on age, but also on gender:

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. Besides, high values are found even in minor diseases of other organs, when they are accompanied by cell destruction.

Among them:

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 of the liver. 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 of 10-12 times 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: excess of the norm by 20-45 times.

Other reasons

In addition to diseases, factors causing upward deviation of ALT values ​​include physiological reasons. 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 get your numbers back to normal

Exceptional information content of blood biochemistry results for ALT, allowing diagnosis wide range 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 integrated approach To eliminate the problem is further examination 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 that are particularly severe clinical course, involve conducting a treatment course in a hospital setting.

These include:

• pancreatic necrosis;
• extensive myocardial infarction;
• acute and infectious hepatitis;
• cirrhosis of the liver;
• 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:

• Essentiale N;
• Heptral;
• Karsil;
• Tykveol.

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 drugs 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.

ALT is an enzyme from the group of transaminases, the full name of which is alanine aminotransferase. Its level is determined by a biochemical blood test. The substance is released during all metabolic processes, but in small quantities.

An increase in ALT concentration may indicate damage internal organs. Largest reserves enzyme in the liver, therefore it is considered a marker of pathologies of the hepatobiliary system. The enzyme enters the blood during the destruction of parenchymal organs and muscle tissue, which doctors determine by comparing its level and other biochemical indicators.

What is ALT and its role in the body

Alanine aminotransferase is a protein substance necessary for amino acid metabolism. Together with other similar enzymes, low molecular weight proteins are transported in this way:

• ALT is responsible for alanine;
• AST (aspartic aminotransferase) - for aspartic acid;
• GGTP (gammaglutamyl transpeptidase) - for glutamic acid.

The active part of the enzyme is detached by the coenzyme pyridoxine (vitamin B6). ALT is present in all organs and muscle tissue. Increased concentrations of the enzyme are detected in parenchymal structures. Largest quantity contained in the liver. In lower concentrations, ALT is determined in tissues:

• heart muscle;
• pancreas;
• kidney;
• lungs.

A small amount of the substance enters the blood during metabolism. The bulk is in the organs in a bound form. Here's the enzyme:

• regulates metabolic rate;
• participates in immunity;
• involved in energy synthesis;
• supports cell vitality.

ALT is released in large quantities during mass cell death. The more enzyme is released, the more intense the destruction process. Determining the level of ALT refers to liver tests, since it is when this organ is damaged that the deviation in enzyme levels is most noticeable.

ALT level is an unstable indicator. It depends on age and gender. The amount of enzyme can change due to hormonal fluctuations and changes in the concentration of vitamins and minerals. The level depends on the characteristics of a person’s metabolism and other individual factors. Stress can affect ALT levels physical exercise, medications, some aspects of the patient’s lifestyle.

Table - ALT norms in blood by age

Population category	Reference value, U/l
Newborns 1–2 days	Up to 31
After 3 days of life	Up to 50
1‒6 months	Up to 56
6‒12 months	Up to 52
1‒3 years	Up to 33
3‒6 years	Up to 30
6–18 years	Up to 26
Adult women	Up to 35
Adult men	Up to 40
Pregnant	Up to 32
Aged people	19‒30

Indications for analysis

A blood test for ALT is carried out for the purpose of prevention, to assess the condition of the body as a whole, the preservation of the functions of internal organs, the balance of electrolytes and vitamins. The study is relevant for early diagnosis diseases, since it reflects the slightest changes in the main parameters of the blood and complements the information obtained from its general analysis. It is prescribed for suspected somatic diseases And functional disorders, the reason is the patient’s complaints.

Table - Symptoms for which ALT needs to be assessed

Category	Alarm Signals
Signs of liver pathologies	Jaundice (icterus of the sclera, discoloration of the skin and mucous membranes, darkening of urine, discoloration of stool) Pain in the right hypochondrium Digestive disorders (alternating constipation and diarrhea, flatulence)
General disorders	Sleep disorders (nightmares, insomnia) Psycho-emotional instability (irritability, tearfulness, apathy, aggression) Lack of appetite Weakness, fatigue
Other	Low-grade fever Headaches, chest pressure Dry mucous membranes Brittle nails and hair Sweating

In addition to heart and liver diseases, damage to the pancreas can be suspected based on ALT levels. Alcoholics, as well as people who regularly consume fatty, fried, smoked foods, are prone to pancreatitis and pancreatic necrosis.

Deviations in biochemical data are observed in cases of extensive injuries (burns, electric shocks, muscle injuries), bone fractures, and hematological pathologies. ALT is often elevated after surgery. Physiological prerequisites for an increase in enzyme levels are stress, strain, and carbohydrate diets.

Drugs that increase ALT include oral contraceptives, glucocorticosteroid hormones, chemotherapy agents, antibiotics and antivirals.

Minor and pathological deviations

Assessing the degree of fermentemia (the presence of enzymes in the blood) is not considered an accurate measure for diagnosing diseases. Based on the analysis data, one can only suspect the presence of pathological processes, as well as their intensity. To draw conclusions correctly, you need to be guided by standards, permissible deviations, as well as their combinations with each other.

Since ALT always indicates cell damage, minor violations of reference values ​​(by 2-3 units) are considered physiological. Such changes are not considered a reason for further examination and are simply ignored. If the level of increase is greater, you need to look for its cause. You can suspect it by how much the ALT indicator changes:

• up to 2 times - possible error during analysis, violation of preparation rules, severe stress, overwork, carrying out medical procedures the day before, you need to retake the test;
• 2-3 times - suspect alcohol consumption, significant errors in diet, injury, excessive physical activity;
• 3-5 times - such an increase is observed against the background of the use of hepatotoxic drugs, injuries to internal organs, after surgical interventions, burns, as well as chronic pancreatitis;
• 5 or more times - inflammation of the liver tissue may be suspected due to an infectious lesion;
• 10 times - muscle dystrophy is possible, chronic diseases liver or initial forms of destructive processes;
• 20 times or more - dangerous liver diseases, cancer progression, cirrhosis.

ALT and other indicators

In order to assess the patient’s condition with maximum accuracy, doctors analyze not only the compliance of each individual indicator with the norms, but also the combination of deviations. In serious diseases, deviations affect most biochemical parameters.

Together with ALT, the importance of another enzyme, AST, is considered. It is also present in the cells of parenchymal organs, but the bulk is concentrated in the heart muscle.

U healthy people the AST level exceeds ALT by approximately 1.5 times. In the opposite situation, metabolic disorders can be suspected when proteins are consumed to obtain energy, and carbohydrates are stored as reserves.

The de Ritis index is considered important for diagnosis. This is the ratio of AST and ALT. Its norm is 1.33, a deviation of 0.4 units upward or downward is allowed. A significant increase in the index is observed with myocardial damage (more than 2). The index approaches 2 with chronic alcoholic liver damage. Pathologies of the hepatobiliary tract provoke a significant decrease in the indicator. In most cases, elevated ALT is accompanied by an increase in bilirubin concentration.

To detect liver diseases, it is important to evaluate several enzymes (ALT, AST, alkaline phosphatase, gammaglutamyl transpeptidase) and the degree of their abnormalities. The larger they are, the more intense pathological process and the higher the threat to the health and life of the patient.

Table - Deviation of enzyme levels

Light and moderate impairment observed in non-alcoholic fatty liver disease, chronic viral hepatitis, as well as in the initial stages of the development of tumor diseases. An average increase accompanies chronic inflammatory lesions of the gland and ethanol poisoning. A significant increase in indicators is observed in acute forms of hepatitis, toxic damage, as well as in the later stages of cancer or cirrhosis.

Why is ALT elevated during pregnancy?

During pregnancy female body undergoes total changes. First of all, metamorphoses affect hormonal levels. Concentrations of bioactive substances constantly increase until childbirth. The enlargement of the uterus and baby is accompanied by pressure on the internal organs. All of them suffer from increased stress associated with the need to supply the fetus with nutrients, utilize the products of its metabolism, and increase blood volume.

Normal level ALT for pregnant women should be below 32 U/l. The rate increases slightly in the first and third trimester. Moderate changes are considered a variant of the norm. If a woman did not suffer from heart or liver disease before conception and does not complain of poor health, treatment is not required. The growth of indices by more than 1.5 times requires increased attention. This may be a signal of the development of gestosis, eclampsia, diseases of cardio-vascular system, liver or gallbladder. This often happens in the background long-term use gestagen drugs - Duphaston, Utrozhestan, Susten.

ALT in children

The concentration of alanine aminotransferase is increased in children of the first year of life. This is due to the active development of organs and systems, adaptation mechanisms that are aimed at adapting to life outside the mother’s womb. The second peak occurs during puberty. At this time, the child is growing rapidly, and hormonal levels are developing. As development slows, ALT levels decrease and remain stable. If enzyme levels are greatly elevated, this indicates dangerous diseases(same as in adults).

What to do if ALT is elevated

In most cases, doctors recommend taking the test again (in case of an error during the blood test or violation of the preparation rules). Additional examination is prescribed only if significant deviations are detected again. It often includes a general blood and urine test, ultrasound of the liver and other internal organs, MRI or CT, and tests for tumor markers.

IN various laboratories Different equipment is used for analyzes and different units of measurement are used. In this case high rate may be perceived by the patient himself as a deviation, when in fact there is none. In addition, ALT needs to be assessed along with other values. Without special knowledge, it is difficult to correctly understand the results.

If there are deviations in blood biochemistry results, you should consult a doctor. The child should be shown to a pediatrician, pregnant women should make an appointment with their obstetrician-gynecologist, and adults should make an appointment with the doctor who prescribed the examination or with a therapist. It is better not to draw independent conclusions, but to entrust the reading of the research protocol to a specialist.

In addition to the analysis itself, it is important to collect a family history, interview the patient for complaints, and conduct a physical examination to detect objective symptoms of the pathology. All this will help narrow down the search for the disease that caused the increase in ALT.

How to be treated

ALT level is a laboratory indicator, a sign of destruction of cells of parenchymal organs. The enzyme elevation itself cannot be treated. Therapy is completely aimed at the underlying disease, which provoked a shift in the result outside the normal range. It is important to stop destructive processes and start organ regeneration (if possible). In case of irreversible changes, the task of treatment is to slow down the destruction and provide surgical care(liver transplantation, for example).

The list of medications depends entirely on the nature of the disease (for infections, antiviral or antibiotics are prescribed, for cancer pathologies, chemotherapy drugs are prescribed). The treatment regimen is selected based on the patient’s condition. If the ALT level is significantly exceeded, the patient is observed in the hospital (hepatitis, cirrhosis, cholestasis). Minor deviations that do not pose a threat to the patient’s life can be corrected on an outpatient basis.

The main group of drugs that are used when enzyme levels deviate from the norm are hepatoprotectors. The products in this group have antioxidant and anti-inflammatory properties. They improve the functioning and trigger the restoration of hepatocytes, optimize the synthesis and properties of bile, preventing its stagnation in the ducts.

Most of the hepatoprotectors have anti-inflammatory properties. The majority of these drugs have similar indications. Some of them are used in the complex therapy of hepatitis, hepatosis and cirrhosis, and some are used for disorders of the biliary tract accompanied by cholestasis (cholelithiasis, cholelithiasis).

Table - The best hepatoprotectors

FAQ

Question: Is a diet necessary for elevated ALT?

Answer: Diet therapy is a mandatory aspect complex treatment any liver pathology. Its task is to reduce the load on the gland, ensure normal outflow of bile and optimize metabolic processes. A therapeutic diet is recommended even for minor deviations in children and pregnant women, so as not to aggravate liver damage. It is also necessary to adjust the diet in cases where it is necessary to be treated with drugs that are dangerous to the organ ( antiviral agents or powerful antibiotics). In most cases, doctors recommend adhering to the Pevzner 5 diet (for diseases of the liver, gallstones, and pancreas).

Question: The diet menu is so complex... Is it possible to briefly describe general principles nutrition with high enzymes?

Answer: Everything harmful is excluded from the diet - fatty, fried, smoked, flour, sweets, canned food, marinades and pickles, fast food, soda and alcohol. The menu should include all types of cereals (except pearl barley), easily digestible proteins (chicken, fish, turkey, dairy products), lots of vegetables and fruits (in any form). It is important to replace animal fats with cold-pressed vegetable oils (to season porridges and salads with them), and to introduce nuts into the menu. You need to eat fractionally, in small portions, every 3 hours to optimize the secretion of bile. Should be observed drinking regime(1.5 liters of water per day, excluding other liquids).

Question: Is it possible to reduce the rate folk ways(without drugs and diets)?

Answer: As part of complex therapy for liver pathologies, you can use herbal remedies (decoctions and infusions). For example, liver extract, Hepatofit tea, milk thistle meal. People recommend brewing corn silk, dandelion root, yarrow, St. John's wort, peppermint. All these methods can be auxiliary or used to prevent bile stagnation. When treating serious diseases, herbs alone cannot be used. Moreover, herbal medicine and vitamins can only cause harm during the development of cancer pathologies. Before using any traditional recipe, it is better to consult your doctor.

Question: Can high ALT be a false result?

Answer: Maybe. An error should be suspected if only this indicator is increased or the deviations are minor (up to 2 times). This is why biochemistry often has to be retaken. To be on the safe side, you should prepare properly for the test:

• Avoid alcohol and medications a week before donating blood;
• limit junk food for 3 days;
• eliminate stress, overexertion and physical activity on the eve of the analysis;
• Donate blood only in the morning, on an empty stomach.

Even if all conditions are met, but the result shows deviations, it is better to repeat the analysis. This will eliminate pointless visits to doctors and costs for hardware diagnostic methods.

Question: By what symptoms can you understand that ALT is elevated and it’s time to take a biochemical blood test?

Answer: An increase in the level of enzymes in the blood does not cause specific symptoms. By clinical signs one can only assume the presence of a disease that can provoke ALT deviations from the norm, for example:

• damage to the pancreas is accompanied by girdle pain in the abdomen, nausea, vomiting, flatulence, stool disorders, and fever;
• liver pathologies are manifested by pain under the right rib, jaundice, periodic disorders in the gastrointestinal tract, general disorders;
• heart disease can be suspected by pressure and stabbing pains in the chest (often radiating to the arm, shoulder blade, collarbone), shortness of breath, swelling, cyanosis of the extremities.

conclusions

ALT is an important laboratory sign that helps assess the health of internal organs. Average norm for adults and children school age- 35 U/l. Deviations mainly indicate diseases of the liver, heart, pancreas and can indirectly indicate pathology of the kidneys and lungs. When ALT levels increase, liver disorders, or more precisely, cell destruction, are first suspected. To accurately determine the problem, ALT is considered in combination with bilirubin and other enzymes. A full diagnosis can be made by comparing the results of biochemistry, general analysis blood and urine, ultrasound of internal organs. It is not high ALT that needs to be treated, but the disease that caused its increase.

Along with ALT, another enzyme is always considered - A WITH T (aspartate aminotransferase). In women it should be up to 31 U/l, in men up to 41 U/l. An increase in the concentration of AST in the blood indicates the destruction of cells of the heart, liver, pancreas and other organs.

IN modern world Almost every time a diagnosis is made, doctors send patients for blood tests to determine the number of red and white blood cells. But in Lately people are increasingly being sent for tests to determine the amount of enzymes such as ALT and AST

What are AlAT and AsAT?

Alanine aminotransferase, abbreviated ALT, is a cellular enzyme involved in nitrogen and energy metabolism, as well as in the synthesis of various amino acids. Alanine aminotransferase is present in all tissues of the body, but in to a greater extent it concentrates in the tissues of the heart, liver and kidneys. ALT is predominantly localized in the cell cytoplasm.

Aspartate aminotransferase, abbreviated AsAT, is another enzyme involved in the synthesis of amino acids. Aspartate aminotransferase is also present in all tissues of the body. The largest amount of AST is found in the heart and skeletal muscles liver, lungs, kidneys and tissues nervous system. AST is concentrated not only in the cell cytoplasm, but also in mitochondria.

Both of these enzymes are an intracellular component, therefore, in the absence of pathologies, their content in the blood is quite small. In turn, an increase in the level of these enzymes promotes their transport from cells to the blood, which indicates massive destruction of cellular structures.

Selective tissue localization makes it possible to consider aminotransferases as marker enzymes: ALT for the liver, AST for the heart.

The indicators of both transferases have important diagnostic value.

Thus, an ALT test is often prescribed for suspected liver damage of various origins. And an AST test can also show cardiac pathologies that are not detected by an electrocardiogram (for example, myocardial infarction).

If the AST value significantly exceeds the norm, then the so-called de Ritis coefficient is often calculated.

The de Ritis coefficient is the ratio of the proportions of both transferases in the blood, named after the Italian scientist Fernando de Ritis, who in 1957 first proposed its use for diagnosing liver damage.

By calculating the de Ritis coefficient, you can determine the etiology of liver damage, for example, viral, dystrophic or alcoholic, and together with the study of albumin content, you can also judge cardiac pathologies.

Norms of indicators

The amount of ALT enzyme present is measured in units per liter and changes with age. Thus, the value of alanine aminotransferase in infants is always overestimated. This is explained by the fact that after labor activity A lot of hemoglobin enters the baby’s bloodstream, which breaks down in the body over 3-5 weeks. As a result of this process, bilirubin is formed, which causes an increase in ALT. This physiological process is called postpartum jaundice.

The following norms for ALT values ​​are noted:

1. The first five days after birth, the ALT level reaches 49 U/l. Subsequently, it can increase up to 60 U/l.
2. Starting from six months of age, the amount of ALT content decreases to 54 U/l.
3. By the age of three, this figure is about 33 U/l.
4. At the age of six years, the norm is considered to be 29 U/l.
5. After six years of age, it can grow again up to 39 U/l.
6. IN adolescence the value is differentiated and related to the gender of the child, so for boys it can reach 27 U/l, and for girls only 24 U/l.

Blood alanine aminotransferase level adult woman is equal to 31 U/l, while for males the norm is 41 U/l.

It should be noted that an increase in the level of alanine aminotransferase in a woman during the first trimester of pregnancy is considered normal, while in later stages it can indicate the so-called gestosis - a complication of pregnancy, also called preeclampsia.

The normal concentration of AST in women is considered to be no more than 31 U/l, while in men it reaches 37 U/l.

Depending on age and gender, the following norms for this enzyme are noted:

1. High levels of aspartate aminotransferase are characteristic of infants under 5 days of age. During this period of life it reaches 97 U/l.
2. By the age of one year, the presented indicator reaches 82 U/l.
3. By the age of six, the enzyme level drops to 36 U/l.
4. At 11-18 years of age, the content of AST in the blood differs between sexes. So, in boys this figure is approximately 28 U/l, while in girls it does not exceed 25 U/l.

During pregnancy, the content of AST in women's blood may differ from the norm not only more, but also less.

Deviations from the norm in the content of enzymes in the blood can indicate a number of pathologies. Thus, myocardial infarction causes an increase in the concentration of AST by 10, or even 20 times. With coronary insufficiency, this indicator increases sharply during the day, after which it gradually returns to normal.

Stable increased rate AST for several days serves as evidence of the patient’s critical condition, and with a further increase in the indicator, it is grounds to assume an increase in the area of ​​damage to the organ.

Sometimes an increase in ASTT can be observed in healthy people. It can be caused by anticancer drugs, antidepressants, oral contraceptives, a number of sedatives, as well as alcohol intake or recent physical activity.

Reduced enzyme activity may occur with vitamin B6 deficiency or recent hemodialysis.

A decrease in ALT can be caused by severe necrosis of liver tissue, as well as by drugs containing phenotheazine and aspirin.

Reasons for the increase

The process of cell death is associated with the following reasons: trauma, oncology, exhaustion, heavy physical activity, stress, in this case the AST enzyme leaves the dead cells and enters the blood. This process leads to the fact that the enzyme noticeably increases its quantitative indicator (about 2-20 times) in human blood.

An increase in this indicator occurs with problems and functional deviations of the following organs:

• liver and gall bladder (liver cancer, various hepatitis, amoeboid infections, inflammation of the bile ducts);
• heart (coronary insufficiency, myocardial infarction, angina pectoris, rheumatic carditis);
• skeletal muscles – injuries and dystrophy of muscle muscles;
• pancreas (phlegmon of retroperitoneal tissue, acute pancreatitis);
• infectious diseases (vasculitis, viral mononucleosis).

If the quantitative indicators of the enzyme increase, this may indicate that pathological course the disease involved neighboring tissues. It is worth considering that in patients with angina and cirrhosis, the amount of AST does not go beyond the normal range.

AST and ALT

The causes of an increase in the enzyme in the blood can also be diseases of a number of organs (primarily the heart and liver). In this case, doctors are faced with the task of identifying the disease of which particular organ caused the change in the AST enzyme coefficient in the blood serum.

Moving on to the AlAT enzyme, it can be noted that the analysis of biomaterial to identify the quantitative coefficient of AlAt is carried out in medical institutions, in order to diagnose diseases developing in the liver, bile ducts, skeletal muscles, as well as to identify diseases of the heart muscle.

A diagnostician can give a referral to donate blood to determine the ALT enzyme if he wants to get a more complete diagnostic picture and identify certain disorders in the human body. This referral is usually given if the doctor wants to know about the effect of medications or other toxic drugs on the liver. Hepatitis can also be an important reason to take ALT. The indicators of this enzyme reflect the degree of liver damage in the human body. Besides, this analysis V mandatory taken from blood donors.

You can find out reasons for concern about your health and the need to get tested for ALT from your doctor or if you find one of the following symptoms:

• general malaise;
• attacks of nausea or vomiting;
• weakened appetite;
• change in urine color;
• yellowing skin;
• change in stool color;
• regular abdominal pain, as well as bloating.

In order to get the most accurate result of an ALT test, you need to properly prepare your body. Biomaterial, in this case blood, is donated early in the morning on an empty stomach. The last meal before the analysis should take place no later than 8 hours. Blood is taken from a vein.

The ALT level may be exceeded in the following cases:

• unbalanced diet;
• viral infections;
• pancreatitis in the acute stage;
• burns of large areas of skin;
• state of shock;
• mononucleosis;
• problems of the hematopoietic system;
• muscular dystrophy.

Treatment

If, after visiting a doctor, you find out that the level of AST in the blood is exceeded, then you urgently need to remove the factors that caused such changes in the body. The right decision would be to give up alcoholic beverages and select alternative treatment, which would not cause such biochemical changes.

The concentration of AST in the blood should be reduced under the supervision of a physician. During the treatment process, the patient should consult a cardiologist and hepatologist.

When carrying out treatment, you need to pay attention to inflammatory processes in the body, as well as heart and liver diseases, which can lead to such an excess of the norm. In such cases, the patient requires hospitalization, treatment and periodic monitoring of the enzyme level in the blood.

In order to lower the concentration of ALT in the blood, it is necessary to find out exactly what pathology caused the changes in the body and begin to treat it. When treating the liver, which usually causes an increase in ALT, medications are prescribed that improve stomach function, hepatoprotectors and choleretic drugs. When using the above remedies, you should consult a doctor, since such drugs have a number of contraindications.

The enzyme ALT or alanine aminotransferase fulfills its purpose inside cells. The peripheral blood contains a small amount of it. 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:

• Liver (most of all);
• Kidneys;
• Lungs;
• Pancreas;
• Muscles;
• Heart.

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 In this regard, C is 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. Causes of development - abuse of fatty foods and alcohol or stones in biliary tract. Patients with chronic form pancreatitis, it is necessary to check this indicator throughout life to prevent exacerbation.

Myocardial infarction is the destruction of a section of the heart as a result of occlusion of the supply artery. When cardiomyocytes die, ALT in the blood will also be increased. In addition, the level of AST also increases, and to a greater extent than ALT, since its content in heart cells is much higher. Thus, deciphering the biochemical analysis can show why ALT and AST are increased.

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

Myocarditis – inflammatory disease heart, 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 complete absence 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 of the following type appear on the body: spider veins, enlargement of the abdomen due to ascites (accumulation of fluid in the abdominal cavity).

Varicose veins veins (esophagus, stomach), which may 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

Main symptom with myocardial infarction - severe, burning pain behind the sternum, which can spread to the left arm, jaw, 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, there may be a violation heart rate, drop in blood pressure. 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, the reasons for the increase in ALT, is carried out by doctors using all available methods research. 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 install correct diagnosis and start 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!