“AlAt” indicator in a blood test: norm and deviations. AlAT and AST in the blood: liver tests for liver enzymes Alat 9 units l what does it mean

09.03.2020 -

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 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 tissues muscular apparatus. Aspartate aminotransferase is concentrated in 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 characteristic symptoms changes in color 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 liver disease;
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

– method laboratory study 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;
V for preventive purposes;
upon contact with patients infected with viral hepatitis;
to control the therapy of diagnosed diseases.

Women during the perinatal period donate blood for biochemistry several times, which allows for timely diagnosis possible violations in the body expectant mother that negatively affect the development of the child. Special attention ALT indicators in a blood test are taken into account when a 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 plaque on the tongue and bitterness in oral cavity;
subfebrile (37–38°C) body temperature;
itchy skin(especially in the face area);
change in the shade of excrement to light yellow, dark color urine;
painful sensations 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:

Avoid drinking alcoholic beverages for 5–7 days, 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, in mandatory, the obtained AST values are taken into account. Analysis results are deciphered within 24 hours.

Reasons for deviation from the norm

The enzyme value may deviate from standard values both upward and downward. Both options are unsatisfactory and indicate intense cell destruction. Reduced level 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 result of neglected chronic diseases liver;
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 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 enzyme immunoassay(ELISA) to detect 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-alimentary – formed against the background chronic pathologies endocrine system; cryptogenic (of unknown nature of origin);
biliary (primary and secondary) – is a complication of gallbladder diseases;
autoimmune, the cause of development is a malfunction immune system body.

Most high rate ALT is fixed in viral and alcoholic types of cirrhosis. If cirrhotic changes are suspected liver tissue, the patient urgently needs to have an ultrasound of the peritoneal organs.

To others possible reasons higher level enzymes 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.
Spicy and chronic diseases liver (steatosis, steatohepatitis, hepatosis).
Cancerous degeneration of hepatocytes (more often, occurs as a complication 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).
Herbal hepatoprotectors. Promotes the restoration of liver cells, treatment requires long-term use. Tablets contain natural extracts 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 elevated, any alcoholic drinks are completely excluded from the menu!

Results

Alanine aminotransferase (ALT) is an endogenous enzyme that accelerates chemical reaction alanine amino acid. The main part of ALT is contained in the liver, the rest is localized in the pancreas, myocardium and muscles. U 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. Determination of ALT level is carried out within the framework of biochemical analysis blood.

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

Alanine aminotransferase and aspartate aminotransferase are endogenous enzymes and are significant markers in biochemical blood tests.

Although an elevated ALT level does not clearly indicate the occurrence of health problems, both enzymes are simply not present in the blood in large volumes.

Yes, both ALT and AST levels can increase with liver problems (such as cirrhosis or hepatitis), but other markers also need to be carefully analyzed. By the way, ALT levels may be elevated if myocardial infarction is diagnosed.

Aminotransferases are a group of enzymes capable of catalyzing transamination reactions, playing a leading role in protein metabolism, as well as maintaining a connection between the metabolism of proteins and carbohydrates. The most significant natural catalysts for transamination reactions in the human body are alanine aminotransferase (otherwise ALT, ALT) and aspartate aminotransferase (otherwise AST, AST).

These enzymes are present in the tissues of many organs. Normally, aminotransferases are practically undetectable in the blood. Minimum activity enzymes is caused by natural regenerative processes in the body. Increased levels of ALT and AST are highly sensitive markers of damage to the tissues in which they are contained.

The method for determining aminotransferases in a biochemical blood test has found wide application in clinical practice due to its high sensitivity and specificity.

AsAT and AlAT. Norm

Normally, aspartate aminotransferase does not exceed 31 U/L in women and 37 U/L in men. In newborns, the level should not exceed 70 U/l.

ALT in women normally does not exceed 35 U/l, and in men – 40 U/l.

Also, the analysis results can be presented in mol/hour*l (from 0.1 to 0.68 for ALT and from 0.1 to 0.45 for AST).

What can affect transaminase levels?

The following can lead to distortion of analysis results:

use of certain medications:
- nicotinic acid,
- immunosuppressants,
- choleretics,
- hormonal contraceptives, etc.),
obesity,
pregnancy,
physical inactivity or excessive physical activity.

How the research is carried out

For analysis, blood is taken from a vein. Results for urgent research are provided within 1-2 hours. With standard diagnostics - within 24 hours.

To obtain the most reliable results you must:

exclude reception medicines a week before the tests (if this is not possible, you must notify the doctor about the medications you are taking);
donate blood exclusively on an empty stomach;
the day before the study, physical activity, smoking, alcoholic beverages, fatty and fried foods are excluded - two days.

What can an analysis of ALaT and AST tell you about?

Alanine aminotransferase and aspartate aminotransferase are characterized by selective tissue activity. If considered in
in descending order of the content of these enzymes in organs and tissues, the list will look like this:

alanine aminotransferase: liver, kidneys, myocardium, muscles;
aspartate aminotransferase: myocardium, liver, muscles, brain, kidneys.

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are enzymes that are active participants in amino acid metabolism. They can be found in the cells of the kidneys, liver, heart muscles and other organs.

If they enter the blood, this indicates the presence of some kind of organ dysfunction due to cell destruction.

When ALT levels are elevated, this most often indicates the development of a certain diseases affecting the liver. A decoding of a blood test can show in more detail which organ is damaged; the level of ALT or AST will be significantly increased in it.

What is ALT in a blood test?

Why is ALT elevated in a blood test, and what does it mean? Alanine aminotransferase (ALT) is an endogenous enzyme belonging to the group of transferases, a subgroup of transaminases, or aminotransferases. Determination of its level in the blood is widely used in medical practice in order to identify pathologies of the liver and some other organs. A blood test for ALT is almost always carried out in conjunction with determining the AST level.

Evaluation of these two laboratory parameters allows the doctor to guess the localization pathological process and determine the likely severity of the disease. For evaluation the Ritis coefficient is applied (AST/ALT ratio), which is normally 1.33. In acute viral hepatitis, this coefficient decreases, while in myocardial infarction and alcoholic liver damage it increases.

Where is ALT found:

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

The main function of alanine aminotransferase is associated with the metabolism of amino acids. This substance acts as a catalyst in the transfer of certain molecules. When energy metabolism is disrupted, permeability increases cell membranes, which leads to cell destruction and release of the enzyme into the blood serum.

Norm

The norms within which alanine aminotransferase in the blood must fit are as follows:

children under 1 year: 13 – 45 U/l;
men up to 1 – 60 years old: 10 – 40 U/l;
women 1 – 60 years old: 7 – 35 U/l.

At analytical studies this enzyme requires high accuracy, and it is directly related to the use of certain drugs that can distort the analytical picture. Therefore, before checking your ALT level, you should consult with your doctor, who will either temporarily stop taking medications or take into account deviations in test results associated with drug therapy.

Increased ALT in the blood: causes

Speaking in simple language, alanine aminotransferase is an enzyme that, in addition to the liver, where its concentration is especially high, is found in literally all parenchymal organs, occupying predominantly the cytoplasm of tissue cells. It is not for nothing that ALT is considered a kind of marker of liver pathology and is regarded as reliable sign damage to its parenchyma, because the activity of the enzyme in the blood plasma is directly dependent on the degree of involvement of the tissue of this important organ in the pathological process.

Given this high sensitivity of ALT, it can be expected that alanine aminotransferase will be elevated in cases of the slightest damage to the hepatic parenchyma.

So, increasing ALT levels happens in following cases :

. This inflammatory disease liver can be presented in several forms. For chronic or viral hepatitis the excess of alanine aminotransferase in the blood is insignificant.
Rarely, an increase in ALT may be observed in cases of obstructive jaundice, however high values This indicator is extremely rare.
. This disease is dangerous because for a long time may not have pronounced symptoms. Patients quickly get tired and feel tired.
Liver cancer. This malignant tumor often occurs in patients with hepatitis. ALT analysis in this case is necessary both for diagnosing the disease and for making operational decisions.
Non-alcoholic fatty liver disease (steatosis): ALT levels increase slightly – 2-3 times. During the transition of the disease to the phase of steatohepatitis, a pronounced increase in ALT is observed, high level general and direct bilirubin, as well as indicators of inflammatory blood activity.
. The presence of this disease is also indicated by the level of ALT. Its increased amount indicates an exacerbation of pancreatitis.
Myocarditis. It manifests itself in lesions of the heart muscle. Its main symptoms are shortness of breath, rapid fatigue of the patient and increased ALT levels in the blood.
. This disease is a consequence of impaired blood flow, resulting in necrosis of cardiac muscle tissue.
Tests may show increased ALT levels during alcoholism and immediately after use alcoholic drinks.

If the ALT level increases by 5 times, myocardial infarction can be assumed; if it reaches 10-15 times, we can talk about the deterioration of the patient’s condition after the attack. The value of the de Ritis coefficient also changes upward.

Acute hepatitis provokes an increase in the enzyme content in the blood by 20-50 times, muscular dystrophy and dermatomyasis - by 8. About gangrene, acute pancreatitis says excess upper limit indicator by 3-5 times.

Reasons for increased ALT not related to diseases

Other reasons can also increase the level of ALT in the blood, for example, some drugs, such as estrogens, oral contraceptives, cholestatics, steroids, iron salts, nicotinic acid, sulfonamides, methyldopa, azithromycin, aminoglycosides, cephalosporins, fluoroquinolones, clofibrate, clindamycin.

In some cases, the cause of increased alanine aminotransferase levels is physiological reasons:

Taking dietary supplements containing components that negatively affect liver cells;

Drinking alcoholic beverages a week before the blood test for ALT;

Emotional stress that can lead to disruptions in work nervous system, and as a result, the body’s reaction to this;

Poor nutrition - in particular, consumption of foods with harmful food additives: semi-finished products, “fast food”, sweet carbonated drinks, etc. – in this case, when adjusting the diet, the ALT level returns to normal.

Of course, mostly the enzyme level increases due to other health problems, but it is for the above reasons that the indicator can be increased, but only slightly.

What to do when ALT in the blood is elevated?

If the ALT blood test is elevated, then more full examination in order to identify the cause of this change. And the sooner this is done, the much more prosperous the outcome will be.

Most often, hepatoprotectors are prescribed to reduce ALT levels:

Heptral;
Essentiale N;
Karsil;
Tykveol.

These drugs have numerous effects. First of all, they protect liver cells from further damage, and also restore cells that are already damaged but not yet dead.

Alanine aminotransferase (abbreviated ALT or Alt) is an enzyme that functions inside various cells human body. Blood contains only small amounts of this substance.

An increase in ALT levels is an important diagnostic criterion, which indicates increased cell destruction due to various pathologies.

The role of ALT in the body and where it is found in the body

Alanine aminotransferase is an essential component of amino acid metabolism. In cells, the enzyme regulates the conversion of alanine, which has many functions, such as energy supply nerve cells, strengthening the immune system, correcting the metabolism of various substances.

ALT is found in:

Liver (highest level).
Lungs.
Pancreas.
Heart.
Kidneys.
Muscles.

How to get tested for AlAt?

To receive correct results The following rules must be observed:

It is best to donate blood in the morning, on an empty stomach.. Food intake can affect the enzymatic activity of the liver and pancreas, causing the results to be overestimated. Therefore, the analysis must be done at least 8 hours after the last meal;
It is necessary to avoid alcohol in any form 7 days before donating blood., because it affects the liver much more than regular food;
Some medications lead to changes in alanine aminotransferase levels, these include: oral contraceptives, acetylsalicylic acid, paracetamol, warfarin. If you are taking anything on this list, tell your doctor.

Normal ALT values for men, women and children

The amount of alanine aminotransferase depends on both age and gender. The enzyme level is influenced by many circumstances, including the so-called “physiological crossovers” in children (changes in the ratio of blood elements), fluctuations hormonal levels, stress and much more.

Normally, ALT is contained in the bloodstream in the following quantities:

Enzyme	Newborns	Children under six months	6 months – 1 year	1 -3 years	3 – 6 years	6 – 18 years old	Adult women	Adult men

ALT	up to 50 U/l	up to 56 U/l	up to 52 U/l	up to 33 U/l	up to 29 U/l	up to 39 U/l	up to 46 U/l	up to 34 U/l

If biochemistry revealed high content ALT, first of all, the doctor should exclude errors in the analysis, taking into account all the indicators during the test.

After confirming that the tests have revealed a real increase in the enzyme, it is worth continuing further research to clarify the location of the pathology.

Depending on the existing symptoms, the patient may be prescribed additional examination of the liver, heart, pancreas or muscles.

If alanine aminotransferase is elevated, this very often indicates liver tissue damage. Exactly this reason is the most common and causes a significant increase in the level of the substance in the blood.

After receiving the biochemistry results, the doctor must calculate the Retis index - the ratio of the amount of aspartate-alanine aminotransferase. Its norm ranges from 0.91 to 1.75.

A reduced index may indicate liver disease, an increased index may indicate liver disease. pathological changes heart muscle.

There are several degrees of increase in alanine aminotransferase:

Reasons for increasing AlAt

An increased concentration of alanine aminotransferase in the blood, when analyzed correctly, indicates the severity of the disease.

Even with liver tumors, the amount of ALT may be increased only slightly if the tumor is in initial stages.
So what should you do if the numbers in your analysis are elevated? How to determine the cause and begin treatment?

An increased level of alanine aminotransferase in the blood is observed after the release of the enzyme from damaged cells. Normally, cells in the body constantly die and are replaced by new ones, but an excess of the level is observed only with massive pathological death, when the enzyme enters the bloodstream in significant quantities

Diseases in which noticeably increased numbers are observed in the ALT analysis include:

Hepatitis (hepatitis types B, C, D are the most dangerous for the liver)– diseases of a viral nature that can be transmitted as by contact(types A, E) and through human body fluids (types B, C, D). This pathology is characterized by a long asymptomatic course. After infection, the first manifestations of the disease may not make themselves felt soon.

Such dangerous disease, like hepatitis C, is “famous” for the fact that the virus destroys liver cells for a long time, and when the first symptoms appear, the process is already quite difficult to treat.

With hepatitis, the amount of ALT becomes significantly higher than normal, in addition, the levels of AST (aspartate aminotransferase) and GGTP (liver gamma-glutamyltransferase) increase.

When analyzed, a significant amount of bilirubin, a bile enzyme produced in liver cells, is detected in the blood:

Cirrhosis– total destruction of organ tissue, in which the organ gradually loses the ability to perform its basic functions.
Liver cancer.
Pancreatitis– inflammation of the pancreas, which very often results in necrosis of the organ tissue. Chronic pancreatitis requires constant monitoring of alanine aminotransferase levels to monitor the course of the disease.

The cause of pancreatitis is most often abuse fatty foods and alcohol. Sometimes inflammation of the pancreas is associated with blockage of the common bile duct, which can cause bile to flow into the gland and damage its cells.

With pancreatitis in an adult there is less sharp jump ALT level than in hepatitis. However, determination of this enzyme by biochemical blood test is mandatory.

Myocardial infarction. This term refers to the death of a certain area of the heart muscle as a result of disruption of the blood circulation process in it. This pathology also leads to an increase in the amount of ALT in the bloodstream. However, it is more characterized by an increase in the level of aspartate aminotransferase. It is this enzyme that will be key in making a diagnosis.
Myocarditis – inflammation of the heart muscle. It is also characterized by the detection of increased levels of AlAt and AsAt during biochemistry.
Other reasons. This includes pathologies such as burns, frostbite, and extensive injuries. muscle tissue. Tumor neoplasms that destroy the tissues of the above organs can also increase the amount of ALT.

If a biochemical analysis determines that your ALT level is elevated, then it’s time to consult a doctor.

Additional examinations will help determine the exact localization of the pathological process and begin treatment in a timely manner.

What can lower the amount of ALT?

A heart attack can be recognized by the appearance of characteristic shortness of breath, chills, changes in heart rate, lowering blood pressure.

How is the treatment carried out?

How to reduce ALT levels? By curing the disease that led to his growth. By stopping the destruction of cells containing alanine aminotransferase, the amount of enzyme in the bloodstream can be returned to normal.

For hepatitis and heart attacks, self-medication will bring nothing but harm.

Serious pathologies such as large heart attacks, pancreatic necrosis, acute hepatitis need to be treated only in a hospital. Without the supervision of specialists, they threaten serious complications, including the death of the patient.

Each pathology must be treated according to a specific algorithm. Since most of them are life-threatening, the choice of treatment should be entrusted to a doctor.

Here are a few general advice to reduce ALT levels:

stop abusing alcohol and medications that affect the enzymatic activity of the liver;
periodically take a course of hepatoprotectors;
limit the consumption of fatty, smoked and spicy foods.

By thus reducing the load on your liver and the body as a whole, you will help it fight the disease.

Only the right lifestyle will help you get away from dangerous complications and maintain health for a long time.

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 cellular structure tissues, promote 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 in the blood of a healthy person during laboratory testing biochemical research alanine aminotransferase is not detected 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 with determination of 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 thing diagnostic value has 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 normal 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 norms in 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 person being examined. In addition, a slight increase in ALT levels is normal in women in the blood during pregnancy. early stages. 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 detected 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 characteristic of the following diseases and states:

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, thrombosis pulmonary artery, 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 concentration of the enzyme in the plasma increases and with such systemic and infectious pathologies, such as vasculitis, mononucleosis, 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 sedatives, barbiturates, oral contraceptives and others. The level of physical activity and intake also influence the growth of indicators. sports nutrition, alcoholic drinks.

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, 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 increased values AlAt and AsAt, especially if the localization of the pathological process has not yet been precisely established. With liver damage, it is usually observed elevated AlAt in the blood, and the content 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 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 such factors as taking dietary supplements and alcohol, 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 the reason becomes drug therapy, 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.