Alanine aminotransferase (ALT) – the norm and test results

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ALAT, ALAT, alanine aminotransferase – these are some names of the indicator enzyme, cytoplasmic origin. It is found in liver cells, skeletal muscle, heart, and kidneys. Increased ALT concentration may indicate impaired liver function. The ALAT test also monitors liver damage.

ALAT is an intracellular enzymewhich is involved in protein metabolism and is found mainly in liver cells. It is slightly less common in the heart muscle, skeletal muscles and kidneys. There are trace amounts of this enzyme in the serum of a healthy person. Only liver dysfunction causes alanine aminotransferase to be released into the blood and visible in the test.

Testing this enzyme helps diagnose liver disease and is often necessary for routine testing. Elevated levels of alanine aminotransferase may indicate hepatitis, cholangitis, liver damage, or liver cancer, among others. Alkaline phosphatase, bilirubin, and aspartate aminotransferase are often performed simultaneously with the ALAT test. In addition, it allows the detection of changes in bile stasis and the assessment of protein synthesis. It controls the load on the liver with contraceptive preparations. The examination does not require any special preparation.

The ALAT concentration test consists in a single blood sampling from a vein in the arm. Any yellowing of the skin and mucous membranes that may suggest impaired metabolism of bilirubin should be disturbing. Other equally disturbing symptoms that should prompt you to consult a doctor are: flatulence, loss of appetite, abdominal pain on the right side, muscle cramps, bleeding from the nose and gums, nausea and vomiting.

In men, impotence and loss of hair in the armpits and in the pubic area are worrying. In turn, in women, the indication for a medical visit should be menstrual disorders and infertility. The doctor may also order ALT for people with possible viral hepatitis, people taking permanent medications that can damage the liver (e.g. birth control pills), diabetics, obese people and people abusing alcohol.

The material needed for the study is serumwhich, after collection, is forwarded for further laboratory analysis. The patient should be fasting for at least eight hours prior to collection. The doctor may refer us to the ALT concentration test when:

  1. there is a suspicion of liver disease (especially damage in the course of viral inflammation and damage under the influence of alcohol)
  2. differentiates jaundice
  3. suspects liver damage as a result of poisoning with pesticides, carbon tetrachloride (then: yellowing of the skin and mucous membranes, nausea, vomiting, abdominal pain, rapid weight gain)
  4. monitors liver damage during the treatment of hyperlipidemia
  5. there was a muscle injury.

TEST TOOL not only is it used to monitor liver damage, it is also used in people who abuse alcohol or are taking medications that can damage the liver. The indication for the examination is also the suspicion that the patient may have been infected with viral hepatitis (viral hepatitis). However, before the examination is performed, inform the doctor about the drugs you are taking, especially those that may affect the test result (e.g. oxacillin, erythromycin, opiates, salicylates, diclofenac). Women expecting a baby should also inform a specialist about this fact.

Waiting time for the ALAT test result: 1 Day.

Standard: not more than 510 nmol / l / s.

The test result may be distorted by:

  1. drinking coffee,
  2. eating chocolate,
  3. physical activity.

Depending on gender and age, the norms are as follows:

  1. women
  2. men
  3. children (1-15 years old)

ALAT test – interpretation of results

A high concentration of ALAT (alanine aminotransferase) is a consequence of the release of this enzyme from damaged cells. Its elevated level is most often associated with liver diseases, such as:

  1. cirrhosis,
  2. acute and chronic viral hepatitis,
  3. alcoholic hepatitis
  4. drug-induced hepatitis,
  5. liver damage due to toxic poisoning with fungi, halothane and carbon tetrachloride,
  6. primary tumor of the liver,
  7. fatty liver,
  8. extrahepatic cholestasis.

ALT levels (along with an increase in AST) are also elevated in other conditions:

  1. skeletal muscle damage,
  2. myocardial necrosis (e.g. cardiac surgery)
  3. during pregnancy,
  4. after acute physical exertion,
  5. as a result of the use of preparations lowering cholesterol,
  6. due to taking psychotropics,
  7. with primary carnitine deficiency.

High levels of this enzyme are also observed in obese people, Wilson’s disease, infections (eg HBV, EBV, HSC, HAV) and in rapidly developing leukemia.

While decreased values ​​of alanine aminotransferase can be observed in the case of vitamin B6 deficiency, in malnourished people and patients with genitourinary system infection.

ALAT and AST

The determination of the ALT level is also often performed with the activity of AST (aspartate aminotransferase). This is to determine which conditions have led to cell damage. When analyzing the test result, the doctor takes into account not only the independent values ​​of these enzymes, but also the ratio of the activity of AST to ALAT, called the so-called Ritis indicator. Most people with liver disease tend to have ALT levels higher than AST, while the AST to ALAT ratio is low.

Do you need a referral or want to discuss the test results? Make an online appointment with your doctor without leaving your home. Make an appointment and send the test results to the specialist.

So when is a high AST / ALAT ratio observed?

  1. cirrhosis
  2. alcoholic hepatitis
  3. acute hepatitis,
  4. liver damage resulting from blockage of the outflow of bile.

In turn, in people whose AST to ALAT ratio is less than 1, and the ALAT itself is three times elevated, we can suspect:

  1. fatty liver,
  2. acute viral hepatitis AE,
  3. chronic viral hepatitis B or C,
  4. Wilson’s disease,
  5. hemochromatosis,
  6. celiac disease,
  7. toxic or drug-induced liver injury.

Chronic abdominal pain, abdominal obesity or diabetes should be grounds for laboratory analysis of liver function.

If the ratio of AST to ALAT is higher than 1, and ALT itself is increased fivefold, there are suspicions:

  1. heart attack,
  2. cirrhosis of the liver,
  3. alcoholic liver disease
  4. the occurrence of myopathy,
  5. thyroid disease,
  6. strenuous physical exertion.

In general, in the diagnosis of liver diseases, in addition to the determination of ALT and AST, the levels of alkaline phosphatase, lactate dehydrogenase and bilirubin are additionally performed.

Elevated ALT in pregnancy

High levels of ALAT and AST in pregnant women occur when she suffers from cholestasis. It is a very common liver disease that occurs only in pregnant women, most often in the third trimester of pregnancy. Intrahepatic cholestasis is caused by stagnation of bile, which in turn leads to increased levels of bilirubin, enzymes and bile acids. The most common symptoms of this condition are:

  1. jaundice,
  2. nausea,
  3. lack of appetite
  4. enlarged liver.

The diagnosis of this disease is very important because, if ignored, it leads to premature birth and even death of the fetus.

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