Liver function test: Difference between revisions

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In clinical [[medicine]], '''liver function tests''' include serum tests such as the transaminases alanine transaminase<ref>{{MeSH|Alanine transaminase}}</ref> (ALT) and aspartate aminotransferase (AST)<ref>{{MeSH|Aspartate aminotransferase}}</ref>.
In clinical [[medicine]], '''liver function tests''' include tests for:<ref name=Covin>{{citation
 
| title = Liver and Gallbladder Pathology
The AST and ALT were formerly called glutamic-oxaloacetic transaminase (SGOT) and glutamic-pyruvic transaminase (SGPT).
| author = Covin, RB
 
| publisher = University of Medicine and Dentistry of New Jersey
| date = April 4, 2006
| url = http://www2.umdnj.edu/pathpweb/Lectures/Liver%20and%20GB%20Pathology%20-%20Covin%202006.pdf}}</ref>
{{col-begin}}
{{col-break|width=50%}}
{|
|- valign=top
|
*Surrogates for hepatic cell breakdown
**Transaminases
***[[alanine transaminase]]<ref>{{MeSH|Alanine transaminase}}</ref> (ALT)formerly called glutamic-pyruvic transaminase (SGPT)
***[[aspartate aminotransferase]] (AST)<ref>{{MeSH|Aspartate aminotransferase}}</ref>, formerly called glutamic-oxaloacetic transaminase (SGOT)
**[[Lactic dehydrogenase]]
*Indicators of obstruction
**[[Alkaline phosphatase]]
**5’-NT (5-nucleotidase)
**GGT ([[gamma-glutamyltransferase]])
**[[Bilirubin]]
*Hepatic synthetic function
**Protein
***[[Albumin]]
***[[Globulin]]
***[[Albumin-globulin ratio]]
{{col-break|width=50%}}
*[[Coagulation|Coagulation factors]]
**[[Prothrombin time]]
**[[International normalized ratio]]
*Tumor markers
**[[alpha-fetoprotein]]
*Special
**Copper metabolism
***[[Ceruloplasmin]]
**[[Human iron metabolism]]
***[[serum iron]]
***[[total iron binding capacity]] (TIBC) % transferrinsaturation
***[[ferritin]]
***[[hepcidin]] (experimental)
*Serology
**HBsAg
**Anti-HBsAg
**Anti-HBcAg ([[Immunoglobin#immunoglobin G|immunoglobin G (IgG)]])
**Anti-HBcAg ([[Immunoglobin#immunoglobin M|immunoglobin M (IgM)]])
|}
==Imaging==
While liver function tests are usually considered to be biochemical or immunologic, which themselves are increasingly overlapping, imaging provides valuable material as well. Liver scanning after injection of a radioactive tracer has been used for years to localize defects. Newer functional imaging is still experimental but shows promise.
==Causes of elevated test results==
==Causes of elevated test results==
{| class="wikitable" align="right"
|+ Patterns of abnormalities of liver function tests
! &nbsp;!! Suggested underlying cause
|-
| AST/ALT ratio > 1<ref name="pmid2774372">{{cite journal| author=Van Ness MM, Diehl AM| title=Is liver biopsy useful in the evaluation of patients with chronically elevated liver enzymes? | journal=Ann Intern Med | year= 1989 | volume= 111 | issue= 6 | pages= 473-8 | pmid=2774372 | doi= | pmc= | url=http://annals.org/content/111/6/473.full.pdf+html }} </ref> || [[Alcoholic liver disease]]s
|-
| [[Alkaline phosphatase]] to total [[bilirubin]] ratio <4<ref name="pmid18798336">{{cite journal| author=Korman JD, Volenberg I, Balko J, Webster J, Schiodt FV, Squires RH et al.| title=Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests. | journal=Hepatology | year= 2008 | volume= 48 | issue= 4 | pages= 1167-74 | pmid=18798336 | doi=10.1002/hep.22446 | pmc= | url= }} </ref><br/>AST/ALT ratio > 2.2<ref name="pmid18798336"/> || [[Hepatolenticular degeneration]] (Wilson's Disease)
|}
Increased blood levels of alanine transaminase have been associated with eating fast food twice a day while limiting [[exercise]].<ref name="pmid18276725">{{cite journal |author=Kechagias S, Ernersson A, Dahlqvist O, Lundberg P, Lindström T, Nystrom FH |title=Fast food based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects |journal=Gut |volume= |issue= |pages= |year=2008 |pmid=18276725 |doi=10.1136/gut.2007.131797}}</ref> The intervention in the trial aimed to "double the regular caloric intake in combination with adoption of a sedentary lifestyle for four weeks."<ref name="pmid18276725"/>
Increased blood levels of alanine transaminase have been associated with eating fast food twice a day while limiting [[exercise]].<ref name="pmid18276725">{{cite journal |author=Kechagias S, Ernersson A, Dahlqvist O, Lundberg P, Lindström T, Nystrom FH |title=Fast food based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects |journal=Gut |volume= |issue= |pages= |year=2008 |pmid=18276725 |doi=10.1136/gut.2007.131797}}</ref> The intervention in the trial aimed to "double the regular caloric intake in combination with adoption of a sedentary lifestyle for four weeks."<ref name="pmid18276725"/>


==References==
==References==
<references/>
{{reflist|2}}[[Category:Suggestion Bot Tag]]

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In clinical medicine, liver function tests include tests for:[1]

Imaging

While liver function tests are usually considered to be biochemical or immunologic, which themselves are increasingly overlapping, imaging provides valuable material as well. Liver scanning after injection of a radioactive tracer has been used for years to localize defects. Newer functional imaging is still experimental but shows promise.

Causes of elevated test results

Patterns of abnormalities of liver function tests
  Suggested underlying cause
AST/ALT ratio > 1[4] Alcoholic liver diseases
Alkaline phosphatase to total bilirubin ratio <4[5]
AST/ALT ratio > 2.2[5]		 Hepatolenticular degeneration (Wilson's Disease)

Increased blood levels of alanine transaminase have been associated with eating fast food twice a day while limiting exercise.[6] The intervention in the trial aimed to "double the regular caloric intake in combination with adoption of a sedentary lifestyle for four weeks."[6]

References

  1. ↑ Covin, RB (April 4, 2006), Liver and Gallbladder Pathology, University of Medicine and Dentistry of New Jersey
  2. ↑ Anonymous (2024), Alanine transaminase (English). Medical Subject Headings. U.S. National Library of Medicine.
  3. ↑ Anonymous (2024), Aspartate aminotransferase (English). Medical Subject Headings. U.S. National Library of Medicine.
  4. ↑ Van Ness MM, Diehl AM (1989). "Is liver biopsy useful in the evaluation of patients with chronically elevated liver enzymes?". Ann Intern Med 111 (6): 473-8. PMID 2774372. [e]
  5. ↑ 5.0 5.1 Korman JD, Volenberg I, Balko J, Webster J, Schiodt FV, Squires RH et al. (2008). "Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests.". Hepatology 48 (4): 1167-74. DOI:10.1002/hep.22446. PMID 18798336. Research Blogging.
  6. ↑ 6.0 6.1 Kechagias S, Ernersson A, Dahlqvist O, Lundberg P, Lindström T, Nystrom FH (2008). "Fast food based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects". Gut. DOI:10.1136/gut.2007.131797. PMID 18276725. Research Blogging.
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