What does elevated alat mean? How is the analysis carried out at the ALAT level and what do its results mean? Preparation for blood tests for ALAT and ASAT

It is imperative to evaluate the AST indicator together with the ALT indicator.... These are the so-called "liver" tests, which can be used to judge the activity of the process. Sometimes an increase in these indicators is the only symptom indicating the development of a serious illness.

Analysis for AST is not expensive, and it can be passed in absolutely any laboratory.

What is ALT in a blood test

ALT, or alanine aminotransferase, in a blood test, is an intracellular enzyme that is involved in cell metabolism, in particular, in the breakdown of the amino acid alanine. Most of the alanine aminotransferase is found in liver cells, less in the myocardium, skeletal muscles and kidneys.

An increase in ALT in a blood test occurs with any damage to hepatocytes (liver cells). An increase in the enzyme is observed already in the first hours after damage and gradually increases depending on the activity of the process and the number of damaged cells.

An increase in alanine aminotransferase is most typical for liver diseases (hepatitis of various origins, toxic damage, cirrhosis, etc.).

Depending on the concentration of ALT in the biochemical blood test, one can judge the degree of activity of hepatitis (hepatitis is with minimal, medium or high degree enzymatic activity), which must be indicated in the clinical diagnosis. It happens that hepatitis occurs without an increase in the specified enzyme. Then they talk about liver damage without enzymatic activity.

Generally speaking, ALT and AST blood counts are elevated in hepatitis and reflect the degree of cytolysis - destruction of liver cells. The more active cytolysis, the less favorable the prognosis of the disease.

Norms of AST and ALAT in the blood test

The reference values \u200b\u200bare normally very low and depend on gender and age. For example, both indicators are higher for men than for women.

Table of norms for ASAT and ALAT for adult men and women:

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With an increase in AST or AST in men or women, it is advisable to calculate the de Ritis coefficient - the ratio of AST to ALT (AST / ALT). Normally, its value is 1.33 ± 0.42.

An increase in the de Ritis coefficient of more than 2 indicates damage to the heart muscle (that is, AST prevails over ALT). With myocardial infarction or acute myocarditis, AST usually rises 8-10 times, and ALT only one and a half to two times.

If the de Ritis coefficient is less than 1 (that is, ALT prevails), then we can safely talk about the defeat of hepatocytes (liver cells). For example, with active viral hepatitis, the ALT concentration increases 10 times, while AST exceeds the norm by only 2-3 times.

As mentioned above, the coefficient can be calculated only when the ALT or AST values \u200b\u200bare increased. It should also be remembered that the reference values \u200b\u200bfor biochemical parameters in each laboratory are different and may not coincide with those indicated above.

Reasons for increasing AST and ALAT

The increase in alanine and aspartic aminotransferase can be increased in many diseases.

The reasons for the increase in AST in the blood test:

• Acute myocarditis;
• Myocardial infarction;
• Pulmonary embolism;
• Acute rheumatic heart disease;
• Unstable angina;
• Various myopathies;
• Skeletal muscle injuries (severe sprains, tears);
• Myositis, myodystrophy;
• Various liver diseases.

The reasons for the increase in ALT in the blood:

• Liver cirrhosis (toxic, alcoholic);
• Acute pancreatitis;
• Cholestasis, cholestatic jaundice;
• Alcoholic liver damage;
• Fatty hepatosis;
• Acute and chronic viral hepatitis (hepatitis C, hepatitis B)
• Malignant neoplasms of the liver and biliary tract, liver metastases;
• Alcoholism;
• Severe burns;
• Taking hepatotoxic drugs (oral contraceptives, psychotropic drugs, antineoplastic drugs, drugs for chemotherapeutic treatment, sulfonamides, etc.)

If detected in a blood test, you must immediately consult a doctor to find out the cause of this phenomenon, since an increase in these indicators often means the presence of serious diseases.

Decreased AST and ALAT

In practice, sometimes there are cases when the AST or ALT indicators become below normal. This can happen with severe and extensive liver necrosis (for example, in the case of advanced hepatitis). A particularly unfavorable prognosis has a decrease in AST and ALT levels against the background of a progressive increase in bilirubin.

An important reason for the decrease in alanine and aspartic aminotransferase is the depletion of vitamin B6 - pyridoxine.

The fact is that vitamin B6 is necessary for the synthesis of AST and ALT in normal conditions. The decrease in B6 concentration may be associated with long-term antibiotic treatment. It is possible to compensate for its deficiency with the help of drugs (intramuscular administration of the vitamin) and diet. The highest amounts of pyridoxine are found in cereal sprouts, hazelnuts, walnuts, spinach, legumes, soybeans, fish, and eggs.

Decreased liver enzymes can also occur as a result of liver injury (eg, ruptured organ). However, such conditions are extremely rare.

The rate of transaminases in a child

Borders normal values for AST and ALT largely depend on the age of the child:

An increase in the activity of AST and ALT in the blood of a child, as well as in adults, indicates the effect of damaging factors on hepatocytes. But, unlike adults, this increase is rarely associated with acute and chronic hepatitis.

The growth of AST and ALT in the child's blood may indicate the presence infectious diseases (leptospirosis, pseudotuberculosis, infectious mononucleosis), congenital malformations.

Often, an increase in liver enzymes is of a secondary nature, that is, it develops after some kind of pathology. For example, an increase in the concentration of AST and ALT can occur in myocardial dystrophy, leukemia, lymphogranulomatosis, vasculitis, etc.

It happens that AST and ALT in children increase in response to taking certain medicationseg aspirin, paracetamol. It is also important to remember that AST and ALT may remain elevated for some time after recovery from an infectious disease.

AST and ALT during pregnancy

An increase in AST and ALT during pregnancy may be the first symptom of gestosis, a condition that threatens the life of the mother and fetus. Therefore, even a slight increase in the concentration of transaminases requires urgent medical advice. He will assess the state of health of the expectant mother, track the indicators in dynamics and, if necessary, prescribe an examination.

In the blood of a pregnant woman, the concentration of the hormone estrogen increases, which affects the liver (this is especially characteristic of the first trimester). That is why a slight excess of AST and ALT levels in early pregnancy is considered normal.

As for the third trimester, there should be no increase in transaminases during this period. If during this period there are deviations in the biochemical analysis, you need to immediately examine the woman so as not to miss the beginning of the development of gestosis.

Preparation for the test

The result of any biochemical analysis, including blood tests for AST and ALAT, largely depends on how to prepare for it.

Rules to follow to avoid false research results:

• It is necessary to take tests strictly on an empty stomach, at least after an 8-hour fast. Allowed to drink clean water in any quantity. It is recommended to exclude coffee, carbonated drinks, juices and teas during the preparation period. As for alcoholic beverages, they are not recommended to be consumed a week before blood sampling for AST and ALT.
• For 3 days, exclude foods rich in animal fats from your diet. Eat steamed, baked, or boiled foods. Fried must be strictly limited, or better - completely excluded.
• Three days before the proposed analysis, intensive physical exercise.
• Blood sampling should be done in the morning, from 7 am to 11 am.
• If you are taking medications, it is advisable to stop them 3 days before the study. But before that, it is important to consult a doctor.
• Try to be tested in the same laboratory.
• Having received the result in your hands, be sure to consult your doctor in order to correctly interpret the results and, if necessary, continue the examination.

Alanine aminotransferase or ALT for short is a special endogenous enzyme. It is included in the group of transferases and the subgroup of aminotransferases. The synthesis of this enzyme takes place intracellularly. A limited amount of it enters the bloodstream. Therefore, when a biochemical analysis shows an increased ALT content, this indicates the presence of a number of abnormalities in the body and the development of serious diseases. Often they are associated with the destruction of organs, which leads to a sharp release of the enzyme into the blood. As a result, the activity of alanine aminotransferase is also enhanced. It is difficult to establish the extent of necrosis or the extent of tissue disease damage on the basis of this, since organ specificity is not characteristic of the enzyme.

Alanine aminotransferase is found in many human organs: kidneys, heart muscle, liver, and even skeletal muscles. The main function of the enzyme is the exchange of amino acids. It acts as a catalyst for the reversible transfer of alanine from the amino acid to alpha-ketoglutarate. As a result of the transfer of the amino group, glutamic and pyruvic acids are obtained. Alanine is necessary in the tissues of the human body, as it is an amino acid that can quickly be converted into glucose. Thus, it is possible to obtain energy for the work of the brain and central nervous system... In addition, among the important functions of alanine is strengthening immune system the body, the production of lymphocytes, the regulation of acid and sugar metabolism.

The highest activity of alanine aminotransferase was found in the blood serum of men. In women, the processes involving the enzyme are slower. The highest concentration is noted in the kidneys and liver, followed by skeletal muscles, spleen, pancreas, erythrocytes, lungs, heart.

What is analysis used for?

The largest amount of transferase is found in the liver. This observation is used to detect diseases of a given organ that do not have external symptoms. ALT, in contrast to many other components considered in the biochemical analysis of blood, has been studied most fully. Therefore, with its help, even minor problems in the body can be identified. In some cases, the amount of ALT is compared with the amount of other elements in the blood. This allows us to draw conclusions about the presence of pathologies.

For example, an enzyme such as aspartate aminotransferase or AST is often used. It is also synthesized intracellularly, and a limited amount of it enters the bloodstream. A deviation from the established norm in medicine for the content of aspartate aminotransferase, as in the case of alanine aminotransferase, is a manifestation of abnormalities in the work of some organs. The most complete picture of the nature of the pathology allows you to get the correlation of the contained amount of both enzymes. If there is an excess of the amount of alanine aminotransferase over aspartate aminotransferase, then this indicates the destruction of liver cells. The AST level rises sharply in the later stages of the disease of this organ, such as. When the level of aspartate aminotransferase exceeds the level of alanine aminotransferase, problems with the heart muscle are observed.

Additional diagnostic methods can confirm the presence of the disease and the degree of organ damage. However, ALT is an accurate indicator, in some cases it can even be used to establish the stage of the disease and suggest possible options its development.

When is an ALT test scheduled?

The amount of alanine aminotransferase for liver problems helps to identify them even before the most characteristic symptom - jaundice. Therefore, the doctor prescribes an ALT test most often in order to check for damage to this important organ as a result of taking medications or any other substances that are toxic to the body. Also, the study is carried out with suspicions of. An ALT test is required in the presence of symptoms such as increased fatigue and weakness of the patient. He loses his appetite, often feels nausea, turning into vomiting. Yellow spots on the skin, pain and discomfort in the abdomen, yellowing of the whites of the eyes, light-colored feces and dark urine can all be signs of liver disease. In such cases, it is absolutely required this analysis.

ALT can be compared with AST to obtain additional information about the causes of liver damage. This is done if the amount of enzymes is significantly higher than the norm. The ratio of AST to ALT is known in medicine as the de Ritis coefficient. Its normal value ranges from 0.91 to 1.75. If this indicator becomes more than 2, then a lesion of the heart muscle is diagnosed, proceeding with the destruction of cardiomycytes. Also possible. The de Ritis coefficient, not exceeding 1, indicates liver disease. Moreover, the lower the value of the indicator, the greater the risk of an unfavorable outcome.

The ALT test can be used not only as a diagnostic method, but also during treatment. This allows you to determine the dynamics of the course of the disease and identify improvements or deterioration in the patient's condition. ALT testing is necessary if there are factors that contribute to liver disease. These include the abuse of alcoholic beverages or drugs that destroy organ cells. If the normal amount of alanine aminotransferase in the blood is exceeded, other drugs are prescribed. It is imperative to check the amount of ALT if the patient has been in contact with patients with hepatitis or has recently had it himself, has diabetes and is overweight. Some people have a predisposition to liver disease. They are also shown to be tested for ALT.

It uses either venous or capillary blood. In order to obtain reliable results, certain requirements must be met. Firstly, do not eat 12 hours before delivery and do not drink alcohol for a week. Even a small amount of food can significantly affect the result. Secondly, for half an hour before the analysis, stop smoking, do not worry, avoid mental and physical stress. The results are usually ready a day after delivery.

ALT rate in blood in men and women

Alanine aminotransferase (ALT, or ALT) - marker enzymes for the liver.

Aspartate Aminotransferase (AST, or AsAT) - marker enzymes for the myocardium.

The amount of the enzyme alanine aminotransferase in the blood is measured in units per liter.

ALT (ALAT) in children

ALT in children varies by age:

In newborns up to 5 days of age: ALT should not exceed 49 U / L. (AST up to 149 U / l.)

For children under six months, this figure is higher - 56 U / l.

At the age of six months to a year, the amount of ALT in the blood can reach 54 U / L

From a year to three - 33 U / l, but gradually the normal amount of the enzyme in the blood decreases

In children from 3 to 6 years old, its upper limit is 29 U / l.

In children, slight deviations from the norm are allowed. This is due to uneven growth. Over time, the amount of the enzyme in the blood should stabilize and approach normal.

ALT (ALAT) in adults

Enzyme enhancement rates

But the results of the analysis for ALT often turn out to be far from the established norms. This may be due not only to the presence of inflammatory processes in the body, but also to other factors. Increased content alanine aminotransferase can be triggered by taking aspirin, warfarin, paracetamol, and oral contraceptives in women. Therefore, the doctor should be aware of the use of such drugs before taking an ALT test. Medicines based on valerian and echinacea have a similar effect. Inaccurate test results can be caused by increased motor activity or intramuscular injections.

The amount of alanine aminotransferase in the blood is considered to be increased if it exceeds the established norm, especially by tens, and in some cases even hundreds of times. Depending on this, the presence of the disease is determined. With an increase in the ALT level by 5 times, it is possible to diagnose myocardial infarction, if it reaches 10-15 times, we can talk about a deterioration in the patient's condition after an attack. In this case, the value of the de Ritis coefficient also changes upward.

Hepatitis provokes an increase in ALT in the blood by 20-50 times, muscular dystrophy and dermatomyositis - by 8. About gangrene, says the excess of the upper limit of the indicator by 3-5 times.

It is possible not only to increase the content of alanine aminotransferase in the blood. Its too low amount is associated with a lack of vitamin B6, which is part of this enzyme, or with complex inflammatory processes in the liver.

What does an increase in ALT mean?

An increase in ALT indicates the course of inflammatory processes in the body. They can be caused by the following diseases:

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IN modern world, practically at every diagnosis, doctors send patients for blood tests to determine the number of erythrocytes and leukocytes. But recently, people are increasingly sent for tests to determine the amount of enzymes such as ALAT and ASAT.

What are ALAT and ASAT?

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

Aspartate aminotransferase, or ASAT for short, is another enzyme involved in the synthesis of amino acids. Aspartate aminotransferase is also present in all tissues of the body. The greatest amount of AST is found in the heart and skeletal muscles of the liver, lungs, kidneys and tissues of the nervous system. AsAT is concentrated not only in 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 low. In turn, an increase in the level of these enzymes contributes to their transport from cells into the blood, which indicates a massive destruction of cellular structures.

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

The indicators of both transferases are of great diagnostic value.

Thus, the analysis for ALT is often prescribed if there is a suspicion of liver damage of various genesis. And an AST test can also show cardiac pathologies that are not detected using an electrocardiogram (for example, myocardial infarction).

If the AST value significantly exceeds the norm, then, often, the so-called de Ritis coefficient is 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, was the first to suggest using it to diagnose liver damage.

By calculating the de Ritis coefficient, it is possible to establish the etiology of liver damage, for example, viral, dystrophic or alcoholic, and together with the study of the albumin content, one can also judge about cardiac pathologies.

Indicator standards

The amount of ALT enzyme present is measured in units per liter and changes with aging. So, the value of alanine aminotransferase in infants always overpriced. This is due to the fact that after labor, a lot of hemoglobin gets into the baby's bloodstream, which decomposes in the body over 3-5 weeks. As a result of this process, bilirubin is formed, which causes an increase in the ALT index. This physiological process is called postpartum jaundice.

The following norms of ALAT values \u200b\u200bare noted:

1. The first five days after birth, the ALT level reaches 49 U / l. In the subsequent time, it can increase up to 60 U / l.
2. Starting from the age of six months, 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, an indicator of 29 U / l is considered to be the norm.
5. After the age of six, it can grow back up to 39 U / L.
6. In adolescence, the value is differentiated and is associated with the gender of the child, so for boys it can reach 27 U / l, and for girls only 24 U / l.

The norm of alanine aminotransferase in the blood of an adult woman is 31 U / L, while in 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 the norm, while at a later date, it can talk about the so-called preeclampsia - a complication of pregnancy, also called preeclampsia.

The 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 of indicators of this enzyme are noted:

1. High levels of aspartate aminotransferase are common in infants up to 5 days of age. During this period of life, he 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 the age of 11-18, the content of AST in the blood differs between sexes. So, for boys this indicator is approximately 28 U / l, while for girls it does not exceed 25 U / l.

During pregnancy, the content of AST in female blood may differ from the norm, not only upwards, but also downwards.

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

Stable increased rate AsAT for several days serves as evidence of the critical condition of the patient, and with a further increase in the indicator, it is a reason to assume an increase in the area of \u200b\u200borgan damage.

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

Reduced enzyme activity can be noted with a deficiency of vitamin B6 or recently underwent hemodialysis.

A decrease in ALT can be caused by severe necrosis of liver tissue, as well as drugs containing phenoteazine 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 bloodstream. This process leads to the fact that the enzyme noticeably increases its quantitative index (approximately 2-20 times) in the human blood.

An increase in this indicator takes place 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 heart disease);
• 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 grow, then this may indicate that neighboring tissues have been included in the pathological course of the disease. It should be borne in mind that in patients with angina pectoris 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 (first of all, it is the heart and liver). In this case, doctors are faced with the task of identifying the disease of which of the organs caused the change in the AST enzyme coefficient in the blood serum.

Turning to the ALAT enzyme, it can be noted that the analysis of the biomaterial to identify the quantitative ALT coefficient 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.

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

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

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

In order to get the most accurate test result for ALT, 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 analysis should take place no later than 8 hours. Blood is taken from a vein.

The ALT indicator can be exceeded in following cases:

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

Treatment

If, after visiting the doctor, you learned that the blood content of AST is exceeded, then urgently you need to remove those factors that caused such changes in the body. The right decision would be to refuse alcoholic beverages and select an alternative treatment that would not cause such biochemical changes.

It is necessary to reduce the concentration of AST in the blood under the supervision of a physician. In the course of treatment, the patient should consult with a cardiologist and hepatologist.

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

In order to lower the concentration of ALT in the blood, it is necessary to find out which pathology has caused changes in the body and to start treating it. When treating the liver, which usually causes an increase in ALT, medications are prescribed that improve the functioning of the stomach, hepatoprotectors and choleretic drugs. When using the above funds, it is worth consulting a doctor, since such drugs have a number of contraindications.

The cells of the liver, heart and some other organs produce special enzymes that are involved in metabolic processes. Normally, they practically do not enter the bloodstream, and during the analysis they are not detected or are contained in very small quantities. However, diseases that cause the destruction of the cellular structure of tissues contribute to the release of these enzymes into the bloodstream. The most significant in the diagnosis of pathological processes are substances abbreviated as AlAt and AsAt.

This is the abbreviated name for one of the main enzymes that ensure the metabolism of amino acids - alanine aminotransferase. It is produced mainly by hepatocytes - liver cells. It is synthesized in smaller amounts in skeletal and cardiac muscle tissue, the pancreas. Usually in the blood healthy person in a laboratory biochemical study, alanine aminotransferase is not detected or is found in very small quantities. At the same time, ALT is increased in men due to the accelerated amino acid metabolism (in women, it is carried out less intensively).

Most often, a comprehensive laboratory analysis is carried out with the determination of the concentration of another substance - aspartate aminotransferase (abbreviated as 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 musculature of the heart, indicating necrotic processes.

But the main diagnostic value is the ratio of these two enzymes, the value of which is called the de Ritis coefficient and allows you to reliably establish the localization pathological process... If the reference (permissible) indicators are exceeded, and the coefficient value is less than 0.91 or more than 1.75, one can assume liver problems in the first case or heart disease in the second.

Norma AsAt and AlAt in biochemical blood test

The concentration of these enzymes change over time, which is the norm in childhood... For example, infants have higher levels than adults due to the characteristics of the period of labor. Due to the massive release of erythrocytes 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, the norms in children different ages and adults can be found from the table:

As you can see from the table, normal performance constantly fluctuate in childhood and adolescence, and from the age of 12 they also differ according to the sex of the subject. In addition, a slight increase in the level of ALT is the norm in women in the blood during early pregnancy. However, in the last trimester, an increase in the concentration of the enzyme indicates gestosis, which threatens the health of the mother and fetus.

Aspartate aminotransferase is also determined in different quantities according to sex and age. In adult men, the upper limit of the norm is 37 units per liter, for women - 31. The highest level is observed in children of the first days of life (up to 97 units / l), decreasing to 82 by one year, and to 36 by six. -17 years old, values \u200b\u200bnot exceeding 29 and 25 U / L for boys and girls are considered normal.

In the analysis of blood, ALT and ASAT are increased - what does this mean, what are the reasons?

An increase indicates pathological destruction of hepatocytes, heart cells, pancreas... Normally, they enter the bloodstream in a minimal amount, 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 serum ALT values \u200b\u200bis characteristic of the following diseases and conditions:

• hepatitis, liver cirrhosis, fatty degeneration;
• acute pancreatitis;
• extensive burns, shock;
• viral infections;
• lymphoblastic leukemia;
• shocks of various etiologies;
• disorders of hematopoiesis;
• muscular dystrophy;
• mononucleosis.

Increased AST in the blood or aspartate aminotransferase appears in blood plasma in large quantities during necrotic processes in the body. Exceeding the maximum permissible indicators 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 heart disease.
• Gallbladder and liver - cholestasis, cholangitis, amebiasis, liver cancer, hepatitis, cirrhosis.
• Pancreas - acute inflammation or phlegmon.
• Skeletal muscle - damage or dystrophy;

The concentration in the plasma of the amount of the enzyme increases and with such systemic and infectious pathologieslike vasculitis, mononucleosis, hemolytic syndrome.

Could the increase in the content of alanine aminotransferase and aspartate aminotransferase be caused by other causes not associated with diseases? Yes, enzyme levels rise in women early in pregnancy, which is normal. The same phenomenon can be observed when using some medicines: antibiotics, antineoplastic and sedative drugs, barbiturates, oral contraceptives and others. The level of physical activity, intake of sports nutrition, alcoholic beverages also affects the growth of indicators.

Who needs research

A referral to the biochemical blood test AsAt and AlAt is obligatory given to all donors before the blood collection procedure, as well as to persons with identified pathologies of the liver, heart, and pancreas.

The results of this study are also used for hepatitis, cirrhosis, as they allow to determine the degree of organ damage. In addition, it is necessary to control the amount of enzymes during treatment with some antibiotics, as well as after the ingestion of toxic compounds.

The basis for a biochemical blood test is also a deterioration in general health in the form of constant weakness, rapid fatigue, and loss of appetite. Frequent symptoms such as abdominal pain, nausea and vomiting, yellowing of the whites of the eyes, darkened urine, and digestive problems are a reason to see a doctor for a referral immediately.

How to prepare for the analysis for AlAt, AsAt

You need to donate blood from a vein for research, which is done in state polyclinics on a referral basis or on a paid basis in private laboratories. A blood test for AlAt and AsAt is taken in the morning and strictly on an empty stomach: after the last meal, at least 12 hours should pass. On the day of visiting the laboratory, you should not smoke, drink any liquid other than water. All week before the test, it is strictly forbidden to drink alcohol.

In addition, the result may be distorted by the intake of any medicines - antimicrobial, contraceptive, choleretic, sedative, and others. So the question of their cancellation or temporary suspension of treatment should be discussed with your doctor in advance. The term for the analysis is a day, that is, the next day you can go for the results. For an additional fee, the process can be accelerated: the express test is done in just 2 hours.

Analysis decoding

The test results must be presented to your doctor. The specialist pays attention to the quantitative indicators of the content of both enzymes, the degree of exceeding the maximum allowable value and their ratio. For example, the concentration of AlAt allows one to draw conclusions about the nature of liver diseases. So, hepatitis A, B, C cause a 20-fold excess of the norm, and alcoholic - 6 times. With fatty degeneration, there is an increase of 2 or 3 times.

As for oncological diseases (liver cancer, in particular), then one should pay attention to aspartrtaminotransferase and its concentration.

With carcinoma, it increases several times, and progresses over time. At the same time, the values \u200b\u200bof alanine aminotransferase increase slightly. In the late, inoperable stages of cirrhosis, the opposite phenomenon is observed.

Of particular importance is the so-called de Ritis coefficient - the numerical ratio of the increased values \u200b\u200bof AlAt and AsAt, especially if the localization of the pathological process has not yet been precisely established. With liver damage, an increased blood ALT is usually observed, and the content of aspartate aminotransferase decreases. If the myocardium is damaged, the proportion is reversed. Normally, the de Ritis coefficient ranges from 0.91 to 1.75, that is, when hepatocytes are destroyed, it is much less than 1, and with a heart attack - more than 2.

In addition, the concentration of enzymes is reduced. For AlAt and AsAt in the blood test, this is typical in the case of repeated sessions of hemodialysis, rupture of the liver, its necrosis or cirrhosis, as well as with a pronounced lack of B-group vitamins in the body or taking anticoagulants. In any case, a specialist should deal with decoding, taking into account third-party factors that could affect the final result of the study, since it is not always determined by pathological reasons. It is unacceptable to draw conclusions and make diagnoses independently without special education.

How to lower ALT in 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 the intake of dietary supplements and alcohol, excessive physical exertion. A diet that includes too many fatty and "heavy" foods 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 should be constantly monitored using regular analyzes. If the concentration of enzymes has changed due to liver disease or other pathological process, it must be identified and cured. For this, a full examination with hospitalization is usually assigned.