What does alanine aminotransferase mean in the blood. Norms and changes in the blood test for alat and asat

Alanine aminotransferase, or ALT, and aspartate aminotransferase, or AST, are enzymes that are found in the cells of the body and are involved in amino acid metabolism. They are located only in the cells of organ tissues, and enter the blood only when the cell disintegrates during traumatic injuries or pathologies.

Types of diseases

Excessive ALT content indicates the development of pathology of the organ, in the cells of which there is the greatest amount of it. The reasons for the increase in alanine aminotransferase are liver pathologies. Feeling of discomfort and pain in the right hypochondrium, diarrhea, icteric staining of the skin and mucous membranes, flatulence, and bitter belching are signs of an increase in ALT. When conducting a blood test, an increase in the level of bilirubin is added to the increased ALT and AST when hepatitis develops. More often, an increase in ALT content indicates the occurrence of other diseases. The ALT concentration is directly dependent on the severity of the pathology.

The necrotic process in the heart muscle causes the release of these enzymes into the blood. Their increased content in serum also indicates the development of other cardiopathologies: insufficiency, inflammation of the heart muscle. Additionally, an increase in serum ALT concentration may be due to trauma in the body that is associated with damage. muscle tissue, and pancreatitis.

If ALT and AST blood test (decoding) showed above normal performance less than twice, it is necessary to organize observation and 2-fold examination. This tactic is optimal for patients.

Blood test ALT and AST - decoding for certain diseases

A slight increase in transferases is indicative of non-alcoholic type of fatty liver damage, including “fatty liver”, non-alcoholic steatohepatosis, and chronic viral hepatitis.

A moderate increase can exist with viral or alcoholic inflammation of the liver and various chronic diseases liver with or without cirrhotic damage.

Elevated levels are typical for severe acute hepatitis, toxic or drug necrosis, shock, or hepatic ischemia.

An excessively high level (more than 2000-3000 U / L) exists with an overdose of acetaminophen and when using the drug in alcohol-dependent patients, with shock and / and hepatic ischemia.

It should be noted, since ALT is found in erythrocytes, it is necessary to prevent their breakdown when preparing serum for analysis. ALT may decrease if serum is stored for several days.

Role of medicines, herbs and other substances

Careful history taking and deciphering of laboratory results are important in identifying drug-induced increases in transferases. Similar liver damage is detected in 1-2% of cases of chronic liver inflammation. They are associated with the intake of antibiotics, antiepileptic drugs, hydroxymethylglutaryl-CoA reductase inhibitors, non-steroidal anti-inflammatory drugs and medicines for the treatment of tuberculosis.

The easiest way to determine the dependence of an increase in aminotransferases with some agent is to reverse it and observe the level of enzymes. Without canceling the remedy, this dependence cannot be determined.

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

Raising ALT levels is important diagnostic criterion, which indicates increased cell destruction due to various pathologies.

Role of AlAt in the body and where it is located in the body

Alanine aminotransferase is an irreplaceable component of amino acid metabolism. In cells, the enzyme regulates the conversion of alanine, which has many functions, such as providing energy to nerve cells, strengthening immunity, and correcting the metabolism of various substances.

ALT is found in:

1. Liver (highest level).
2. Lungs.
3. The stomach.
4. A heart.
5. Kidneys.
6. Muscles.

How to get tested for ALAT?

To obtain correct results, you must follow these rules:

• 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, due to which the results will be overestimated. Therefore, you need to do the analysis at least 8 hours after the last meal;
• It is necessary to exclude alcohol in any form 7 days before donating blood, because it affects the liver much more than ordinary food;
• Some medications lead to a change in the level of alanine aminotransferase, these include: oral contraceptives, acetylsalicylic acid, paracetamol, warfarin. If you are taking any of this list, please report this fact to your doctor.

Normal ALT values \u200b\u200bfor men, women and children

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

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

Enzyme	Newborn	Children under six months	6 months - 1 year	1-3 years	36 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 has revealed a high ALT content, first of all, the doctor should exclude errors in the analysis, taking into account all the indicators at the time of delivery.

After confirming that the analyzes 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 an additional examination of the liver, heart, pancreas or muscles.

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

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

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

There are several degrees of alanine aminotransferase increase:

Reasons for increasing Alat

An increased concentration of alanine aminotransferase in the blood, with the correct analysis, shows the severity of the disease.

Even with liver tumors, the amount of ALT can be increased only slightly if the tumor is on initial stages.
So what if the numbers in your analysis are high? How to determine the cause and start treatment?

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

Diseases in which markedly increased numbers are observed in the analysis for AlAt include:

1. Hepatitis (the most dangerous for the liver are hepatitis B, C, D) - diseases of a viral nature, which can be transmitted both 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 a dangerous disease as 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.

In the analysis, a significant amount of bilirubin, a bile enzyme produced in liver cells, is also found in the blood:

1. Cirrhosis of the liver - total destruction of organ tissue, in which the organ gradually loses its ability to perform its main functions.
2. Liver cancer.
3. Pancreatitis - inflammation of the pancreas, the result of which is very often necrosis of organ tissue. Chronic pancreatitis requires constant monitoring of the level of alanine aminotransferase to control the course of the disease.

The most common cause of pancreatitis is the abuse of fatty foods and alcohol. Sometimes inflammation of the pancreas is associated with a 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 a less sharp jump in ALT levels than with hepatitis. However, the determination of this enzyme by biochemical blood test is mandatory.

1. Myocardial infarction... This term denotes the death of a certain part of the heart muscle as a result of a violation of the blood circulation process in it. This pathology also leads to an increase in the amount of AlAt 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 the diagnosis.
2. Myocarditis - inflammation of the heart muscle... It is also characterized by the detection of an increased level of AlAt and AsAt in biochemistry.
3. Other reasons... This includes pathologies such as burn injuries, frostbite, extensive muscle injury. Tumor neoplasms that destroy the tissues of the above organs can also increase the amount of ALT.

If a biochemical analysis has determined that your ALT level is increased, then it's time to consult a doctor.

Additional examinations will help determine the exact location pathological process and start treatment in a timely manner.

What can lower ALT counts?

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

How is the treatment carried out?

How to lower the ALT level? By curing the disease that led to his growth. By stopping the destruction of cells containing alanine aminotransferase, you can return the amount of enzyme in the bloodstream to normal.

With hepatitis and heart attacks, self-medication will do nothing but harm.

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

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

Here are some general tips for lowering ALT levels:

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

By reducing the load on your liver and the body in general, you will help it fight disease.

Only correct image life will help to get away from dangerous complications and maintain health for a long time.

Biochemical blood tests for ALT and AST are prescribed most often in the diagnosis of liver diseases. In some cases, the doctor prescribes research data to the patient when diagnosing pathologies of cardio-vascular system and skeletal muscles. What do the designations ALAT and ASAT mean, and what can deviations of these indicators from the norm indicate?

Biochemical blood test for ALT

Alanine aminotransferase (ALT) is an intracellular enzyme from the aminotransferase group, which is involved in the exchange of amino acids.

The largest amount of alanine aminotransferase is found in liver and kidney cells. A slightly lower content of this enzyme in the cells of the heart muscle, skeletal muscle, spleen, pancreas, lungs, erythrocytes. The ALT activity in the blood serum of men is slightly higher than that of women.

Indications for analysis

There are certain indications for a blood test for the level of alanine aminotransferase:

• diagnosing liver diseases;
• monitoring of patients with different kinds hepatitis;
• examination of contact persons in the outbreak of viral hepatitis;
• examination of donors.

Norm

The ALT rate in the blood test depends on age. In addition, the activity of this enzyme is slightly higher in men than in women.

The value of the ALT norm in the blood test in children under six months is less than 60 U / L, up to a year - less than 54 U / L, up to six years - less than 30 U / L, up to 12 years - less than 38 U / L. For boys under 18, this indicator should normally not exceed 27 U / l, for girls under 18 - 24 U / l. For adult men normal value AlAT in blood is less than 41 U / L, for adult women - less than 31 U / L.

Increased values

An increase in the value of alanine aminotransferase in the blood test is observed with the following pathologies:

• viral hepatitis;
• toxic liver damage;
• cirrhosis of the liver;
• primary or metastatic liver cancer;
• fatty hepatosis;
• obstructive jaundice;
• severe pancreatitis;
• hypoxia, shock (usually with an asthmatic condition);
• myocarditis, extensive myocardial infarction;
• myodystrophy, myositis;
• right heart failure;
• severe burns;
• chronic alcoholism;
• some hemolytic diseases;
• taking hepatotoxic drugs (immunosuppressants, antibiotics, anabolic steroids, psychotropic drugs, antineoplastic drugs, contraceptives, sulfa drugs, salicylates).

Reduced values

In most cases, the doctor prescribes blood tests for ALT and AST at the same time.

Aspartaminotransferase (AST) is an enzyme that is involved in the exchange of amino acids. Its greatest amount is found in the cells of the liver, cardiac myocardium, nerve tissues, muscles. Also, this enzyme is found in the cells of the pancreas, kidneys, and lungs. In case of damage and pathologies of the above organs, AST is released into the bloodstream, and therefore its content in the blood test increases.

Indications for analysis

• diagnosing liver pathologies;
• diagnostics of myocardial infarction and some other diseases of the heart muscle;
• diagnosis of pathologies of skeletal muscles.

Norm

The norm of AST in the blood in children under 12 months of age should be no higher than 60 U / L, up to nine years old - no higher than 55 U / L, in adult men - less than 41 U / L, in adult women - less than 31 U / L.

Increased values

The level of aspartaminotransferase in the blood increases in the following diseases and conditions:

• toxic, viral, alcoholic hepatitis;
• primary and metastatic liver cancer;
• acute pancreatitis;
• cholestasis;
• severe attack of angina pectoris, myocardial infarction;
• pulmonary thrombosis;
• conducting angiocardiography, cardiac surgery;
• rheumatic heart disease in the acute stage;
• myopathies (chronic muscle diseases);
• skeletal muscle injury;
• heatstroke;
• burns.

A slight increase in ASAT is observed with excessive muscular load.

Reduced value

A decrease in the level of this enzyme in the blood indicates a deficiency of vitamin B6 in the body, severe liver pathologies (liver rupture).

Preparation for blood tests for ALAT and ASAT

In order for there to be no false deviations from the norm in blood tests for ALT, as well as for ASAT, it is necessary to properly prepare for donating blood.

• The day before blood sampling, fried, fatty, spicy foods, and alcoholic beverages should be excluded from the diet. It is recommended to avoid excessive physical activity.
• Blood is taken for analysis in the morning on an empty stomach; at least eight hours should have passed since the last meal.
• You should not donate blood for these studies immediately after fluorography, X-ray, ultrasound, rectal examination, physiotherapy procedures.
• In case the patient takes any medications, he must warn the doctor prescribing the analysis about this. Some medications can significantly distort the test results.

Only a qualified doctor can make a competent decoding of a biochemical blood test for ALAT, as well as for ASAT.

The enzyme ALT, or alanine aminotransferase, serves its purpose within cells. The peripheral blood contains a small amount. When cells are destroyed as a result of damage to an organ, ALT enters the bloodstream, representing an important diagnostic indicator.

What is alanine aminotransferase needed for and where is it contained

Alanine aminotransferase in the body plays an important role, participating in the exchange of amino acids, in particular the essential amino acid alanine. He, in turn, plays a role in providing energy to the central nervous system, strengthening of immunity, regulation of metabolism and production of lymphocytes.

Where ALT is contained:

• Liver (most);
• Kidneys;
• Lungs;
• Pancreas;
• Muscles;
• A heart.

Analysis for ALT, delivery rules and norms

The ALT indicator is included in the biochemical blood test along with other transaminases. It is necessary to take the analysis on an empty stomach, in the morning. Eliminate alcohol for a week. Must be at least eight hours after dinner. All this is important for obtaining reliable data. Taking some medications affects the ALT index, which is why when taking oral contraceptives, aspirin, paracetamol, warfarin, inform your doctor about it.

A blood test is taken from a vein

Reasons for increasing ALT

An increase in ALT in the blood occurs as a result of cell destruction. What diseases lead to this.

Hepatitis - Acute or Chronic inflammatory process in the liver of an infectious or alimentary 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, the viral hepatitis C in this regard is called the "affectionate killer", since for a long time, damaging liver cells, he does not manifest himself in anything. Ultimately, cirrhosis develops. Alimentary-toxic hepatitis develops under the influence of substances that destroy liver cells. Including, long-term alcohol consumption leads to it.

This is the effect of large doses of alcohol on the liver.

Liver cirrhosis is the outcome of all liver damage when destroyed cells are replaced connective tissue, and she can no longer fulfill her 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. The reasons for the development are the abuse of fatty foods and alcohol or stones in biliary tract... Patients with chronic form pancreatitis must be checked throughout life to prevent exacerbation.

Myocardial infarction - destruction of a portion of the heart as a result of occlusion of the feeding artery. With the death of cardiomyocytes, 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 the heart cells is much higher. Thus, the decoding of 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.

Myocarditis - inflammatory disease heart, characterized by damage to the heart muscle. In this situation, the blood test is also characterized by an increased concentration 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-named organs are the reasons when ALT is increased.

When ALT is lowered

Decreased ALT content is possible with a deficiency folic acid and some vitamins. In liver cirrhosis, a decrease in ALT is a poor prognostic sign, indicating the complete absence of preserved healthy cells.

Pregnancy

During pregnancy, in the first trimester, a slight increase in ALT is possible. There is nothing terrible in this, it is physiological and is connected with the pregnancy itself. If ALT rises significantly, and characteristic symptoms appear, an urgent need to consult a doctor for examination.

Symptoms

Symptoms of an increase in alanine transaminase in the blood are varied. Clinical picture due to the affected organ and the disease that led to it.

From the liver

Characteristic symptom cirrhosis of the liver - "jellyfish head", a combination of ascites and varicose veins of the abdominal wall

With liver damage, pain in the right hypochondrium, nausea, and vomiting are possible. Possible yellowness skin, icterus sclera. When viral etiology there may be hyperthermia. With the development of cirrhosis, rashes appear on the body of the type spider veins, an increase in the abdomen due to ascites (accumulation of fluid in the abdominal cavity).

Varicose veins veins (esophagus, stomach), which can be complicated by bleeding. Multiple organ failure gradually develops.

From the pancreas

Pancreatitis is manifested by severe pain in the abdomen, in the navel, its swelling, repeated vomiting, weakness, clouding of consciousness later.

From the side of the heart

The main symptom in myocardial infarction is severe, burning pain behind the sternum, which can spread to left hand, jaw, under the scapula

A painless form of a heart attack is possible, or atypical, when pain is localized in the abdomen, or severe shortness of breath develops. In addition to pain, heart rhythm disturbances, a drop in blood pressure are possible. Disturbed by severe weakness, fear of death, chills.

In the presence of oncological process in the affected organ, strong weight loss is possible in a short period of time, weakness, and increased fatigue.

Diagnostics

Diagnosis of the disease, the reasons for the increase in ALT, is carried out by doctors using all available research methods. In many cases, on an emergency basis, since there are among them life-threatening diseases and leading to disability.

A correctly interpreted biochemical blood test can push you on the right diagnostic path. So, there is the concept of the de Retis index, which is the ratio of increased AST and ALT. Its rate is 0.91-1.75.

If it exceeds two, then the reason is in the heart muscle. If less than one, then the liver is affected.

In the hospital, a full examination is carried out, which also includes MRI or CT, extended blood and urine tests. Invasive methods such as puncture biopsy and angiography of the heart vessels are also used. All this allows you to quickly deliver correct diagnosis and start treatment.

Treatment

In order to lower the ALT level, it is necessary to cure the disease that led to this, after which the ALT rate will return on its own.

Approximate set of products for patients with liver and pancreas diseases

Such serious diseases as pancreatic necrosis, extensive myocardial infarction, severe hepatitis complicated by multiple organ failure are treated in the department intensive care.

The treatment of each disease is specific and it makes no sense to describe it. A few words can be advised for people taking medications that affect the liver, as well as alcohol abusers. In such cases, it will be useful to periodically drink a course of hepatoprotectors (Carsil, Essentiale) and at least somehow protect liver cells from damage, thereby lowering ALT.

For many diseases, such as pancreatitis, hepatitis, diet is very important. Reduce consumption or completely eliminate all fatty, spicy, smoked, salty and alcohol. To prevent exacerbations healthy image life should become your goal in itself!

Alanine aminotransferase and aspartate aminotransferase are endogenous enzymes and are significant markers when conducting a biochemical blood test.

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

Yes, both ALT and AST levels can be elevated in liver abnormalities (such as cirrhosis or hepatitis), but other markers should also be carefully analyzed. By the way, the level of ALT can be increased 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 the link between protein and carbohydrate metabolism. The most significant natural catalysts for transamination reactions in the human body are alanine aminotransferase (aka ALT, ALT) and aspartate aminotransferase (aka AST, AST).

These enzymes are present in the tissues of many organs. Normally, aminotransferases are practically not found in the blood. Minimum activity enzymes are caused by natural regenerative processes in the body. Elevated levels of ALT and AST are highly sensitive markers of tissue damage in which they are contained.

Method for the determination of aminotransferases in biochemical analysis blood 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 indicator should not exceed 70 U / l.

AlAT in women normally does not exceed 35 U / L, and in men - 40 U / L.

Also, the analysis results can be presented in moles / hour * L (from 0.1 to 0.68 for ALAT and from 0.1 to 0.45 for ASAT).

What can affect transaminase levels

The distortion of the analysis results can be caused by:

• the use of certain medications:
  • a nicotinic acid,
  • immunosuppressants,
  • choleretics,
  • hormonal contraceptives, etc.),
• obesity,
• pregnancy,
• hypodynamia or excessive exercise stress.

How the research is done

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

To obtain the most reliable results, you must:

• exclude admission medicines a week before the test (if this is not possible, you must notify the doctor about the drugs 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 - for two days.

What analysis can tell about ALaT and ASAT

Alanine aminotransferase and aspartate aminotransferase are characterized by selective tissue activity. If viewed in
In descending order, 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.