Alanine aminotransferase (ALT) is a special substance involved in amino acid metabolism. It is usually found in organs such as the liver, heart, and kidneys.
The penetration of this enzyme into the bloodstream is evidence of a pathological process. What this means and with what ailments it is connected will be described later in the article.
In most cases, alanine aminotransferase is elevated in diseases affecting the liver. However, the possibility of pathology and other vital organs is not excluded.
The concentration of ALT in the blood is an important diagnostic indicator that determines the localization and severity of the pathology.
The main functions of ALT
This enzyme is essential for health. Thanks to him, metabolic processes are carried out, which helps to strengthen the immune system, provide the body with the necessary energy supply, as well as the production of lymphocytes.
All processes take place inside cells with a small release of the enzyme into the bloodstream.
Due to the destructive process that occurs in the cells of the liver and other organs affected by the disease, ALT in large quantities penetrates into the blood. Its presence, exceeding the permissible values, becomes an important indicator for the diagnosis of certain diseases.
The presence of alanine aminotransferase is characteristic of organs such as:
- the liver, where its concentration is highest;
- heart muscle;
- lungs;
- kidneys;
- pancreas.
This becomes a prerequisite for a thorough examination of these particular organs when high ALT values \u200b\u200bare found in the biochemical blood test.
Indications for analysis
An increase in ALT levels in a blood test signals not only pathology in the listed organs. It also indicates the possibility of the presence of other diseases.
That is why blood biochemistry is assessed... The analysis reveals deviations, becomes an integral part of preventive measures, effective way diagnosing serious diseases of the liver, myocardium and pancreas.
This study becomes mandatory when observing pathological changes in the liver that occur as a result of taking medications, hepatitis and poisoning with toxic substances.
A biochemical blood test is prescribed in case of the following symptoms:
- intense pain in the right hypochondrium;
- yellowness skin and ocular sclera;
- clarification of feces and dark urine;
- lack of appetite;
- general weakness.
Other symptoms
In addition to the manifestations listed above, indicating a high level of ALT in the blood, there are symptoms that appear depending on the defeat of a particular organ:
- Liver. Ailments are accompanied by painful manifestations under the right ribs, discoloration of the skin and yellowness of the eyes. Viral hepatitis occurs in the background elevated temperature body. Cirrhosis is characterized by the accumulation of fluid in abdominal cavity, the so-called spider veins appear on the skin.
- A heart. The main symptom of myocardial infarction is intense pain in the area chest, giving to the subscapularis, left hand and jaw. Violated heartbeat, shortness of breath occurs, blood pressure decreases. There is general weakness, chills.
- Pancreas. Nausea, repeated vomiting, sharp or aching pains in the stomach, bloating, weakness.
If there is oncological process, in addition to these signs, there is a sharp loss of weight and loss of strength.
Diagnostics
Identification of a high level of enzymes in combination with the listed manifestations makes it possible to quickly diagnose diseases, which significantly increases the effectiveness of treatment.
For research, blood from a vein is taken in the morning on an empty stomach. The reliability of the results depends on the preliminary preparation of the patient with the following simple rules:
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- last meal no later than 8 hours before sampling biomaterial;
- elimination of alcohol and smoking cessation;
- limiting physical activity.
In the case of the use of medication, the doctor should be notified.
Only if these requirements are met, the analyzes will be accurate, which will make it possible to make an accurate diagnosis.
Decoding analysis
It should be noted that when decoding the results, the values \u200b\u200bof such an enzyme as AST are also taken into account. According to the Ritis coefficient scale, which considers the ratio of these enzymes, indices up to 1.65 conventional units are taken as the norm.
Exceeding these values \u200b\u200bby 2 times indicates pathological changes in the heart muscle. Readings below 1.0 indicate liver damage.
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However, with hepatitis of viral origin, a decrease in these values \u200b\u200bis observed, and liver damage due to alcohol poisoning provokes their significant increase.
A comprehensive examination of a patient with a high level of enzymes involves the use of MRI, CT, general analysis of urine and blood, and a number of other measures.
ALT norms
In an adult and in children, there is a significant difference in indicators that are considered within the normal range. The table shows that the permissible concentration of this substance depends not only on age, but also on gender:
The indicated values \u200b\u200bare approximate, but small fluctuations up or down are allowed - from 1 to 3 units.
Factors affecting performance
The reasons for the increase in ALT are quite varied. But most often they indicate liver pathology and are a kind of marker of its condition. In addition, high values \u200b\u200bare found even with minor diseases of other organs, when they are accompanied by cell destruction.
Among them:
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- Varieties of hepatitis. At the same time, chronic and viral forms do not cause a significant deviation of ALT from the norm.
- Obstructive jaundice. High rates are also extremely rare.
- Cirrhosis of the liver. It is characterized by the absence of pronounced symptoms for a long time.
- Fatty liver disease - steatosis. This condition is characterized by a slight increase in the blood count. However, if the pathology turns into steatohepatitis, alanine aminotransferase increases significantly, and the level of direct and total bilirubin also increases.
- Malignant neoplasms in the liver. They are often the result of hepatitis. Biochemical analysis to determine ALT indicators allows not only to diagnose the disease, but also to draw a conclusion about the need for surgical intervention. ALT values \u200b\u200bincrease significantly after chemotherapy.
- Pancreatitis With exacerbation inflammatory process in pancreas ALT rises. Indicators can increase 3-6 times.
- Myocarditis (damage to the heart muscle). In addition to increasing enzyme levels, a striking symptom shortness of breath becomes.
- Myocardial infarction. The pathology is indicated by an excess of ALT values \u200b\u200bby 5 times. An increase of 10-12 times indicates the progression of deterioration.
- Alcoholism. There is an increased concentration of ALT, which increases after drinking.
- Muscular dystrophy. ALT values \u200b\u200bcan increase 8-9 times.
Exceptionally high rates provoke acute hepatitis: exceeding the norm by 20-45 times.
Other reasons
In addition to diseases, physiological reasons also act as factors causing the ALT values \u200b\u200bto deviate upward. Among them:
- exceeding the permissible physical activity;
- taking alcohol before the examination;
- stressful situations;
- eating fatty, fried, spicy foods.
Increased rates are observed during pregnancy. A slight deviation is considered natural.
Uncontrolled drug intake significantly affects the test results. Therefore, if possible, you should refrain from using them before performing the analysis.
How to bring the indicators back to normal
Exceptional informational content of the results of blood biochemistry on ALT, which makes it possible to diagnose wide range pathological conditions, does not give reason to independently draw conclusions and make decisions.
This prerogative should be given to qualified doctors.
The underlying principle in integrated approach to eliminate the problem is further examination in order to find out the root cause of the deviation from the norm. Having found out which disease triggered the increase in values, the doctor will choose the correct treatment tactics.
Diseases characterized by a particularly severe clinical course require a treatment course in a hospital setting.
These include:
- pancreatic necrosis;
- extensive myocardial infarction;
- sharp and infectious hepatitis;
- cirrhosis of the liver;
- oncology.
The treatment of each of them is specific and requires strict adherence to the doctor's recommendations.
Drug treatment
Among the most effective drugs used specifically to lower enzymes in the blood, hepatoprotectors should be noted:
- Essentiale N;
- Heptral;
- Carsil;
- Tykveol.
Drugs in this group prevent further destruction of liver cells and other organs. At the same time, they restore cells damaged by the pathological process.
Other measures
In addition to taking hepatoprotectors, choleretic agents and drugs that improve digestive processes, it is recommended to stick to a diet:
- meals should be fractional and frequent;
- fatty, fried and spicy foods should be excluded from the diet;
- banned smoked meats, sausages;
- it is not recommended to use marinades, get carried away with pickles;
- food should be steamed, baked, simmered or boiled;
- limit the use of strong tea, coffee;
- exclude alcohol and smoking.
On the use of folk methods
As an aid, it is allowed to use decoctions and infusions of chamomile, thyme, St. John's wort, peppermint.
However, you should consult your doctor before using them.
The biggest harm comes from self-medication and an irresponsible attitude to one's health.
In order to avoid serious consequences caused by untimely access to a specialist, a blood test should be done 1-2 times a year. This will allow not to miss the beginning of the destructive effect on the body of diseases of the liver, pancreas and heart.
ALT is an enzyme from the group of transaminases, the full name of which is alanine aminotransferase. Its level is determined by a biochemical blood test. The substance is excreted during all metabolic processes, but in small quantities.
An increase in ALT concentration may mean damage internal organs... The largest reserves of the enzyme are in the liver, therefore it is considered a marker of pathologies of the hepatobiliary system. The enzyme enters the bloodstream when the parenchymal organs are destroyed and muscle tissuethat doctors determine by comparing its level and other indicators of biochemistry.
What is ALT and its role in the body
Alanine aminotransferase is a protein substance necessary for amino acid metabolism. Together with other similar enzymes, low molecular weight proteins are transported in this way:
- ALT is responsible for alanine;
- AST (asparaginaminotransferase) - for aspartic acid;
- GGTP (gamma glutamyl transpeptidase) - for glutamic acid.
The active part of the enzyme is removed by the coenzyme pyridoxine (vitamin B6). ALT is present in all organs and muscle tissue. Increased concentrations of the enzyme are detected in the parenchymal structures. The largest amount is found in the liver. At lower concentrations, ALT is determined in tissues:
- heart muscle;
- pancreas;
- kidney;
- lungs.
A small amount of the substance enters the bloodstream during metabolism. The bulk is in the organs in a bound form. Here's the enzyme:
- regulates metabolic rate;
- participates in immunity;
- involved in the synthesis of energy;
- supports the vital functions of cells.
The release of ALT in large quantities occurs during massive cell death. The more the enzyme is released, the more intense the destruction process. Determination of the ALT level refers to liver tests, since it is with damage to this organ that the deviation of the enzyme indicators is most noticeable.
ALT is an unstable indicator. It depends on age, gender. The amount of the enzyme can change with hormonal fluctuations, changes in the concentration of vitamins and minerals. The level depends on the characteristics of a person's metabolism and other individual factors. Stress can affect the ALT value, physical exercise, medications, some aspects of the patient's lifestyle.
Table - Norms of ALT in blood by age
| Population category | Reference value, U / l |
| Newborns 1-2 days | Up to 31 |
| After 3 days of life | Up to 50 |
| 1-6 months | Up to 56 |
| 6-12 months | Up to 52 |
| 1-3 years | Up to 33 |
| 3-6 years | Up to 30 |
| 6-18 years | Up to 26 |
| Adult women | Up to 35 |
| Adult men | Up to 40 |
| Pregnant | Up to 32 |
| Elderly people | 19‒30 |
Indications for analysis
A blood test for ALT is carried out for the purpose of prophylaxis, in order to assess the state of the body as a whole, the safety of the functions of internal organs, the balance of electrolytes and vitamins. The study is appropriate for the early diagnosis of diseases, since it reflects the slightest changes in the basic parameters of blood and complements the information obtained in its general analysis. He is prescribed for suspicions of somatic diseases and functional disorders, the reason is the patient's complaints.
Table - Symptoms for which ALT should be assessed
| Category | Alarms |
| Signs of hepatic pathologies | Jaundice (scleral icterus, discoloration of the skin and mucous membranes, dark urine, discoloration of feces) Pain in the right hypochondrium Digestive disorders (alternating constipation and diarrhea, flatulence) |
| General condition disorders | Sleep disorders (nightmares, insomnia) Psycho-emotional instability (irritability, tearfulness, apathy, aggression) Lack of appetite Weakness, fatigue |
| Others | Subfebrile condition Headaches, pressure behind the breastbone Dry mucous membranes Brittle nails and hair Sweating |
In addition to diseases of the heart and liver, the level of ALT can be suspected of damage to the pancreas. Alcoholics are prone to pancreatitis and pancreatic necrosis, as well as persons who regularly consume fatty, fried, smoked foods.
Deviations in biochemical data are observed with extensive injuries (burns, electric shocks, muscle injuries), bone fractures, hematological pathologies. ALT is often elevated after surgery. Physiological prerequisites for an increase in the level of the enzyme are stress, exercise, carbohydrate diets.
Drugs that increase ALT are oral contraceptives, glucocorticosteroid hormones, chemotherapy drugs, antibiotics and antiviral drugs.
Minor and pathological deviations
Evaluation of the degree of enzyme (the presence of enzymes in the blood) is not considered an accurate measure of disease diagnosis. Based on the analysis data, one can only suspect the presence of pathological processes, as well as their intensity. To draw conclusions correctly, you need to be guided by the norms, permissible deviations, as well as their combinations with each other.
Since ALT always indicates cell damage, insignificant violations of the reference values \u200b\u200b(by 2-3 units) are considered physiological. Such changes are not considered a reason for further investigation and are simply ignored. If the level of increase is greater, you need to look for its cause. You can suspect it by how much the ALT indicator has changed:
- up to 2 times - a mistake is possible during the analysis, violation of the rules of preparation, severe stress, overwork, medical procedures the day before, you need to retake the test;
- 2-3 times - suspect alcohol consumption, significant errors in diet, injury, excessive physical activity;
- 3-5 times - such an increase is observed against the background of the use of hepatotoxic drugs, traumas of internal organs, after surgery, burns, as well as chronic pancreatitis;
- 5 or more times - inflammation of the liver tissue with an infectious lesion can be suspected;
- 10 times - muscle dystrophy, chronic liver diseases or initial forms of destructive processes are possible;
- 20 times or more - dangerous liver diseases, cancer progression, cirrhosis.
ALT and other indicators
In order to assess the patient's condition with maximum accuracy, doctors analyze not only the compliance of each individual indicator with the norms, but also a combination of deviations. In case of serious diseases, deviations affect most of the biochemical parameters..
Together with ALT, the importance of another enzyme, AST, is considered. It is also present in the cells of parenchymal organs, but the bulk is concentrated in the heart muscle.
In healthy people, the AST level exceeds ALT by about 1.5 times. In the opposite situation, metabolic disorders can be suspected, when proteins are consumed to obtain energy, and carbohydrates are stored as reserves.
An important value for diagnosis is the de Ritis index. This is the ratio of AST and ALT. Its norm is 1.33, a deviation of 0.4 units is allowed upward or downward. A significant increase in the index is observed with myocardial damage (more than 2). The index approaches 2 in chronic alcoholic liver damage. Pathologies of the hepatobiliary tract provoke a significant decrease in the indicator. In most cases, elevated ALT is accompanied by an increase in bilirubin concentration.
To detect liver diseases, it is important to evaluate several enzymes at once (ALT, AST, alkaline phosphatase, gammaglutamyl transpeptidase) and the degree of their deviations. The larger they are, the more intense the pathological process and the higher the threat to the patient's health and life.
Table - Deviation of enzyme levels
Mild to moderate disorders are observed in non-alcoholic fatty liver disease, chronic viral hepatitis, and initial stages development of tumor diseases. The average increase accompanies chronic inflammatory lesions of the gland, ethanol poisoning. A significant increase in indicators is observed when acute form hepatitis, toxic damage, as well as in the late stages of cancer or cirrhosis.
Why ALT is elevated during pregnancy
While carrying a child female body is undergoing total changes. First of all, metamorphoses affect the hormonal background. The concentration of bioactive substances is constantly increasing until delivery. The enlargement of the uterus and the baby is accompanied by pressure on the internal organs. All of them suffer from increased loads associated with the need to supply the fetus with nutrients, utilize its metabolic products, and an increase in blood volume.
The normal ALT level for pregnant women should be below 32 U / L. The indicator rises slightly in the first and third trimester. Moderate changes are considered a normal variation. If a woman did not suffer from heart or liver diseases before conception, does not complain of poor health, treatment is not required. The growth of indices by more than 1.5 times requires increased attention... This may be a signal of the development of gestosis, eclampsia, diseases of the cardiovascular system, liver or gallbladder. Often this happens in the background long-term intake drugs of the gestagen series - Dyufaston, Utrozhestan, Susten.
ALT in children
The concentration of alanine aminotransferase is increased in children of the first year of life. It's connected with active development organs and systems, adaptation mechanisms that are aimed at adapting to life outside the mother's womb. The second peak occurs during puberty. At this time, the child is growing rapidly, the formation of hormonal levels occurs. When development slows down, ALT levels decline and remain stable. If the enzyme levels are greatly increased, this indicates a dangerous disease (as in adults).
What to do with elevated ALT
In most cases, doctors recommend taking the test again (in case of an error in the study of blood or violation of the rules of preparation). An additional examination is prescribed only if significant deviations are re-identified. Often it includes a general analysis of blood and urine, ultrasound of the liver and other internal organs, MRI or CT, tests for tumor markers.
Different laboratories use different equipment for analysis, different units of measurement are used. In this case, a high indicator can be perceived by the patient himself as a deviation, when in fact it is not. In addition, ALT should be assessed along with other values. Without special knowledge, it is difficult to correctly understand the results.
With deviations in the results of blood biochemistry, you should consult a doctor. The child must be shown to the pediatrician, pregnant women must make an appointment with their obstetrician-gynecologist, and adults must see the doctor who ordered the examination or the therapist. It is better not to make independent conclusions, but to entrust the reading of the research protocol to a specialist.
In addition to the analysis itself, it is important to collect a family history, interview the patient for complaints, conduct a physical examination in order to detect objective symptoms of pathology. All this will help narrow down the search for the disease that caused the increase in ALT.
How to be treated
ALT is a laboratory indicator, a sign of destruction of cells of parenchymal organs. The increase in the enzyme itself is not subject to treatment. Therapy is completely aimed at the underlying disease, which provoked a shift in the result outside the normal range. It is important to stop destructive processes and start organ regeneration (if possible). In case of irreversible changes, the task of treatment is to slow down the destruction and provide surgical care (liver transplant, for example).
The list of medications completely depends on the nature of the disease (for infections, antiviral or antibiotics are prescribed, for oncopathologies - chemotherapy drugs). The therapy regimen is selected based on the patient's condition. With a significant excess of the ALT indicator, the patient is monitored in a hospital (hepatitis, cirrhosis, cholestasis). Small deviations that do not pose a threat to the patient's life can be eliminated on an outpatient basis.
The main group of drugs that are used when the enzyme indicators deviate from the norm are hepatoprotectors... Means of this group have antioxidant, anti-inflammatory properties. They improve the functioning and start the recovery of hepatocytes, optimize the synthesis and properties of bile, preventing its stagnation in the ducts.
Most of the hepatoprotectors have anti-inflammatory properties. Most of these drugs have similar indications. Some of them are used in the complex therapy of hepatitis, hepatosis and cirrhosis, and some are used for disorders of the biliary tract, accompanied by cholestasis (gallstone disease, cholelithiasis).
Table - The best hepatoprotectors
Frequently asked Questions
Question: Do you need a diet with elevated ALT?
Answer: Diet therapy is a mandatory aspect complex treatment any liver pathology. Its task is to reduce the load on the gland, ensure the normal outflow of bile and optimize metabolic processes. A therapeutic diet is recommended even with minor deviations in children and pregnant women, so as not to aggravate liver damage. It is also necessary to adjust the diet when it is necessary to be treated with drugs that are dangerous to the organ (antiviral agents or powerful antibiotics). In most cases, doctors recommend adhering to the Pevzner diet 5 (for liver, biliary, pancreatic diseases).
Question: The dietary table menu is so complicated ... Is it possible to briefly describe the general principles of nutrition with high enzymes?
Answer: Everything harmful is excluded from the diet - fatty, fried, smoked, flour, sweets, canned food, pickles and pickles, fast food, soda and alcohol. The menu should contain all types of cereals (except for barley), easily digestible proteins (chicken, fish, turkey, dairy products), a lot of vegetables and fruits (in any form). It is important to replace animal fats with cold-pressed vegetable oils (fill them with cereals and salads), add nuts to the menu. You need to eat fractionally, in small portions, every 3 hours to optimize bile flow. Drinking regime should be observed (1.5 liters of water per day, except for other liquids).
Question: Is it possible to reduce the indicator using folk methods (without drugs and diets)?
Answer: As part of the complex therapy of liver pathologies, you can use herbal remedies (decoctions and infusions). For example, hepatic collection, Hepatofit tea, milk thistle meal. The people recommend brewing corn silk, dandelion root, yarrow, St. John's wort, peppermint. All these methods can be auxiliary or used to prevent bile stagnation. In the treatment of serious diseases, herbs alone are indispensable. Moreover, phytotherapy and vitamins during the development of oncopathologies can only harm. Before using any folk recipe, it is better to consult with your doctor.
Q: Could a high ALT be a false result?
Answer: Maybe. An error should be suspected if only this indicator is increased or the deviations are insignificant (up to 2 times). That is why biochemistry often has to be retaken. In order to be on the safe side, you should properly prepare for the test:
- exclude alcohol and drugs a week before donating blood;
- limit junk food in 3 days;
- eliminate stress, overstrain and physical activity on the eve of the analysis;
- donate blood only in the morning, on an empty stomach.
Even if all the conditions are met, and the result shows deviations, it is better to repeat the analysis. This will eliminate the pointless visit to doctors and the cost of hardware diagnostic methods.
Question: What symptoms can be used to understand that ALT is elevated and it is time to take a biochemical blood test?
Answer: An increase in the level of enzymes in the blood does not cause specific symptoms. By clinical signs one can only assume the presence of a disease that can provoke ALT deviations from the norm, for example:
- damage to the pancreas is accompanied by girdle pain in the abdomen, nausea, vomiting, flatulence, stool disorders, fever;
- liver pathologies are manifested by pain under the right rib, jaundice, periodic disorders in the gastrointestinal tract, general disorders of the condition;
- heart disease can be suspected by pressing and stitching pains in the chest (often radiating to the arm, shoulder blade, collarbone), shortness of breath, edema, cyanosis of the extremities.
conclusions
ALT is an important laboratory indicator that helps assess the health of internal organs. The average rate for adults and school-age children is 35 U / l. Deviations mainly indicate diseases of the liver, heart, pancreas and indirectly can talk about pathology of the kidneys and lungs. With an increase in ALT levels, hepatic disorders are primarily suspected, or rather, cell destruction. To pinpoint the problem, ALT is considered in combination with bilirubin, other enzymes. A full diagnosis can be carried out by comparing the results of biochemistry, general analysis blood and urine, ultrasound of internal organs. It is not high ALT that needs to be treated, but the disease that caused its growth.
Along with ALT, another enzyme is always considered - A FROMT (aspartate aminotransferase). In women, it should be up to 31 U / l, in men up to 41 U / l. An increase in the concentration of AST in the blood indicates the destruction of cells of the heart, liver, pancreas and other organs.
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are enzymes that are active participants in amino acid metabolism. They can be found in cells of the kidneys, liver, heart muscles and other organs.
If they enter the bloodstream, this indicates the presence of any disruption in the functioning of organs due to the destruction of cells.
When ALT levels are elevated, this most often indicates the development of a certain diseases affecting the liver... Deciphering the 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 the blood test, and what does it mean? Alanine aminotransferase (ALT) is an endogenous enzyme belonging to the transferase group, transaminase subgroup, or aminotransferase. 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 level of AST.
Evaluation of these two laboratory parameters allows the doctor to suggest the localization of the pathological process and determine the likely severity of the disease. For rate ritis coefficient applied (AST / ALT ratio), which is normal 1.33. In acute viral hepatitis, this coefficient decreases, while in myocardial infarction and alcoholic liver damage, it increases.
Where ALT is contained:
- Liver (most)
- Kidneys;
- Lungs;
- Pancreas;
- Muscles;
- A heart.
The main function of alanine aminotransferase is associated with the exchange of amino acids. This substance acts as a catalyst for the transfer of certain molecules. When energy metabolism is disturbed, the permeability of cell membranes increases, which leads to cell destruction and the release of the enzyme into the blood serum.
Norm
The norms in which alanine aminotransferase should fit in the blood are as follows:
- children under 1 year old: 13 - 45 U / l;
- men under 1 - 60 years old: 10 - 40 U / l;
- women 1 - 60 years old: 7 - 35 U / l.
In analytical studies for this enzyme, high accuracy is required, and it is directly related to the intake of certain drugs that can distort the analytical picture. Therefore, before checking the ALT level, you need to consult with your doctor, who will either temporarily stop taking medications, or will take into account the deviations in the test results associated with drug therapy.
Elevated ALT in the blood: causes
In simple terms, alanine aminotransferase is an enzyme that, in addition to the liver, where its concentration is especially high, is found literally in all parenchymal organs, occupying mainly 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 a reliable sign of damage to its parenchyma, because the activity of the enzyme in the blood plasma is in direct proportion to the degree of involvement of the tissue of this important organ in the pathological process.
Given such a high sensitivity of ALT, it can be expected that alanine aminotransferase will be increased in cases of the slightest suffering of the hepatic parenchyma.
So, an increase in ALT indicators happens in following cases :
- ... it inflammatory disease the liver can be presented in several forms. For chronic or viral hepatitis, the excess of the level of alanine aminotransferase in the blood is insignificant.
- Rarely, an increase in ALT can be observed in cases of obstructive jaundice, but high values \u200b\u200bof this indicator are extremely rare.
- ... This disease is dangerous because for a long time it may not have pronounced symptoms. Patients get tired quickly and feel tired.
- Liver cancer. This malignant tumor often formed in patients with hepatitis. Analysis for ALT in this case is necessary both for the diagnosis of the disease and for making a decision on an operational decision.
- Non-alcoholic fatty liver disease (steatosis): ALT levels increase slightly - 2-3 times. With the transition of the disease to the phase of steatohepatitis, there is a pronounced increase in ALT, a high level of total and direct bilirubin, as well as indicators of the inflammatory activity of the blood.
- ... The presence of this disease is also indicated by the ALT level. 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 content ALT in the blood.
- ... This disease is a consequence of impaired blood flow, resulting in tissue necrosis of the heart muscle.
- Tests can show an increase in ALT levels with alcoholism and immediately after taking alcoholic beverages.
With an increase in the ALT level by 5 times, one can assume myocardial infarction, if it reaches 10-15 times, we can talk about a worsening of the patient's condition after an attack. In this case, 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 dermatomyasitis - by 8. Gangrene, acute pancreatitis is indicated by an excess of the upper limit of the indicator by 3-5 times.
Non-disease-related causes of ALT elevation
There are other reasons that can raise the level of ALT in the blood, for example, some medicines, such as estrogens, oral contraceptives, cholestatics, steroids, iron salts, a nicotinic acid, sulfonamides, methyldopa, azithromycin, aminoglycosides, cephalosporins, fluoroquinolones, clofibrate, clindamycin.
In some cases, the cause of an increase in the level of alanine aminotransferase is physiological reasons:
Of course, mainly the level of the enzyme increases due to other health problems, but it is for the above reasons that the indicator can be increased, but not significantly.
What to do when blood ALT is elevated?
If the ALT blood test is elevated, then a more complete examination is necessary to identify the cause of this change. And the sooner this is done, the much better the outcome will be.
Most often, hepatoprotectors are prescribed to reduce ALT indicators:
- Heptral;
- Essentiale N;
- Carsil;
- Tykveol.
These drugs have multiple effects. First of all, they protect liver cells from further damage, as well as restore already damaged, but not yet dead cells.
Alanine aminotransferase (also ALT, ALT) is a protein enzyme that is responsible for the transport of certain molecules and acceleration of biochemical processes involving amino acids.
ALTs are found mostly in organ tissue cells. In healthy people, the ALT in the blood cannot be increased, since if ALT is released into the blood, it is likely that a serious illness occurs in some part of the body.
Most of all ALT is found in the liver, it can also be found in the kidneys, heart muscle, nerve connections, lungs. Damage to these organs and tissues can cause an increase in ALT in the blood.
Optimal value in organism
This parameter is measured in units per liter of blood. ALT is age dependent in childhood and sex dependent in adults.
Children under one year old: no more than 55 units / l
Children 1-3 years old: no more than 34 units / l
Children 3-6 years old: no more than 30 units / l
Children 6-12 years old: no more than 39 units / l
Men: no more than 45 units / l
Women: no more than 35 units / l
The norm in this case is not a strict only possible value, but an approximate assessment criterion. In some laboratories, devices may have varying degrees of sensitivity, which means that the analysis results should be discussed with the attending physician. medical institution.
Alanine aminotransferase is elevated, what does it mean?
According to the degree of difference between the actual result of the analysis and the value taken as the norm, they are distinguished:
- Slight increase (200-500%);
- Moderate increase (up to 1000%, that is, 10 times more);
- Expressed (more than 10 times higher than the norm).
The second and third stages most likely indicate that the increased ALT in the blood is a consequence of the disease, and the third case occurs in those patients who have already begun to seriously destroy the organ.
In addition to the diseases that we will consider below, elevated ALT may be associated with the following confounding factors:
- Muscle injuries;
- Burns;
- Intramuscular injectionmade the day before;
- Large weight (body mass index over 30);
- Taking medications (estrogens, antibiotics, cholestatics, heparin, oral contraceptives, anti-epilepsy drugs, warfarin, echinacea, valerian, etc.);
- Mononucleosis;
- Pregnancy (third semester), provided that ALT is slightly increased;
- Chemotherapy;
- Drug use;
- Lead intoxication;
- Laboratory inaccuracies.
In order to get a reliable result, it is necessary to donate blood on an empty stomach, 12 hours after the last meal. Refrain from alcohol a week before going to the clinic, and from smoking an hour before donating blood. Try not to get stressed or physically overwhelmed. If you doubt the accuracy of a blood test, take it to another laboratory.
To determine if normal or elevated ALT in the blood, more often blood is taken from the vein, but in some cases also from the capillaries.
Causes and diseases when ALT is elevated in the blood
Since the enzyme under study can be retained in various organs, it may indicate a problem with their health. Let's consider what it means "ALT is raised" in each case.
- Liver disease
The largest amount of ALT, as already mentioned, is located here, it is not surprising that this analysis is recognized in time to notice and cure liver diseases.
- Steatosis
The accumulation of fat in liver cells affects the fact that ALT is increased by 2 times. But if the painful condition worsens to steatohepatitis, ALT will increase much more, and the level of bilirubin will also increase.
- Hepatitis
If ALT is increased in the blood test, and the symptoms of the disease have not yet appeared, we can talk about hepatitis A. Usually, the symptoms are delayed, and thanks to the timely donation of blood for analysis, you can speed up the healing process.
With hepatitis B and C, ALT increases even 100 times, since the toxic effect of the virus spread in the liver is especially great on its cells.
Chronic hepatitis causes an increase in ALT during an exacerbation, but the increase is usually no more than 3-4 times.
Other symptoms of hepatitis include pain and discomfort in the right side, under the ribs, a feeling of a bitter taste in the mouth, yellowing of the skin, mucous membranes, whites of the eyes, and stool disorder.
- Cirrhosis
Very high blood ALT may not be observed in cirrhosis. ALT will increase, but 1-5 times from the norm. This is due to the replacement of liver cells with connective tissue.
- Liver cancer
Usually, malignant tumors in the liver appear in people with hepatitis. The level of how much alanine aminotransferase is elevated helps to decide on further treatment cancer in a surgical way. For example, if ALT is very high, the operation has a high risk of complications.
- Autoimmune hepatitis
A disease more common in women than men. To clarify its presence or absence, the doctor may prescribe a biopsy.
- A heart
Heart disease, or rather heart muscle, is primarily indicated by another analysis - AST, but along with it, ALT is also used for diagnosis.
- Myocardial infarction
The death of a part of the heart muscle, as a result of which a certain amount of AST and ALT enters the bloodstream. If the AST analysis is greatly increased and the alanine transaminase is increased by 5 times, the reasons should be sought in the possibility of myocardial infarction.
Other symptoms: sharp pain in the region of the heart, radiating to the left upper side of the body, the pain can last half an hour or more, the patient has shortness of breath, dizziness, panic fear of death, weakness.
- Myocarditis
Just as for other diseases of the heart muscle, myocarditis cannot be established only on the basis of the fact that ALT is elevated. The reasons for this can be varied. Often, to clarify the diagnosis, an analysis for AST is also considered and the de Ritis coefficient is calculated, equal to ALT / AST.
Symptoms include shortness of breath, weakness, and rapid fatigability of the patient.
Heart failure, rheumatic heart disease, recently transferred surgical intervention on the heart can also cause an increase in ALT in the blood.
- Pancreas
- Pancreatitis
The disease can occur in acute or chronic form... An increase in ALT indicates an exacerbation stage. For people with pancreatitis, it is advisable to donate blood regularly for ALT analysis.
ALT elevated in a blood test can be an alarm bell of any serious and even destructive disease, or it can be a common mistake or a normal reaction of the body. Your further examination determines the prompt diagnosis and possible treatment.
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