Alanine aminotransferase and aspartate aminotransferase are endogenous enzymes and are significant markers in biochemical blood tests.
Although an elevated ALT level does not clearly indicate the occurrence of health problems, nevertheless, both enzymes are simply not present in blood in large volumes.
Yes, the level of both ALT and AST can increase with liver disorders (for example, with cirrhosis or hepatitis), but other markers must be carefully analyzed. By the way, the level of AlAT can be increased if myocardial infarction is diagnosed.
Aminotransferases are a group of enzymes that can catalyze transamination reactions, playing a leading role in protein metabolism, as well as maintaining the relationship between protein and carbohydrate metabolism. The most significant natural catalysts for transamination reactions in the human body are alanine aminotransferase (otherwise ALT, ALAT) and aspartate aminotransferase (otherwise AST, AsAT).
These enzymes are present in the tissues of many organs. Normally, aminotransferases are practically not detected in the blood. The minimum activity of enzymes is determined by the natural regenerative processes in the body. Increased levels of AlAT and AsAT are highly sensitive markers of tissue damage in which they are contained.
The method for determining aminotransferases in a biochemical blood test has been widely used in clinical practice due to its high sensitivity and specificity.
AsAT and AlAT. Norm
Normally, aspartate aminotransferase does not exceed 31 IU / L in women and 37 IU / L in men. In newborns, the indicator should not exceed 70 PIECES / L.
ALAT in women normally does not exceed 35 IU / l, and in men - 40 IU / 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 may affect transaminase levels
The following can lead to distortion of the analysis results:
- the use of certain medications:
- a nicotinic acid,
- immunosuppressants
- choleretics
- hormonal birth control, etc.),
- obesity,
- pregnancy,
- lack of exercise or excessive physical activity.
How is the study
For analysis, blood is taken from a vein. Results from an urgent study provide within 1-2 hours. With standard diagnostics, during the day.
To obtain the most reliable results, you must:
- exclude the use of medicines a week before the test (if this is not possible, it is necessary to notify the doctor about the drugs taken);
- donate blood exclusively on an empty stomach;
- the day before the study excludes physical activity, smoking, alcohol, fatty and fried foods - two days in advance.
What can the analysis on ALaT and AsAT tell?
Alanine aminotransferase and aspartate aminotransferase are characterized by selective tissue activity. If considered in 
in decreasing order the content of these enzymes in organs and tissues, the list will look like this:
- alanine aminotransferase: liver, kidney, myocardium, muscles;
- aspartate aminotransferase: myocardium, liver, muscles, brain, kidneys.
Laboratory studies allow a little deeper study of the causes of the onset or development of a particular disease. Some test results openly raise concern: when ALT is elevated, the doctor immediately prescribes additional studies. Hospitalization is often recommended. Why are the excess indicators ALT and AST are dangerous indicators for human life?
Aminotransferases: the role of the enzyme in the human body
Analyzes can be prescribed both during the period of a regular examination, and at the time of exacerbation of certain diseases. Tests such as ALT and AST are critical indicators of the proper functioning of many internal organs. A deficiency or a significant concentration of them in blood plasma means serious disturbances in the functioning of organs such as the heart, kidneys and liver. Violation of the integrity of the skin (burn) also provokes an increase in the concentration of the enzyme in the blood plasma. With a significant excess of the indicator, special attention is still paid to the liver. In 75%, an elevated ALT level indicates a serious disruption in the functioning of the vital for the human gland - the liver. The higher the indicator, the worse the diagnosis.
Aminotransferases are important proteins that are actively involved in the work of internal organs. Proteins are divided into several groups and each such group is able to transfer certain amino acids. The transaminase group is determined by the amino acid that these compounds transfer: for example, alanine aminotransferase transfers alanine, aspartate aminotransferase - aspartic acid, and glutaminate aminotransferase - glutamic acid. The correct reaction of the transfer of amino acids provides coenzyme pyridoxine - vitamin B6. A lack of such a vitamin can provoke a violation of the correct transfer, and as a result, disrupt the functioning of the organ. Alanine aminotransferase in the assays is prescribed by the abbreviation - “ALT” (alt), aspartate aminotransferase - “AST” (ast).
As mentioned earlier, ALT is concentrated in the internal cells of many organs. And only a violation of the functions of a particular organ can provoke an increase in protein in the blood. What reasons can provoke the need to take an analysis for enzymes? A number of dangerous diseases may not appear in acute symptoms for a number of reasons. The clinical picture of deadly diseases is sluggish and little noticeable:
- headaches of various types;
- sleep disturbance, insomnia, nightmares;
- increased sweating;
- skin rashes in the form of acne, acne, redness;
- dry mucous membranes;
- weakened immunity;
- constantly depressed state, depressive mood;
- minor disturbance of the digestive system (periodic diarrhea, constipation, bloating);
- the manifestation of "vascular asterisks" in large numbers (especially on the skin of the face, neck, hands);
- aggression, fatigue and apathy.
But, it is the indicators of this protein and its concentration in blood plasma that can show the true cause of the depressed state. Often timely diagnosis reveals emergency conditions that were without an obvious clinical picture:
- cirrhosis, necrosis, hepatitis of the liver, tumors - 50%;
- myocardial infarction - 30%;
- pancreatitis - 10%;
- internal organ ruptures (with the exception of burns) - 10%.
A general blood test cannot show the concentration of this protein. In the presence of chronic diseases, a depressed mood and general weakness can be observed. An adult patient may have previously been prescribed antidepressants and sedatives. Meanwhile, without accurate and timely diagnosis, the underlying disease progresses, the patient's condition does not improve. When does the doctor prescribe an additional test for ALT in the blood? These may be different reasons. A biochemical blood test can show a true picture of the patient's condition. To refute or confirm the diagnosis, the doctor may additionally prescribe a biochemical blood test for the presence of AST and ALT enzymes.
When ALT protein is elevated, this can mean serious liver problems (often). However, for each age there are specific "norms".
When is ALT elevated in children? Norms of this enzyme for children:
- infant from birth to two days - ˂31 IU / l;
- infant from two days to 5 days - ˂52 IU / l;
- a child up to six months - ˂60 IU / l;
- children up to a year - ˂57 IU / l;
- child from a year to 3 years - ˂39 IU / l;
- 4-6 years - ˂29 IU / l;
- 7-12 - ˂39 IU / l;
- from 13 to 18 years old boys - ˂26 IU / l;
- from 13 to 18 girls - ˂23 IU / l.
ALT standards for men and women for different ages:
- women from 20 to 60 years old - ˂32 IU / l;
- men from 20 to 60 years old - ˂40 IU / l;
- elderly people from 60 to 90 years old - ˂19-30 IU / l.
If ALT protein is elevated, then doctors determine the degree of difficulty. There are three degrees of difficulty:
- easy - excess of indicators by 1.5 - 3 times;
- average - excess of indicators by 5-10 times;
- severe - increased ALT protein by 10 or more times.
It is worth noting that the excess of aminotransferase in liver diseases is observed even without visible symptoms. A rise in protein in the blood with a simultaneous increase in AST indicates complex and extremely complex conditions.
Proper blood sampling is a guarantee of an accurate result.
At the first overestimated rates of this enzyme, the doctor usually prescribes re-sampling of the biomaterial. Such actions are necessary in order to exclude / confirm the diagnosis, to establish the exact figure of aminotransferase in the patient's blood.
It is important to take blood for further laboratory research. The biomaterial (in this case, blood from a vein) is taken only in the morning on an empty stomach. In addition, it is not recommended to eat protein animal and vegetable foods the night before: meat, legumes, peas, milk, sour cream, eggs, soy, sausages, cheeses, cottage cheese.
To determine the aminotransferase in the blood, 1 ml of blood serum is enough. Blood for examination is taken directly by a medical professional using a syringe. Blood is placed in a vacuum container. Within 2 hours, the material must be delivered to the laboratory. The temperature regime of the collected blood is also important to observe. Otherwise, the indicators will be distorted. Temperature storage of blood: 2-8 ° C.
Increased ALT: Causes
Among the main causes are disorders and severe liver diseases. The activity of the enzyme in the blood increases only due to the release of the enzyme by the diseased organ. With an increase in ALT, we can talk about such diseases:
- necrosis of liver cells of any localization;
- oncological malignant tumors of internal organs;
- heart failure;
- cirrhosis of the liver;
- hepatitis of viral etiology;
- obstructive jaundice;
- myocarditis;
- chronic or acute pancreatitis;
- extensive myocardial infarction;
- muscle dystrophy (as a result of alcoholism);
- hemolytic diseases;
- extensive burns;
- bone fractures;
- preeclampsia.
Reasons for lower ALT
Reduced ALT protein levels are not associated with liver disease. Most often, a depressed state provokes a lack of vitamin B in the body. Improper diet, chronic long-term alcoholism are the main causes of reduced ALT. To normalize the condition, you need to adapt your diet, enriching it with protein vegetable and animal foods.
While elevated rates most often indicate liver problems, underestimated rates suggest a malignant tumor of the digestive and genitourinary systems. Infectious diseases of the genitourinary system can also provoke a decrease in ALT.
Pregnancy is a period of increased stress on literally all the internal organs and systems of a woman. Hormonal changes can also affect the functioning of the liver, and therefore the level of protein in the blood.
Indicators in pregnant women should be normal. An exception is the first trimester of pregnancy. It is during this period that an increased load on the liver occurs, which now provides clean blood not only to the mother, but also to the child. However, any norms must be negotiated exclusively with the doctor.
If ALT is elevated after the third month of pregnancy, we can talk about gestosis. In this case, constant dizziness, fainting, pain in the temples, high blood pressure, nausea, and vomiting can be observed. A very high load on the liver can be aggravated by chronic diseases of a pregnant woman: diseases of the genitourinary system, infectious diseases, pancreatitis, thyroid disease, heart disease.
ALT and AST are just a “picture” of the state of internal organs. If there are complex liver diseases, then the level of protein in the blood will decrease only if cured. ALT alone cannot rise or fall. This is almost always an “alarm” signal of your body. It is possible to stabilize the concentration of alanine aminotransferase only by eliminating the underlying disease. To maintain liver function with a lack of vitamin B, a proper diet, vitamin complex and maintenance therapy with hepatoprotectors are prescribed.
A correctly performed biochemical blood test can show the condition of both the liver and other internal organs. However, if the norms are exaggerated several dozen times, then we can talk about complex fatal diseases of the gland. For example, in cirrhosis, the norm of alanine aminotransferase can be increased by more than 50 times. And the higher this indicator, the worse the condition of the patient. If the enzyme norms are increased after a previous heart attack, then we can talk about the increasing risk for the patient: the higher the ALT level, the higher the likelihood of relapse.
Analysis of the level of enzymes - aminotrasferases AlAt and AsAt - are considered the two most important indicators for detecting liver damage and are most often prescribed together, since their ratio helps differentiate various diseases of this gland and diseases of other internal organs. In this article we will analyze in which cases it is necessary to take an analysis for the level of the AlAt enzyme (alanine aminotransferase), we learn about the normal levels of AlAt and the reasons for the deviation from the norm.
AlAt in the results of a blood test: what is it?
Alanine aminotransferase, or AlAt, is a specific enzyme that is found in all cells of the body, is present in a larger amount in the liver, heart and kidneys, in a smaller one - in the pancreas, spleen, and lungs. The enzyme is produced inside the cells and is involved in the synthesis of many amino acids. Normally, it is present in the blood in very small quantities, and its detection beyond the limit may indicate serious pathologies of the above organs. The fact is that when the cells of the latter are destroyed, the enzyme is released and enters the blood. In a blood test, AlAt levels are measured in units per liter.
AlAt is an intracellular enzyme from the group of aminotransferases that catalyzes the interconversion of amino acids (proteins) and keto acids (oxocarboxylic acids) by reversible transfer of an amino group. This process is called transamination. AlAt plays an indispensable role both in nitrogen (protein-carbohydrate) and in energy metabolism, when, under its influence, organic substances (synthesized or ingested by food) decompose to end products with the release of energy necessary for cell activity. For diagnostic purposes, the analysis of AlAt is most revealing in terms of detecting liver damage than its "brother" AsAt (aspartate aminotransferase).
By itself, the level of AlAt in a blood test is not a specific indicator and may indicate necrotic processes (cell death) of many organs. However, most often, such an analysis is prescribed for suspected liver pathology with the appearance of the following symptoms:
- nausea or bitterness in the mouth;
- yellowed skin;
- discomfort and pain in the right hypochondrium;
- enlargement of the liver.
These signs may indicate impaired liver function and the death of hepatocytes - liver cells. In order to assess the magnitude of pathological processes, a biochemical blood test is prescribed to determine the content of substances in it that are synthesized with the participation of the liver. These substances include specific hepatic enzymes and bilirubin (bile pigment). Thus, the level of AlAt alone cannot speak of abnormalities in the liver; it is analyzed in conjunction with the following indicator enzymes:
- aspartate aminotransferase (AcAt);
- aldolase;
- lactate dehydrogenase (LDH);
- γ-glutamyltranspeptidase (GGT).
Moreover, not only the quantitative content of these enzymes in the blood is important, but also their ratio. For example, if AlAt is increased more than AsAt, this is a sure sign of liver cell destruction. If the level of AsAt is higher than the level of AlAt, then such a "picture" indicates heart problems. With muscle injuries (necrosis of muscle cells), both AlAt and AsAt are increased equally.
Preparation and conduct of the study
To determine the level of AlAt in the blood, venous or capillary blood is used, which surrenders from 8 to 11 in the morning, on an empty stomach. AlAt belongs to the category of biochemical analysis of blood. 30 minutes before the analysis, it is recommended to quit smoking and avoid physical and emotional stress. The day before, it is advisable not to expose the body to food overloads, drink only water (as usual). The deadline for the study, as a rule, is 1 working day, not counting the day of taking the biomaterial. It should be remembered that the level of AlAt can be increased due to the use of certain drugs, therefore, before passing the analysis, you should consult your doctor about the possibility of suspension of their use. If the reception cannot be canceled, the doctor will be able to take into account the influence of this factor on the analysis results.
A list of essential drugs that increase AlAt is given below:
Deciphering the results of the analysis on AlAt
As already mentioned, alanine aminotransferase is an intracellular enzyme, which means that when cells die, it is released and enters the bloodstream, which is then detected. Deciphering the results of the analysis of AlAt is not particularly difficult, however, it should be remembered that it is desirable to analyze the level of the enzyme in combination with other indicators - AsAt, LDH, etc. However, if you have in your hands only the results of the AlAt analysis and there are suspicions of a serious liver disease, then you can take into account several basic patterns:
- in viral hepatitis, the level of AlAt is proportional to the degree of cytolysis (destruction of liver cells);
- in acute viral hepatitis, the level of AlAt may exceed the normal value by 50-100 times;
- with alcoholic hepatitis, the increase in AlAt level is moderate, no more than 6 times;
- toxic liver diseases give a picture similar to viral hepatitis;
- with cirrhosis, the level of AlAt can reach a 4–5-fold increase from the norm;
- with liver carcinoma, AlAt and AsAt increase 5–10 times;
- fatty degeneration of the liver leads to an increase in AlAt by 2 or 3 times.
Especially informative is the determination of AlAt activity for early diagnosis of hepatitis, since AlAt activity in blood serum begins to increase already in the first (prodromal, preicteric) stage, which lasts from 10 to 350 days, depending on the form of hepatitis (A, B, C, D , E, etc.), when other signs of the disease have not yet manifested.
In newborns, the AlAt level does not exceed 17 units per liter, then the enzyme content increases every day, which is explained by the launch of all protective mechanisms in the body. In addition, the amount of enzyme in the blood serum in women is slightly lower than in men. In pregnant women, this indicator is usually increased, however, an excessive increase in the level of AlAt may indicate liver pathology. Here is a table of norms for the analysis of AlAt:
The study can be prescribed by the following doctors: therapist, gastroenterologist, infectious disease specialist, hematologist, endocrinologist, surgeon. It is also advisable to consult a hepatologist, urologist and oncologist to get advice on the results of the AlAt analysis, especially if there are any complaints about well-being according to the profile of these doctors.
Pathologies associated with increased levels of the enzyme in the blood
What diseases can an increased level of the enzyme indicate? First of all, these are liver diseases of various etiologies: viral hepatitis, cirrhosis, toxic and alcoholic damage, liver cancer, jaundice, fatty hepatosis. Toxic liver damage can be caused by the use of hepatotoxic drugs - psychotropic drugs, anabolic steroids, contraceptives, antibiotics, immunosuppressants and others. An increase in AlAt, as already mentioned, can also be associated with pathologies of other organs: heart failure, skeletal muscle necrosis, extensive myocardial infarction, myocarditis, myositis, myodystrophy, severe pancreatitis. Also, an increased level of AlAt occurs when getting extensive burns, hemolytic and genetic diseases, with a primary lack of alpha1-antitrypsin and carnitine, Westphal-Wilson-Konovalov disease.
On a note
Carnitine is a natural substance related to B vitamins. It is synthesized in the human body and is present in the tissues of striated muscles and liver.
In some patients, elevated ALA may be due to intramuscular injections and intense physical exertion, as well as taking medications and dietary supplements (dietary supplements). Unhealthy diet - eating foods with unhealthy dietary supplements - can also slightly affect the results of an AlAt assay. Two and three-fold excess of the norm is interpreted by doctors as a “slight increase", up to 20 times - "moderate", and only more than twenty times relative to normal indicators "allow" to sound the alarm - this is a pronounced increase.
What does low alanine aminotransferase mean?
A reduced enzyme content indicates severe liver damage when extensive cell necrosis occurs. In this case, a decrease in the level of the enzyme is explained by a critical reduction in the number of cells themselves synthesizing it. In addition, a decrease may indicate a deficiency of vitamin B6.
Since the analysis of AlAt is not specific for the determination of many diseases, it is worth remembering that an indicator within the normal range is not evidence of the absence of liver pathologies. For an accurate diagnosis, AlAt analysis should be taken simultaneously with other related tests that were mentioned above. This study should be carried out in the presence of certain risk factors - for example, in contact with patients with viral hepatitis, with a hereditary predisposition to liver disease, with diabetes and overweight, while taking toxic drugs.
Alanine aminotransferase or abbreviated ALT is a special endogenous enzyme. It is included in the group of transferases and a subgroup of aminotransferases. The synthesis of this enzyme takes place intracellularly. A limited amount of it enters the bloodstream. Therefore, when biochemical analysis shows an increased content of ALT, this indicates the presence of a number of deviations 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 degree 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: the kidneys, heart muscle, liver, and even skeletal muscle. The main function of the enzyme is to exchange amino acids. It acts as a catalyst for the reversible transfer of alanine from an amino acid to alpha-ketoglutarate. As a result of the transfer of the amino group, glutamic and pyruvic acids are obtained. Alanine in the tissues of the human body is necessary, as it is an amino acid that can quickly turn into glucose. Thus, it is possible to obtain energy for the brain and central nervous system. In addition, among the important functions of alanine is the strengthening of the body's immune system, the production of lymphocytes, and the regulation of acid and sugar metabolism.
The highest activity of alanine aminotransferase was detected in blood serum in men. In women, processes involving the enzyme proceed more slowly. The highest concentration is observed in the kidneys and liver, followed by skeletal muscle, spleen, pancreas, red blood cells, lungs, heart.
What is analysis used for?
The greatest amount of transferase is found in the liver. This observation is used to detect diseases of this organ that do not have external symptoms. ALT, unlike many other components considered in the biochemical analysis of blood, has been studied most fully. Therefore, with its help it is possible to identify even minor problems in the body. In some cases, the amount of ALT is compared with the volume 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 enters the bloodstream. Deviation from the aspartate aminotransferase content established in medicine, as in the case of alanine aminotransferase, is a manifestation of deviations in the functioning of some organs. The most complete picture of the nature of the pathology allows one to obtain a correlation of the contained amounts 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. AST levels increase sharply in the later stages of the disease of this organ, such as. When the level of aspartate aminotransferase exceeds the content of alanine aminotransferase, problems with the heart muscle are observed.
Confirm the presence of the disease and the degree of organ damage allow additional diagnostic methods. However, ALT is an accurate indicator, in some cases it can even be used to establish the stage of the disease and suggest possible variants of its development.
When is an ALT test scheduled?
The amount of alanine aminotransferase for liver problems helps to identify them even before the appearance of 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, a study is conducted with suspicions of. An ALT test is required if you have symptoms such as fatigue and weakness. He loses his appetite, often feels nauseous, turning into vomiting. Yellow spots on the skin, pain and discomfort in the abdomen, yellowing of the eye proteins, light stool and dark urine - all this can be a sign of liver disease. In such cases, this analysis is required.
ALT can be compared with AST for more information on the causes of liver damage. This is done if the number of enzymes is significantly higher than normal. 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 cardiomyocytes. Possible too. The de Ritis coefficient, not exceeding 1, indicates liver diseases. Moreover, the lower the indicator value, the greater the risk of an adverse outcome.
ALT analysis can be used not only as a diagnostic method, but also during treatment. This allows you to determine the dynamics of the disease and identify improvements or worsening of the patient. An ALT test is necessary if factors contributing to liver disease are present. 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. Be sure to check the amount of ALT if the patient has been in contact with hepatitis patients or has recently had it, has diabetes and is overweight. Some people have a predisposition to liver disease. He also shows ALT analysis.
When it is used, either venous or capillary blood is used. To get reliable results, you must follow some requirements. First, do not eat 12 hours before delivery and do not drink alcohol in a week. Even a small amount of food can significantly affect the result. Secondly, within half an hour before the analysis, give up smoking, do not worry, avoid moral and physical stress. The results are usually ready a day after delivery.
The norm of ALT in the blood of men and women
Alanine aminotransferase (ALT, or ALAT) - marker enzymes for the liver.
Aspartate aminotransferase (AST, or AsAT) - marker enzymes for the myocardium.
The amount of alanine aminotransferase enzyme in the blood is measured in units per liter.
ALT (ALAT) in children
ALT in children varies depending on age:
In newborns up to 5 days: ALT should not exceed 49 U / L. (AST up to 149 units / liter.)
For children up to six months, this figure is higher - 56 units / liter.
At the age of six months to a year, the amount of ALT in the blood can reach 54 units / 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 units / liter.
In children, slight deviations from the norm are allowed. This is due to uneven growth. Over time, the amount of enzyme in the blood should stabilize and approach normal.
ALT (ALAT) in adults
Enzyme Enhancement Degrees
But the results of the analysis on ALT often turn out to be far from the established standards. This may be due not only to the presence of inflammatory processes in the body, but also to other factors. The increased content of alanine aminotransferase can be triggered by the intake of 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. Similar effects have drugs based on valerian and echinacea. Unreliable analysis results can be caused by increased motor activity or intramuscular injections.
The amount of alanine aminotransferase in the blood is considered increased if it exceeds the established norm, especially by tens, and in some cases, hundreds of times. Depending on this, the presence of the disease is determined. With an increase in ALT level by 5 times, it is possible to diagnose myocardial infarction, if it reaches 10-15 times, we can talk about the deterioration of the patient's condition after the attack. 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 exceeding the upper limit of the indicator by 3-5 times.
Perhaps not only an increase in 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 occurrence of inflammatory processes in the body. They can be caused by the following diseases:
What do blood tests for ALAT and ASAT show? The attending physician will tell about this. ALAT and ASAT are 2 enzymes that are involved in biochemical reactions.
The abbreviation is deciphered as follows: ALAT (ALT) - alanine aminotransferase or simply aminotransferase, ACAT (AST) - aspartate aminotransferase or simply aspartate.
Essence of the question
These enzymes transport amino acids from one molecule to another. Amino acids play a major role in the construction of proteins. In ALAT, there is an amino acid - alanine (hence the name ALAT), and in ASAT there is asparagine and the enzyme pyridoxine (vitamin B 6). There is a list of organs in which these enzymes are synthesized, in descending order, i.e. in the list in the first place will be the body where the enzyme is most.
ALAT is present in:
- liver
- kidneys
- a heart,
- in skeletal muscle.
ASAT is present in:
- a heart,
- liver
- brain cells
- muscular tissue skeletal muscles.
There are specially established numbers (limit) by which the doctor sees the condition of these organs. If the destruction of cells occurs, then their integrity is violated, and the enzymes enter the bloodstream. Depending on which enzyme is more in the blood test, it can be concluded about the state of the corresponding organ.
Norms of indicators
The norm of the number of units per 1 liter of blood:
- ALT - in men up to 40 units / l, and in women up to 32 units / l;
- AST - in men from 15 - 31 units / l, and in women from 20 - 40 units / l.
What is a biochemical blood test? When the study is carried out in laboratory conditions, then this is a biochemical analysis. It is a guide for the attending physician, since it shows a complete picture of the work of all vital organs:
- liver
- pancreas,
- kidney
- gall bladder, etc.
The following indicators are considered in this analysis:
- blood glucose
- bilirubin;
- ASAT and ALAT;
- gamma - GT;
- alkaline phosphatase;
- cholesterol;
- LDL (unhealthy fats);
- triglycerides;
- total protein;
- albumen;
- potassium;
- sodium;
- chlorine;
- creatinine;
- urea and uric acid;
- C-reactive protein (CRP);
- iron.
If a deviation from the norm of one or another indicator occurs, the doctor becomes clear what exactly needs to be regulated or treated.
Preparation for the delivery of material for research
If the patient takes some medications, then most likely, shortly before the test, the doctor will cancel the drug that can change the accuracy of the blood count. Blood is donated in the morning to an empty stomach (last meal in 12 hours).
To prepare for the analysis, you must:
- 1. To exclude alcohol one day before blood donation.
- 2. For an hour, give up cigarettes.
- 3. Chewing gum should not be chewed either.
- 4. Drinking any liquids is also impossible.
For analysis, blood is taken from a vein. The answer will be in one day. Decryption of the analysis without medical knowledge is impossible, therefore, a doctor’s consultation is necessary.
In most cases, elevated ALAT is associated with liver disease. This is a sign that there is a disease of this organ. It should be noted that in the biochemical analysis of blood the level of this enzyme is higher than normal 1 or 4 weeks before the onset of symptoms of the disease. And in the acute period of the disease, indicators increase almost 10 times.
In 1 minute, the liver can cleanse or neutralize up to a million molecules of toxic substances, and in about an hour - up to 100 liters of blood. Sometimes, for some reason, the cells are damaged, the contents of the cells go outside and enter the bloodstream. If such indicators are high in a biochemical analysis of blood, this will mean that cell destruction occurs in the body.
Why does the ALAT enzyme increase in the blood?
There can be many reasons for increasing the amount of ALAT enzyme:
- excess fat stored in the liver cells;
- hepatitis, jaundice;
- cirrhosis;
- taking medications, such as Paracetamol or antibiotics;
- chemical poisoning;
- swelling, cancer, or metastases;
- myocardial infarction, heart surgery;
- muscle injuries;
- alcohol addiction.
If the body does not have enough vitamin B6, then the level of this enzyme in the blood will decrease.
The liver is a unique organ that can recover in 3 months if you take on its treatment.
ASAT, like the previous enzyme, transports (transfers) amino acids from molecule to molecule. It contains vitamin B6. As a result of the work of enzymes, glucogenes (sugar, but not from carbohydrates) are formed, which support the body during exercise, starvation, when energy is needed i.e. this enzyme is a participant in energy exchange.
The difference between these two enzymes is that an increased level of ASAT in the blood warns first of all about heart diseases, more precisely, about myocardial infarction. The largest proportion of the enzyme ACAT occurs in muscle tissue - myocardium and muscles. In other organs, their concentration is less.
At the time of the analysis, the person's age and gender are important. Since muscles play a leading role in this analysis, men have more muscle mass than women, respectively, and rates will be high. In children, rates will be higher due to the active development of the muscular skeleton.
Indicators will be variable in pregnant women. An increased level of the estrogen hormone has an effect on the liver, therefore, an increase in ALT and AST in pregnant women is considered to be the norm. But if high rates are accompanied by toxicosis, then urgent treatment is required, because it can be dangerous for both the baby and the mother. If a pregnant woman does not eat properly, then she may have a deficiency of vitamin B6, and then a blood test will show a decrease in the levels of AST and ALT.
Why does the level of ASAT deviate from the norm?
The reasons for increasing and decreasing the level of AST are almost the same as for ALT, only if the state of the liver is in the forefront with ALAT, then in the case of ASAT, the heart and muscles.
Some of the reasons are:
- 1. Heart - myocardial infarction, coronary insufficiency, heart surgery, angina pectoris, tachycardia, rheumatic heart disease, blood clots.
- 2. The liver.
- 3. The gall bladder.
- 4. The pancreas.
After receiving laboratory tests, doctors need to determine the painful process of the organ in which the violations occurred. What is needed to normalize the level of ALT and AST enzymes:
- 1. Do not take alcohol, even in small doses.
- 2. Review drugs and, if necessary, change medications.
- 3. To cure inflammatory processes in the body.
- 4. Take a course of treatment for the liver or heart.
- 5. Change your lifestyle, in particular, review your diet. Refuse harmful fats and include healthy foods.
All treatment should be under the supervision of a physician in order to correctly bring normal enzyme levels. Typically, if abnormal, AST or ALT is consulted with a hepatologist or cardiologist.
Medicines that increase the level of these enzymes:
- Heparin;
- antibiotics
- NSAIDs (non-steroidal anti-inflammatory drugs);
- antifungal;
- anticonvulsants;
- lowering blood sugar;
- fluoroquinolones - antimicrobial agents;
- nitrofurans - antibacterial drugs;
- beds - drugs that lower cholesterol.
If the body has a deficiency of vitamin B6, then the activity of enzymes will be reduced. In this case, it is useful to eat foods rich in this vitamin:
- 1. Sprouted grains, any.
- 2. Walnuts.
- 3. Legumes, soybeans, cereals.
- 4. Vegetables - carrots, cabbage, spinach, tomatoes.
- 5. Strawberries, lemon, oranges, cherries.
- 6. Meat and dairy products, eggs, fish.
It is not difficult to normalize the level of enzymes, you just need to pass an appropriate analysis and follow the doctor's instructions.
