Optimal Evaluation of the Results of Liver Function Tests

Abstract

Physicians of all specialties are required to assess abnormal results of liver function tests. Many patients with abnormal results in liver function tests do not have primary liver disease; most of the frequently requested tests are influenced by myriad non-hepatic factors. The most common tests are those for serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and bilirubin. Hepatocellular injury is indicated by abnormally elevated AST and ALT levels compared to the ALP level. Cholestatic injury is indicated by an abnormally elevated ALP level compared to AST and ALT levels. The majority of bilirubin circulates as unconjugated bilirubin, and an elevated conjugated bilirubin level is a marker of hepatocellular or cholestatic injury. Obtaining a detailed medical history, a clinical examination, and optimal interpretation of abnormal results of liver tests can enable the determination of the cause of liver diseases, facilitating their diagnosis and therapy.

Effect of Soybean and Soybean Koji on Obesity and Dyslipidemia in Rats Fed a High-Fat Diet: A Comparative Study

“…Both AST and ALT are concentrated in the liver, but liver damage eventually increases serum aminotransferase levels [ 34 ]. In general, mild aminotransferase elevation is found in non-alcoholic fatty liver disease [ 45 ]. ALP is an enzyme involved in the transport of metabolites through the cell membrane.…”

“…ALP is an enzyme involved in the transport of metabolites through the cell membrane. Although elevated ALP levels do not always imply liver damage, it has been reported that the most common cause of elevated ALP levels is liver disease [ 45 ]. LDH is present in most living cells, but at higher levels in the muscle, liver, and kidney.…”

Mulberry (Morus alba L.) Fruit Extract Ameliorates Inflammation via Regulating MicroRNA-21/132/143 Expression and Increases the Skeletal Muscle Mitochondrial Content and AMPK/SIRT Activities

“…Instead, the ME alleviated the HFD-induced elevation of serum ALT levels. ALT is suggested to be a more specific indicator of liver damage than other parameters considering the ALT is present primarily in the liver [ 29 ]. In general, a slight elevation of aminotransferase is found in non-alcoholic fatty liver disease [ 29 ].…”

“…ALT is suggested to be a more specific indicator of liver damage than other parameters considering the ALT is present primarily in the liver [ 29 ]. In general, a slight elevation of aminotransferase is found in non-alcoholic fatty liver disease [ 29 ]. Therefore, the ME was thought to alleviate HFD-induced hepatic toxicity partially by reducing hepatic lipid accumulation.…”

Production of Bioactive Substances to Alleviates Hangover and Ethanol-Induced Liver Damage through Fermentation of Oenanthe javanica Using Lactiplantibacillus plantarum

“…Following the administration of ethanol and the experimental substances including OEFL and p-coumaric acid, the blood ALP concentration increased by 1.6-fold in the ethanol-administered group (55.4 K-A unit) compared with that of the normal group (33.8 K-A unit; Figure 6C). Ethanol-induced liver damage causes the release of ALP into the blood, increasing blood ALP concentration [29]. Kang et al reported a 1.2-fold increase in the blood ALP concentrations of ethanol-administered SD rats for 5 weeks compared with the normal group, further confirming that ALP is closely related to ethanolic liver damage [30].…”