The blood alt answers. Alt and ast blood test indications for carrying out

Most often, the opinion is widespread, which is partly correct: in case of liver diseases, with the appearance of jaundice, doctors prescribe a study of the ALT enzyme, or alanine aminotransferase, and in patients with chronic liver damage, most often this enzyme is elevated. This is exactly the case, but if we open serious laboratory reference books, we will be surprised to find that a dozen and a half reasons for an increase in the concentration of this enzyme in the blood are listed, and almost never we will find under what conditions the level of ALT is lowered.

Why is this so, and what prevents lowering the level of the enzyme? After all, it is known that for almost every analysis there is a certain corridor of reference values, for which you can go both in one direction and in the other. Let's figure out whether a decrease in this enzyme in the blood serum is a diagnostic marker, and why it is so difficult to find the cause of the decrease.

Alanine aminotransferase, or ALT for short, is an enzyme that is locked inside cells in a healthy organ and appears only in residual amounts in the blood. It is found in the liver, myocardium, and skeletal muscles. It is in these tissues that a process occurs in which ALT is involved, namely, the transfer of an amino group from one amino acid to another acid, the so-called transamination.

As a result, metabolites important for the body are formed, and this process cannot occur without vitamin B6, or without pyridoxal phosphate. The highest activity of this transferase is in the liver tissue, since it is the liver that is the "kitchen of chemical reactions" of the whole organism.

Almost the same concentration of the enzyme is found in the liver, but there is little of it in the heart and muscles. Similarly, a small concentration of the enzyme is found in red blood cells, in lung tissue and in the spleen.

Due to the fact that men have more developed muscles, women have a slightly lower level of this enzyme in the blood. In any organ and at any second, thousands of cells age, and throughout the body, millions of cells decay every second, and usually it is this “scheduled disposal” that is the cause of the low, “basic” level of the enzyme in the blood.

In the organs listed above, its concentration is more significant. And in the event that there is a pronounced destruction of the tissues in which this enzyme is "locked", then it immediately appears in significant quantities in the peripheral blood. This is possible with myocardial infarction, with damage to the skeletal muscles, with kidney infarction.

Since this enzyme is “general”, it is not always clear where it came from in the event of a sharp change, and its high concentration does not always indicate the severity of the condition. Thus, it becomes clear why there is an increase in concentration. But it turns out that this enzyme cannot occur below the norm at all, because the planned decay of cells cannot be stopped? If ALT is lowered, can there be reasons for this, or not? They are, but first we will find out when an examination is usually scheduled.

When do you need to be examined, and how to prepare?

It can be said that in almost 100% of cases, situations that require examination and determination of the concentration of ALT in the blood plasma are suspected to be elevated, not reduced values. For example, this is an extended donor survey, as a slight increase in concentration may indicate signs of viral hepatitis.

With muscle pathology, diseases such as myasthenia gravis, myopathy, muscular dystrophy, this examination is also prescribed. Finally, almost 90% are patients with various forms of viral hepatitis and symptoms of liver disease. There is also an emergency indication for the determination of this enzyme, for example, if a heart attack is suspected, but there are much more diagnostically significant tests that can more accurately confirm the presence of a zone of necrosis of the heart muscle, for example, the determination of the AST enzyme. Alanine aminotransferase also increases, but at the same time shows a lower value.

How to prepare for analysis?

The study of this enzyme is carried out when taking a biochemical blood test, and usually other indicators are also determined, for example, such as AST, or an enzyme responsible for a similar function, glucose levels, total protein, and so on. Rarely, an isolated examination exclusively for this enzyme is prescribed.

In this case, the blood is taken in the morning, strictly on an empty stomach, preferably after an 8-hour overnight fast. In extreme cases, you can take an analysis during the day, but not earlier than 4-5 hours after a light meal, because during the day a person is awake, and the blood plasma quickly takes on a “hungry” look.

Since the level of muscle load can change the value of the analysis, as well as the intake of alcohol, which destroys liver cells, it is recommended to exclude increased sports, psycho-emotional stress and the use of alcoholic beverages before the study.

Normal values ​​and reduction

Normal, reference values ​​for alanine aminotransferase depend on age, and to a greater extent on gender. So, in adult women over 17 years old, the level of this enzyme should not exceed 31 U / l, and in men 41 U / l. In adolescents, boys and girls, the enzyme level is approximately 25 U / l, and in children, when there is still no difference in muscle mass, because there is no puberty, the level fluctuates from 54 units at the age of up to a year, and then gradually decreases to adult levels .

The reasons for the decrease in this case are purely physiological - it’s just that the child’s enzyme systems and cellular reactions begin to work more perfectly, and the breakdown of blood cells containing fetal hemoglobin stops.

Why is ALT lowered?

But still, in some diseases, ALT in the blood is lowered, and what does this mean? Yes, two conditions can be deduced that contribute to a decrease in the concentration of this enzyme.

In the first case, we are really talking about the fact that the “scheduled utilization” of cells is decreasing. In the event that a person has severe cirrhosis of the liver, symptoms of severe liver failure, and normal hepatocytes, in which the process of transamination with the participation of these enzymes, is simply very small, then there will be a general decrease in the level of the enzyme in the blood plasma, since the liver is its main source . And "reducing the decline" further is a fatal outcome.

But in this case, signs of severe liver damage will appear much earlier, such as a decrease in total protein, a prothrombin index, an increase in bilirubin levels and other signs.

The second case in which a diagnostically significant decrease in the level of this enzyme can be observed is the lack of its "helper", pyridoxal phosphate, or vitamin B6, which helps to carry out the transfer of the amino group.

In this case, a decrease may be diagnostic evidence of beriberi, which specifically indicates a lack of vitamin B6.

If you dream up, then with a sharp decrease in the mass of the pancreas, with the development of hemorrhagic or fatty pancreatic necrosis, this enzyme will also cease to enter the blood as planned, since there is no gland tissue left. But since the pancreas makes a relatively small contribution to the overall picture, nothing can be found here.

Thus, a decrease in the concentration of ALT is not diagnostically significant in most conditions that are important in the clinic, perhaps with the exception of confirming the diagnosis of avitaminosis B6. But in the conditions of a modern varied diet, such cases of isolated beriberi

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.

An increase in ALT levels is an important diagnostic criterion that indicates increased cell destruction due to various pathologies.

The role of Alat in the body and where it is located in the body

Alanine aminotransferase is an essential 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 pancreas.
4. Heart.
5. Kidney.
6. Muscles.

How to take an analysis for ALT?

To obtain correct results, the following rules must be observed:

• Donating blood is best 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, it is necessary 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 regular food;
• Some drugs 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, tell your doctor.

Normal ALT levels for 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 crossovers" in children (changes in the ratio of blood elements), hormonal fluctuations, stress, and much more.

Normally, ALT is found in the bloodstream in the following quantities:

After confirming that the tests revealed a real increase in the enzyme, it is worth continuing further research to clarify the location of the pathology.

If alanine aminotransferase is elevated, this very often indicates damage to the liver tissues. 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-thyalanine aminotransferase. Its norm is in the range from 0.91 to 1.75.

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

There are several degrees of increase in alanine aminotransferase:

Reasons for the increase in ALT

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

Even with liver tumors, the amount of ALT can be increased only slightly if the tumor is in the initial stages.
So what do you do if the numbers in your analysis go up? 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 in the body constantly die and are replaced by 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 ALT include:

1. Hepatitis (hepatitis types B, C, D are most dangerous for the liver)- diseases of a viral nature that can be transmitted both by contact (types A, E) and through the fluids of the human body (types B, C, D). This pathology is characterized by a long asymptomatic course. After infection, the first manifestations of the disease may not be 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.

In hepatitis, the amount of ALT becomes significantly higher than normal, in addition, the levels of AST (aspartate aminotransferase) and GGTP (gamma-glutamyltransferase of the liver) increase.

When analyzed in the blood, a significant amount of bilirubin, a bile enzyme produced in liver cells, is also detected:

1. Cirrhosis of the liver- total destruction of the tissue of an organ, in which the organ gradually loses the ability to perform its main functions.
2. Liver cancer.
3. pancreatitis- inflammation of the pancreas, the result of which very often is necrosis of the tissues of the organ. 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 blockage of the common bile duct, which can cause bile to reflux into the gland and damage its cells.

With pancreatitis in an adult, there is a less sharp jump in the level of ALT than with hepatitis. However, the determination of this enzyme by biochemical blood testing is mandatory.

1. myocardial infarction. This term refers to the death of a certain area of ​​​​the heart muscle as a result of a violation of the circulatory process in it. This pathology also leads to an increase in the amount of ALT in the bloodstream. However, it is more characteristic of an increase in the level of aspartate aminotransferase. It is this enzyme that will be key in making a diagnosis.
2. Myocarditis - inflammation of the heart muscle. It is also characterized by the detection of elevated levels of AlAt and AsAt in biochemistry.
3. Other reasons. These include pathologies such as burn lesions, frostbite, extensive muscle tissue injuries. Tumor neoplasms that destroy the tissues of the above-mentioned organs can also increase the amount of ALT.

If a biochemical analysis has determined that your ALT level is elevated, then it's time to seek the advice of a doctor.

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

What can lower the amount of ALT?

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

How is the treatment carried out?

How to reduce the level of Alat? By curing the disease that led to his growth. By stopping the destruction of cells containing alanine aminotransferase, it is possible to return the amount of the enzyme in the bloodstream to normal.

Serious pathologies like 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.

It is necessary to treat each pathology according to a certain algorithm. Since most of them are life-threatening, the choice of treatment should be entrusted to the doctor.

Here are some general tips for lowering ALT levels:

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

By reducing the load on your liver and the body as a whole, you will help it fight the disease.

Only the right lifestyle will help to avoid dangerous complications and maintain health for a long time.

Periodically, a person is sent to surrender. This may be preceded by some complaints, or simply a routine examination during a medical examination. Sometimes, purely by chance, an increase in the level of alanium aminotransferase (or ALT for short), which is a specific one found and produced inside cells, is detected. That is why, if suddenly, within the framework of a simple one, it is revealed that the level of ALT is elevated, then this may indicate a number of diseases.

Before moving on to what deviations in analyzes will mean and what their cause is, it is necessary to get better acquainted with the component itself and understand what role it plays in the human body.

It should be noted right away that this enzyme is produced exclusively inside the cells and enters the blood in a limited amount, because, in fact, it is no longer needed. And if for some reason, an increased content of it was noticed in the blood test, then this indicates deviations in the operation of the entire system.

The main function of alanine aminotransferase is the exchange of amino acids.

In addition, it acts as a catalyst for reversible transfers of alanine. Alanine is needed in the body to be converted into glucose. In addition, alanine plays a large role in supplying the brain with nutrients, and also strengthens the immune system, produces lymphocytes and regulates metabolism and acids.

Most of the enzyme can be seen in organs such as the heart, kidneys, liver, lungs and pancreas. Scientists have discovered an unusual feature. The activity of the enzyme is much higher in the male body than in the female.

When is an ALT blood test ordered?

As mentioned above, the level of alanine aminotransferase is determined in simple. And so sometimes there are no special appointments.

But in order to more accurately find out what the level of the enzyme in the blood is, it is necessary to take an analysis for, which the doctor can prescribe if:

• There is a suspicion that a person has.
• A person gets tired quickly and at the same time feels constant weakness, which is a very dangerous symptom.
• A person gradually or abruptly loses his appetite, while he is sick, and sometimes there is an urge to vomit.
• There were signs.
• It is necessary to identify the effect of drugs on the liver in order to prevent the development of jaundice. This is usually done during treatment with strong drugs that can adversely affect many organs.
• The person abuses alcohol.

A doctor may prescribe an analysis for ALT, simply suspecting some kind of ailment, because in most cases they are all associated with the liver, kidneys, and heart. And if there are deviations in the analyzes, namely an increase in alanine aminotransferase in the blood, it means that the problem actually exists.

Normal performance

Separately, it must be said about the normal levels of alanine aminotransferase in the blood. For men, women and children, they are different, moreover, they directly depend on age.

If we talk about children, then the level of alanine aminotransferase in the blood should be within (measured in U / l):

• In newly born children up to five days of life, the ALT level normally does not exceed 49.
• In children from 6 days of life to six months, the ALT level normally does not exceed 56.
• In children from six months to one year, the ALT level is normally not higher than 54.
• In children from one to three years old, the ALT level normally does not exceed 33.
• In children from three to six years old, the ALT level normally does not exceed 29.
• In children from six to twelve years of age, the ALT level normally does not exceed 39.

At the same time, it is in children that small fluctuations in indicators are possible, which are due to uneven growth (some children at the age of 12 are already going through the stage of puberty, while others are not, some at 6 years old will be 126 cm tall, while others will be 112, etc.). Over time, as growth slows and organ development stops, enzyme levels will settle to normal levels.As for women and men, the indicators are slightly different for them, because the enzyme is more active in males than in women.

In women, ALT levels of up to 30 U / L will be normal, but in men it is 40 U / L.

Sometimes this happens. That ALT levels in the blood may not be within the normal range and not due to some inflammatory processes, this may be affected by taking medications (of a certain group), as well as increased physical activity.

Increased rates

By handing over a simple one, each person hopes that everything is in order with him. But sometimes it happens that one of the indicators is above the norm. And sometimes this deviation is insignificant, and sometimes it is several times more.

Depending on how much the deviation was detected, the severity of the disease will depend. So, few people pay attention to a deviation of one or two units, since this may be due to simple physical workload. But if the level of alanine aminotransferase is several times higher, then you should undergo a more complete examination to find out the cause.

It is believed that with an increase in alanine aminotransferase by about 5 times, it is fashionable to have a myocardial infarction when heart cells die. If the level is increased by 10 or even 15 times, then the patient's condition after an attack (myocardial infarction) has deteriorated sharply.

An 8-fold increase in the enzyme level can indicate muscular dystrophy and dermatomyositis, diseases no less dangerous than myocardial infarction.

In patients with hepatitis, the rate increases a record number of times and reaches 20-50.Separately, it must be said about the acute stage of pancreatitis, when ALT is increased by 3 or 5 times.

As a rule, not only the level of alanine aminotransferase in the blood increases. Along with it, other important indicators are deviated from the norm.

More information about the ALT blood test can be found in the video.

Reasons for the increase in ALT

There are a number of reasons, in addition to certain medical conditions, that cause the enzyme levels to increase.

These include:

• Taking certain medications, including antibiotics.
• Eating fast food, especially before giving up.
• Damage to any muscle.
• Drinking alcoholic beverages a week before the due date for an ALT blood test.
• Emotional stress that can lead to malfunctions of the nervous system, and as a result, the body's reaction to it.
• Large physical loads as a result of enhanced training.
• Operation shortly before delivery of the analysis.
• chemotherapy sessions.
• Poisoning the body with hazardous metals, such as lead.
• Psychological shock.
• Drug use, and it can be either once or several times.

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.

Diseases and increased ALT in the blood

In most cases, elevated ALT indicates the presence of some serious disease, for example:

• . With hepatitis, especially if it is of viral or alcoholic origin, the level of alanine aminotransferase increases many times over. This phenomenon can be noticed even a week before the first symptoms appear. If we talk about, then it is the increase in ALT that makes it possible to identify the infection at an early stage.
• Liver cancer. In this case, the level of the enzyme is significantly increased, since a malignant tumor disrupts the functioning of the entire organ. And in the event that the level of alanine aminotransferase in the blood is significantly increased, doctors may even postpone the operation due to the risk of complications.
• Pancreatitis. With an increase in the level of the enzyme in the blood, doctors can diagnose the stage of exacerbation. And therefore, people suffering from the disease throughout their lives have to take tests in order to notice the onset of an attack in time.
• Myocarditis, during which, in addition to an increase in ALT, there is also shortness of breath, fatigue.
• Cirrhosis. With cirrhosis of the liver, the level of ALT increases slightly, about 5 times. And if the patient suffers only from pain in the liver area, this analysis will help to diagnose and detect the problem.
• Myocardial infarction, during which ALT levels may rise due to damage to the heart muscle, but only slightly.

If increased, then a more complete examination is necessary to identify the cause of this change. And the sooner this is done, the better the outcome will be.