Liver function test

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In clinical medicine, liver function tests include tests for:^[1]

Surrogates for hepatic cell breakdown
- Transaminases
  - alanine transaminase^[2] (ALT)formerly called glutamic-pyruvic transaminase (SGPT)
  - aspartate aminotransferase (AST)^[3], formerly called glutamic-oxaloacetic transaminase (SGOT)
- Lactic dehydrogenase
Indicators of obstruction
- Alkaline phosphatase
- 5’-NT (5-nucleotidase)
- GGT (gamma-glutamyltransferase)
- Bilirubin
Hepatic synthetic function
- Protein

Coagulation factors
- Prothrombin time
- International normalized ratio
Tumor markers
- alpha-fetoprotein
Special
- Copper metabolism
  - Ceruloplasmin
- Human iron metabolism
  - serum iron
  - total iron binding capacity (TIBC) % transferrinsaturation
  - ferritin
  - hepcidin (experimental)
Serology
- HBsAg
- Anti-HBsAg
- Anti-HBcAg (immunoglobin G (IgG))
- Anti-HBcAg (immunoglobin M (IgM))

Imaging[edit]

While liver function tests are usually considered to be biochemical or immunologic, which themselves are increasingly overlapping, imaging provides valuable material as well. Liver scanning after injection of a radioactive tracer has been used for years to localize defects. Newer functional imaging is still experimental but shows promise.

Causes of elevated test results[edit]

Patterns of abnormalities of liver function tests
	Suggested underlying cause
AST/ALT ratio > 1^[4]	Alcoholic liver diseases
Alkaline phosphatase to total bilirubin ratio <4^[5] AST/ALT ratio > 2.2^[5]	Hepatolenticular degeneration (Wilson's Disease)

Increased blood levels of alanine transaminase have been associated with eating fast food twice a day while limiting exercise.^[6] The intervention in the trial aimed to "double the regular caloric intake in combination with adoption of a sedentary lifestyle for four weeks."^[6]

References[edit]

↑ Covin, RB (April 4, 2006), Liver and Gallbladder Pathology, University of Medicine and Dentistry of New Jersey
↑ Anonymous (2024), Alanine transaminase (English). Medical Subject Headings. U.S. National Library of Medicine.
↑ Anonymous (2024), Aspartate aminotransferase (English). Medical Subject Headings. U.S. National Library of Medicine.
↑ Van Ness MM, Diehl AM (1989). "Is liver biopsy useful in the evaluation of patients with chronically elevated liver enzymes?". Ann Intern Med 111 (6): 473-8. PMID 2774372. ^[e]
↑ ^5.0 ^5.1 Korman JD, Volenberg I, Balko J, Webster J, Schiodt FV, Squires RH et al. (2008). "Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests.". Hepatology 48 (4): 1167-74. DOI:10.1002/hep.22446. PMID 18798336. Research Blogging.
↑ ^6.0 ^6.1 Kechagias S, Ernersson A, Dahlqvist O, Lundberg P, Lindström T, Nystrom FH (2008). "Fast food based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects". Gut. DOI:10.1136/gut.2007.131797. PMID 18276725. Research Blogging.

[Covin-1] Covin, RB (April 4, 2006), Liver and Gallbladder Pathology, University of Medicine and Dentistry of New Jersey

[2] Anonymous (2024), Alanine transaminase (English). Medical Subject Headings. U.S. National Library of Medicine.

[3] Anonymous (2024), Aspartate aminotransferase (English). Medical Subject Headings. U.S. National Library of Medicine.

[pmid2774372-4] Van Ness MM, Diehl AM (1989). "Is liver biopsy useful in the evaluation of patients with chronically elevated liver enzymes?". Ann Intern Med 111 (6): 473-8. PMID 2774372. ^[e]

[pmid18798336-5] 5.0 ^5.1 Korman JD, Volenberg I, Balko J, Webster J, Schiodt FV, Squires RH et al. (2008). "Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests.". Hepatology 48 (4): 1167-74. DOI:10.1002/hep.22446. PMID 18798336. Research Blogging.

[pmid18276725-6] 6.0 ^6.1 Kechagias S, Ernersson A, Dahlqvist O, Lundberg P, Lindström T, Nystrom FH (2008). "Fast food based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects". Gut. DOI:10.1136/gut.2007.131797. PMID 18276725. Research Blogging.

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