Transaminase is elevated - what does it mean. Transaminases AlAt and AsAt: what is it, normal levels in a blood test and a pathological increase

Nutrition recipes for the normalization of the liver and heart:

• Dissolve half a teaspoon of turmeric and a tablespoon of honey in a glass of water. Take three times a day.
• Oatmeal with milk will help cleanse the liver of accumulated toxins.
• Juice from freshly squeezed beets.
• A delicious dessert made from boiled pumpkin and honey will help to remove cholesterol.

Prevention

• You can prevent liver disease by a special diet that includes foods rich in vitamin D in your diet: milk, eggs, apples, sea fish, caviar, buckwheat and oatmeal. By eating wholesome plant foods, you will help the liver become more disease resistant and remove dangerous toxins. Eliminate fatty and salty foods from your diet so as not to overload the liver beyond the norm.
• Give up bad habits: alcohol and smoking.
• Avoid exposure to toxins. They can easily penetrate the body, having a detrimental effect on the liver.
• Do not self-medicate. Uncontrolled intake of antibiotics may not bring the indicators back to normal, but, on the contrary, significantly weaken liver function.

Transaminase is the general name for enzymes found inside the cells of various organs. With the destruction or damage of tissues, with injuries or pathologies, enzymes leave the cells, so their level in the blood rises.

The role of these proteins in the body is very large: they are involved in the process necessary for nitrogen and energy metabolism. These enzymes accelerate the transfer of amino groups from amino acids to keto acids.

The content of transaminase in the blood is important in diagnosis, as it is a sign of certain diseases. Particular attention in diagnostic practice is given to two types of enzymes - AST and ALT. Their content in the blood serves as a marker of damage to the liver, heart, pancreas (the most common cases are hepatitis, myocardial infarction, pancreatitis). Their absolute values ​​and the ratio of AST and ALT levels make it possible to determine the affected organ, trace the dynamics of the pathological process, and establish the degree of damage.

For biochemical analysis for transaminase, venous blood is taken

ALT

The full name of the enzyme is alanine aminotransferase. From the name it is clear that this protein is involved in the transfer of the amino acid alanine. It is mainly found in the liver, as well as in the cells of the heart, pancreas, kidneys, muscles.

Norm in the blood

Valid values ​​are different for women and men:

• for women, the norm is not higher than 32 units / liter;
• for men - less than 40 units / liter.

For children of different ages, the norms are different:

• in the first five days of life - up to 49 units / liter;
• up to six months - 56;
• from six months to a year - 54;
• from one to three - 33;
• from three to six years - 29;
• from six to 12 - no higher than 39.

Reasons for the increase

A high level of ALT is characteristic of such pathologies:

• cirrhosis of the liver;
• acute hepatitis (viral, alcoholic);
• acute pancreatitis;
• malignant liver tumor or metastases;
• mechanical jaundice;
• tumor breakdown;
• extensive heart attack;
• heart diseases in which the destruction of heart muscle cells occurs (heart failure, myocarditis);
• burns;
• extensive traumatic muscle injury.

A slight increase is observed in the following cases:

• after heart surgery;
• with uncomplicated myocardial infarction;
• chronic hepatitis;
• fatty hepatosis;
• mononucleosis.

In addition to pathological reasons for the increase in ALT levels, there are physiological ones. These include:

• great physical activity;
• taking certain medications (antibiotics, valerian, echinacea, non-steroidal anti-inflammatory drugs, contraceptives);
• taking certain dietary supplements that negatively affect liver cells;
• a slight increase can be observed in pregnant women in the first trimester (this condition is considered normal);
• malnutrition (presence of fast food, soda, semi-finished products in the diet).

ALT transaminase in the blood - a marker of liver disease

Of particular importance is the indicator in the diagnosis of liver diseases. A high ALT level is a specific sign of hepatic pathology. Already 1-4 weeks before the onset of symptoms in the blood, an increased content of this enzyme is detected. In the case of acute liver disease, it exceeds the norm by more than five times. If a high level persists for a long time or in the later stages of the disease its growth occurs, then this indicates a massive destruction of liver tissues.

This indicator allows you to identify such a dangerous disease as cirrhosis of the liver at an early stage. As a rule, this pathology has no symptoms for a long time, and only with the help of a biochemical blood test for a high level of ALT can such a diagnosis be suspected. In this case, the norm is exceeded, as a rule, three times.

ALT analysis shows:

• in the diagnosis of pathologies of the liver, biliary tract, pancreas;
• to control the treatment of viral hepatitis;
• in the differential diagnosis of hepatic and hemolytic jaundice;
• with heart failure and other heart diseases;
• with pathologies of skeletal muscles;
• when examining a donor's blood.

The analysis is prescribed for people with the following symptoms:

• constant weakness;
• fast onset fatigue;
• poor appetite;
• dark urine and light feces;
• yellowness of the skin and whites of the eyes;
• bloating;
• nausea, vomiting;
• abdominal pain.

An ALT test may be prescribed for people at risk:

• who had contact with a patient with hepatitis;
• suffering from diabetes;
• having excess weight;
• suffering from alcohol addiction;
• taking drugs with a toxic effect;
• people with a hereditary tendency to liver disease.

It is important to know that a normal ALT level is not a guarantee of the absence of liver disease.

AST

AST, or aspartate aminotransferase, is involved in the transfer of the amino acid aspartate. Contained mainly in the heart, liver, kidneys, muscles.

Norm

• in women - from 20 to 40 units / liter;
• in men - from 15 to 31 units / liter;
• in newborns (5 days) - up to 140 units / liter;
• in children under nine years old - no more than 55.

Elevated blood levels of AST are an important diagnostic sign of myocardial infarction.

Reasons for the increase

Increased activity of AST in the blood is observed in the following cases:

• with hepatitis of various origins;
• myocardial infarction;
• myocarditis;
• inflammation of the heart muscle in acute rheumatic fever;
• liver cancer and secondary tumors in the liver;
• cirrhosis and necrosis of the liver;
• alcoholism;
• autoimmune muscle diseases;
• pancreatitis (acute and chronic);
• cholelithiasis and other pathologies in which the outflow of bile is impaired;
• cholestasis;
• mononucleosis;
• hepatosis;
• burns;
• heat stroke;
• mushroom poisoning;
• injuries.

Most often, the indicator is used to diagnose pathologies of the heart and liver. With the destruction of tissues of other organs, its increase, although it takes place, cannot be considered a specific sign, therefore it is not of great diagnostic value.

In myocardial infarction, AST in the blood rises 5 times and remains at a high level for five days, while ALT increases slightly. If the decrease does not occur after five days, we can talk about a poor prognosis, and if the level rises, it is likely that the zone of myocardial tissue necrosis has expanded.

The content of AST also increases with necrosis of liver tissues. The higher its value, the more severe the defeat.

How is liver disease different from a heart attack?

In order to find out from a blood test in which organ - the myocardium or the liver - tissue destruction occurs, it is necessary to determine the ratio of AST / ALT, the norm of which is 1.3. If the value exceeds 1.3, this is a heart attack, if it is below normal, liver pathology.

Conclusion

Determining the level of transaminase in the blood is of great importance in the diagnosis of certain diseases. The content of ALT is especially important for the detection of hepatic pathologies of various origins. Increased changes in such an indicator as AST are an important diagnostic sign of damage to myocardial cells during a heart attack.

The abbreviation ALT is deciphered as an indicator of the blood enzymes of alanine aminotransferase, AST - asparagine aminotransferase. Indicators of AST and ALT are included in the study of biochemical blood analysis.

They were discovered in medicine relatively recently. A blood test for AST and ALT is carried out jointly and, accordingly, their norm should be the same, and fully dependent on each other.

Such an indicator of analyzes as an increase in ALT and AST in the blood by 2 or more times should make you think about the occurrence of certain diseases. First you need to understand what ALT and AST are. What is the norm of these compounds in the blood and what should be done if at least one indicator is elevated?

What does an increase in ALT and AST above normal mean?

In adults, the content of ALT and AST in different organs is not the same, so an increase in one of these enzymes may indicate a disease in a particular organ.

• ALT (ALAT, alanine aminotransferase)- an enzyme that is found mainly in the cells of the liver, kidneys, muscles, heart (myocardium - heart muscle) and pancreas. When they are damaged, a large amount of ALT is released from the destroyed cells, which leads to an increase in its level in the blood.
• AST (ASaT, aspartate aminotransferase)- an enzyme that is also found in the cells of the heart (in the myocardium), liver, muscles, nerve tissues, and to a lesser extent in the lungs, kidneys, pancreas. Damage to the above organs leads to an increase in the level of AST in the blood.

Basically, the rate of ALT and AST in the blood depends entirely on the work of the most important parenchymal organ - the liver, which performs such functions as:

1. Protein synthesis.
2. Production of biochemical substances necessary for the body.
3. Detoxification is the removal of toxic substances and poisons from the body.
4. Storage of glycogen - a polysaccharide, which is necessary for the full functioning of the body.
5. Regulation of biochemical reactions of synthesis and decay of most microparticles.

Depending on the equipment used for the study, it is possible to vary the norms and reference values ​​of the level of enzymes. An increase in the rate of enzyme renewal, cell damage leads to an increase in the level of transaminases in the blood.

Reasons for increasing ALT and AST

Why are ALT and AST elevated in adults, what does this mean? The most likely cause of increased levels of liver enzymes in the blood are:

1. and other liver diseases (, fatty hepatosis - replacement of liver cells with fat cells, liver cancer, etc.).
2. An increase in ALT and AST as a result of a disease of other organs (autoimmune thyroiditis,).
3. - this is necrosis (death) of a section of the heart muscle, as a result of which ALT and AST are released into the blood.
4. Diffuse liver damage, which may be caused by alcohol, drugs and/or exposure to a virus.
5. Extensive injuries with muscle damage, as well as burns, cause an increase in ALT in the blood.
6. Sharp and.
7. Metastases or neoplasms in the liver.
8. Reaction to drugs.
9. Taking anabolic steroids.

AST and ALT are important indicators of the state of various organs. An increase in these enzymes indicates damage to organs such as the liver, heart, muscles, pancreas, etc. Thus, a decrease in their level in the blood occurs independently when the underlying disease is eliminated.

Prevention

In order to ensure that the norm of indicators does not exceed the permissible limits, it is recommended to avoid long-term medications.

If this is not possible due to a chronic disease, then it is better to regularly take an analysis for AsAT so that it is not elevated or a serious increase can be prevented in time. Periodically, you need to visit a gastroenterologist and a hepatologist who can identify a possible disease and prescribe treatment.

What to do if ALT and AST are elevated

In order to quickly and objectively understand the true reason for the increase in the levels of activity of ALT and AST enzymes, it is necessary to additionally pass biochemical tests.

First of all, it is advisable to determine alkaline phosphatase and GGTP (gamma-glutamyl transferase) and assess the degree of preservation of the main functions of the liver. To exclude the viral nature of liver damage (acute viral hepatitis), which is also accompanied by an increase in ALT and AST in the blood, you will need to donate blood for specific antigens of viral hepatitis and specific antibodies to these antigens.

In some cases, a PCR test of blood serum for the presence of HBV DNA and HCV RNA is indicated.

Transaminases ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are endogenous enzymes that play an important role in the production of various amino acids.

AST transaminase is primarily found in red blood cells, skeletal muscle tissue, and the liver.

Taking samples of various transaminases in the blood and finding out their concentration plays an important role in diagnosing and tracking the development of many diseases. Standard indicators of transaminases fluctuate depending on the gender of the patient, the number of years lived, temperature and body weight, and lifestyle. They are present in small amounts in a healthy body: a little more in men and a little less in women.

Elevated levels of AST and ALT do not necessarily reflect an abnormality in the body. The medical practice for making a diagnosis requires repeating laboratory tests over several weeks, as well as taking a family history and performing a complete physical examination of the patient. The anamnesis must include various data:

1. Information about the patient taking medications, including commercial, untested drugs.
2. Information about possible blood transfusion procedures.
3. Data on whether or not the patient had jaundice, hepatitis.
4. Information about family cases of liver and kidney diseases.
5. Explanation of the presence or absence of pain in the abdomen.
6. General material about systemic conditions - weight loss or gain, oncological pathologies, diabetes.
7. Material about the patient's sexual activity.

Family liver diseases include alcoholism, liver complications, Wilson-Konovalov disease, alpha1-antitrypsin deficiency.

The norm of ALT and AST indicators

In clinical activities, ALT and AST indicators are determined based on the activities of biochemical tests. To get the most truthful indicators, it is recommended to conduct a blood test in the first half of the day before meals (the time of abstinence from eating is recommended - at least 8 hours).

To determine the indicators of AST and ALT, venous blood is taken using a thick medical needle.

Normally, ALT and AST levels are not equal for women and men. In female patients, the analysis of ALT and AST is considered good if the concentration of enzymes is not higher than 31 U / l. In men, ALT transaminase should not exceed 45 U/L, and AST aminotransferase readings should be within 47 U/L. In children of any gender, ALT and AST indicators change relative to the age of the child, but cannot be higher than critical values: ALT - 50 U / l. Normally, AST should be 140 U / l for children of preschool and primary school age and 55 U / l for children over 9 years old. If AST is elevated, then this indicates the presence of a certain pathology.

When examining laboratory tests, the physician must take into account the capabilities of the laboratory equipment and interpret the test results based on the standards and capabilities of the laboratory that performed the liver tests.

Why are AST and ALT transaminase levels elevated?

High levels of ALT determine the pathology in those tissues in which this transaminase is present. In clinical practice, the main reasons that ALT are elevated are as follows:

1. Hepatitis and liver diseases, such as cirrhosis of the liver, fatty steatohepatosis, cancer, etc. With hepatitis types A, B, C, D and E (as well as medication, alcohol, allergic), a huge number of liver cells are destroyed, and therefore ALT from liver cells immigrate into the blood. With a biochemical blood test against the background of the development of hepatitis, an increase in the concentration of bilirubin is noted. ALT levels in the blood rise according to the severity of the disease.
2. Myocardial infarction, where the death of zones of the heart muscle is noted. At the time of the onset of pathology, an increased amount of ALT and AST enters the bloodstream.
3. General pathologies of the heart, accompanied by degradation of the heart muscle. Pathology is characterized by an increase in the level of ALT in the blood, which confirms the presence of destructive processes.
4. Injuries with impressive muscle injury, including extensive burns.
5. Acute pancreatitis, accompanied by inflammatory processes in the pancreas. With this pathology, the level of ALT in the blood rises.

Causes of an increase in AST in the blood

Aspartic transaminase AST increases in diseases of the heart, liver and pancreas. The reasons for the increase can be different:

1. Myocardial infarction is the most common root cause of an increase in the level of AST in the blood. When a pathology occurs in the blood, AST increases tenfold, and ALT only changes slightly.
2. Inflammatory heart diseases - myocarditis, rheumatic carditis, conditions after a recent operation.
3. Serious damaging conditions in the liver - viral hepatitis, alcoholic, drug-induced, allergic, toxic hepatitis, cirrhosis of the liver, liver cancer and similar disorders for which liver tests are taken.
4. Significant burns and serious injuries.
5. Acute and advanced form of pancreatitis.

There is a special case when ALT and AST are elevated. Liver tests often show by blood tests that most women experience a slight increase in ALT during the first period of pregnancy. The condition does not prove the presence of the disease. If high levels of ALT and AST are detected in the body during pregnancy, this requires an urgent examination for the possible development of liver pathology.

Liver tests: what are they, what tests do they include?

Biochemical analysis of blood and liver tests can detect high levels of liver enzymes, as well as detect a wide range of substances, substrates, hormones, which can be used in the diagnosis or control of the disease and influence the treatment prescribed by the doctor. Liver tests involve taking a biomaterial - venous blood. As a material for analysis, the laboratory assistant will use blood serum. During the tests, the laboratory assistant will be able to find out various indicators:

1. total protein in the blood. An increase in the concentration of protein in the blood confirms the presence of dehydration processes in the body, the development of chronic inflammatory processes.
2. albumin concentration. An increase in albumin indicates dehydration in the body and liver failure.
3. Urea concentration.
4. Creatinine concentration. High rates confirm the presence of renal dysfunction, overlap of the urethra, rupture of the bladder.
5. ALT. High readings confirm the presence of hepatocellular destruction, muscle damage, and hyperthyroidism.
6. ALP. High values ​​indicate the presence of bone deposition, liver damage, hyperthyroidism, biliary tract disease, intestinal damage, Itsenko-Cushing's disease, the presence of corticosteroids, barbiturates, and generalized tissue damage (including neoplasms).
7. GDH. High rates diagnose liver necrosis and hepatocellular inflammatory processes.
8. AST. High rates indicate damage to the liver, the presence of hypothyroidism.

Preparation for analysis

The correct behavior of the patient before taking the tests can guarantee the reliability of the tests. Therefore, if a patient needs to find out reliable indicators of AST and ALT, he must follow certain rules:

1. Visit (on an empty stomach) the laboratory of a polyclinic or hospital in the morning.
2. On the day of the test, the patient can only drink unsweetened, non-carbonated water.
3. Blood must be donated before taking medications prescribed by a doctor. If possible, then not earlier than 7-14 days after their cancellation.
4. The day before the test, the patient should limit the use of fried, salty and spicy foods, exclude chocolate, tea and coffee from the diet, and refuse any alcoholic and carbonated drinks.
5. A few days before the test, the patient should reduce the intensity of physical activity, abandon active sports training.

How to reduce ALT and AST levels?

Transaminases AST, ALT are meaningful medical coefficients showing the healthy or pathological state of human organs. An increase in the concentration of enzymes in the body confirms an infectious, traumatic or age-related lesion of organs whose cells have ALT and AST transaminases. A decrease in the concentration of ALT and AST in the blood can be carried out independently, immediately after the elimination of the causes of the present disease.