Lactate dehydrogenase (LDH) in a biochemical blood test: what is it, norms for age, which means an increase and decrease in the level of the enzyme. Lactate dehydrogenase (LDH) (venous blood) Lactate dehydrogenase what shows

General information about LDH

Lactate dehydrogenase (LDH) is an important intracellular, zinc-containing enzyme that is present in most organs and tissues. An increase or decrease in the amount of lactate dehydrogenase and its multiple isoenzymes may indicate damage to the integrity or destructive changes in the organs in which they are located.

The main biochemical function of LDH in the human body is the conversion of lactic acid into pyruvic acid. This is due to the specific structure of the enzyme, which allows the hydroxyl group to be cleaved from the lactate molecule, followed by the formation of pyruvate. Pyruvic acid is the key to the tricarboxylic acid cycle, also known as the Krebs cycle. The Krebs cycle is the most important stage in the respiratory processes of almost all cells that use oxygen.

Lactic acid is a dangerous and numerous metabolite in the body. Thanks to the enzyme LDH, lactate is used to break down glucose, which then produces a large amount of energy. The generated energy is used by the body to carry out vital biochemical reactions and muscle contraction, resulting in the formation of lactic acid.

With a lack of oxygen in the human body, the reverse transformation of lactate into pyruvic acid can occur. In yeast, which are anaerobic organisms, lactate is converted into ethyl alcohol. This phenomenon is known as fermentation and is actively used in industry and everyday life.

If there is an insufficient amount of oxygen in the human body, the enzyme lactate dehydrogenase accumulates, which leads to fatal changes in cell metabolism and disruption of the integrity of its membrane. The release of the contents of the cell into the bloodstream leads to an increase in the amount of LDH, which doctors will detect in a biochemical blood test. Lactate dehydrogenase is one of the most important indicators of cell destruction of tissues and organs in which it is located.

Types of LDH

LDH-1. Found in heart muscle and brain cells
LDH-2. Localized in the tissues of the kidney and spleen
LDH-3. Most commonly found in the lungs, thyroid gland, pancreas, and adrenal glands
LDH-4. Is characteristic of the placenta and male sex hormones
LDH-5. Marker of destructive lesions of muscle tissue and liver.

Most often, the first isoenzyme is found in acute myocardial injury, known as a heart attack. These phenomena are used to diagnose myocardial infarction, which helps to significantly reduce mortality. With myocardial infarction, LDH-1 rises after 12-16 hours.

Currently, troponin tests are used for the rapid diagnosis of myocardial damage. They are more specific and appear faster in the blood. Troponin tests become positive in the first hours after the onset of necrotic changes in the heart muscle.

An increase in the number of isoenzymes 2, 3 and 4 in the bloodstream will indicate not only destructive changes in the relevant organs, but also a massive death of platelets. These changes may indicate that the patient has pulmonary embolism. Since the mortality in PE is very high, timely diagnosis will help save the patient's life.

An increase in the amount of the fifth isoenzyme of lactate dehydrogenase (LDH) in most cases occurs in the acute phase of viral hepatitis.

How is LDH determined?

To determine LDH and its isoenzymes, the patient's venous blood is examined. There is no special preparation for donating blood for LDH, since this indicator is not specific.

To conduct an adequate study, doctors recommend several general rules:

Blood sampling from the patient is done on an empty stomach. It is desirable that the procedure was carried out before 10-11 am. A specific diet does not need to be followed. It is necessary not to eat 8 hours before the proposed trip to the hospital. If this rule is violated, then the blood will clot and will be unsuitable for further research.
Stop smoking the day before the test
A few days before going to the laboratory, you must refuse to take alcoholic beverages. Alcohol affects the coagulation and rheological properties of blood. Also, when drinking alcohol, the amount of LDH-5 increases, due to necrosis of liver cells.
On the day of blood donation, you should refuse to take medicines. Acetylsalicylic acid, contraceptives, antidepressants can significantly change the coagulation properties of the blood, which will make it impossible to conduct a study. If the patient has taken some medicine, he should inform the doctor about it. Most likely, medical staff will reschedule the blood draw to another day.
Significant physical activity on the eve of the study significantly changes blood counts, which leads to an inadequate result.

Which specialist pays attention to this parameter?

Studies of lactate dehydrogenase is not a specific indicator of the disease. This analysis is used as an auxiliary and indicates cell destruction or an inflammatory process. The internist, oncologist, cardiologist and general practitioner - family medicine can prescribe this analysis if you suspect the development of the disease based on symptoms and anamnesis.

In such cases, the doctor prescribes lactate dehydrogenase studies:

With pain of a different nature behind the sternum. Used as a differential parameter. Such pains can cause pulmonary infarction, myocardial infarction, angina pectoris and calmness, gastroesophageal reflex disease. Increases in the first isoenzyme will indicate the development of a myocardial infarction in a patient
In malignant tumors, the oncologist prescribes this analysis to monitor the dynamics of the development and course of the disease. Also, a decrease in the LDH enzyme will indicate the success of treatment and the regression of the tumor process. Not so long ago, scientists synthesized a substance that blocks the production of lactate dehydrogenase. This leads to the accumulation of lactic acid inside the cell and its death. If this substance is introduced into the location of the development of the tumor process, then the cancer cells will die. It has been experimentally proven that such a drug is effective only in the first stages of the development of the tumor process.
When staging previously diagnosed diseases of the kidneys and liver
When analyzing the state of muscle tissue
When monitoring the condition of a patient with chronic diseases
When examining the whole body for preventive purposes
To determine the type of anemia

LDH values

Based on changes in the concentration of LDH in the blood, it is impossible to make a diagnosis. Only a doctor can interpret and draw any conclusions. The normal concentration of LDH in the blood depends on the age, gender and condition of the patient. Doctors in their work use the following reference values:

From the birth of a child to the first year, this parameter is 451 units per liter
From the first to the third year of life, this value is 344 units per liter
From 3 to 6 years, the norm will correspond to 314 units per liter
At 6-12 years old, the norm is 332 units per liter
From 12 to 17 years old, the norm will be in the range of 279 units per liter
17 years and older, the reference value of the norm is already distributed depending on the sex of the subject. For male patients, these values will be at the level of 135-225 units per liter. For the female - 135-214 units per liter

For pregnant women and professional athletes, LDH reference values are higher than in the general population.

Changes in LDH levels in the bloodstream

The cause of an increase in the amount of lactate dehydrogenase in the blood may be the following pathological conditions:

myocardial infarction
Viral hepatosis
Cirrhotic changes in the liver
Oncological diseases
Acute pancreatitis
kidney disease
anemia
Traumatic injuries
Muscle tissue disease
Functional disorders of the cardiovascular and respiratory systems
Lymphoma
Leukemia
Myositis and polymyositis
Inflammation of the lungs
Phlebothrombosis of the lower limb
AIDS virus
Sepsis
Acute necrotic process

The amount of lactate dehydrogenase decreases with successful treatment of oncological pathology, hemolytic anemia, and lymphomas. LDH also decreases if the patient has oxalates, urea, and a specific inhibitory enzyme. If the patient took medication before the study, the result will be underestimated. These drugs include: amikacin, ascorbic acid, hydroxyurea, dofibrate, captopril, prednisolone, naltrexone, cefotoxime, antispasmodics.

LDH in cerebrospinal fluid and pleural effusion

An increase in the amount of the enzyme lactate dehydrogenase in the pleural effusion helps doctors differentiate between exudate and transudate. If this figure is more than twice, then this indicates in favor of the exudate, and if it is lower, then this is a transudate. With pleural empyema, the amount of lactate dehydrogenase rises to 1000 units per liter.

In the cerebrospinal fluid, an increase in LDH is found in bacterial meningitis.

Conclusion

The value of the determination of LDH in the blood is not high, due to its low specificity. LDH rises in diseases of the kidneys, liver, heart and characterizes the destruction of their cells.

An analysis for LDH can lead to the idea of \u200b\u200bthe disease. It is impossible to make a diagnosis without additional studies.

Many tests are used to diagnose various pathological processes. Recently, such an indicator as LDH (lactate dehydrogenase) has often been considered.

In order for an ordinary person to understand its meaning, it is necessary to understand what it is. And also find out why it is being investigated, what may be the danger of an increased or decreased level of LDH in a biochemical blood test.

Basic information

Lactate dehydrogenase belongs to the class of oxidoreductases and is an essential enzyme that is involved in the oxidation of glucose and the formation of lactic acid. Its peculiarity lies in the fact that it does not accumulate in the cells.

The enzyme undergoes complete cleavage and excretion.

The intermediary in this process is oxygen, due to which glucose is decomposed into water, energy and carbon dioxide. In the absence of oxygen, energy production is reduced by 20 times, which leads to the accumulation of lactic acid.

Unlike healthy cells, cancer cells can feed without oxygen.

Classification

LDH can be subdivided into isoenzymes that have differences in composition or are located in one specific organ.

Lactate dehydrogenase is classified into several types depending on the organs in which it is present:

LDH-1 - in the brain and heart;
2 - in the blood composition (platelets and erythrocytes) and liver;
3 - in skeletal muscles, lungs, pancreas and thyroid gland, adrenal glands and spleen;
4 and 5 - in the same organs as mentioned in the previous paragraph, plus in the liver, placenta, male germ cells, granulocytes.

Depending on the type of LDH, the activity of the enzyme in the blood composition may differ slightly.

Norm for children and adults

Depending on the gender and age category, the norm of the indicator in the blood will be different.

The values of the LDH level are presented in the table below.

The age during which the LDH norm is the same for everyone		LDH, normal
The age during which the LDH norm is the same for everyone
Newborn baby
4 day life
1 week - 6 months
6 months - 1 year


	boys

13 years and older	Boys and men
13 years and older	Girls and women

As can be seen, in children at birth, the values are higher than in adults. With age, the norm in a child decreases.

The high value in men is explained by the fact that they are more susceptible to intense physical exertion.

In women during pregnancy, the values \u200b\u200bmay also exceed the norm. Before donating blood for biochemistry, it is imperative to inform the specialist about this.

When is an analysis ordered?

It is mandatory done when donating blood fluid for biochemistry. It is prescribed not only for almost any disease, but also for preventive purposes.

Close attention to this indicator is paid if there are suspicions of such pathological processes as:

Anemia. With the development of the disease, there is a more rapid destruction of red blood cells, which leads to an increase in LDH. Indications for analysis in this case will be the following symptoms: pallor of the skin, tinnitus, dizziness.
Myocardial infarction. If the heart muscle is destroyed, then the indicator has quite high values.
Oncological pathologies.
Acute or chronic tissue damage.

In addition, in some cases, determination of the amount of LDH in the fluids of other organs may be prescribed.. This is necessary in order, for example, to differentiate between viral and bacterial meningitis by studying the cerebrospinal fluid.

Reasons for the increase

LDH activity increases with almost any disease accompanied by inflammatory processes and cell death. Among the reasons for the increase in the indicator are the following:

Myocardial infarction in the acute phase.
Functional insufficiency of the vascular and cardiac systems, lungs. Failures in the work of the heart lead to circulatory disorders, the appearance of congestive symptoms and the activation of LDH 4 and 5 fractions.
Inflammation of the lungs, hepatic and renal parenchyma.
Hemolytic and pernicious anemia.
, pulmonary embolism.
Viral hepatitis in the period of exacerbation. While in the chronic form of pathology, the level of LDH does not go beyond the normal range.
Tumor formations of a malignant nature, in particular, with metastases, the localization of which is the liver.
Hematological diseases, for example, granulocytosis, anemia, the development of which was preceded by a lack of vitamin B12 or folic acid deficiency.
Massive platelet destruction. The main reason for this pathological condition is blood transfusion.
Pathologies of the musculoskeletal system. First of all, this applies to lesions of the skeletal muscles (atrophy in the initial stages, various injuries).

Determination of glycolytic enzyme is very important in the diagnosis of myocardial infarction.

Lactate dehydrogenase may also be elevated for other reasons. These include:

megaloblastic anemia;
conditions in which there is an increased destruction of the cellular structure (necrotic processes of an acute form);
damage to the parenchyma of the kidneys;
oncological formations localized in the glands of the reproductive system of men and women.

Thus, pathologies in which the cells of the renal and hepatic parenchyma, as well as erythrocytes and platelets are destroyed, are considered the main reasons for the increase in enzymes in the blood serum.

Reasons for the drop in the indicator

If LDH is low, which is extremely rare, the following factors may contribute to this:

taking ascorbic acid, Metronidazole and other medicines for a long time;
mutations at the gene level;
treatment of anemia, oncological diseases, leukemia and lymphoma.

In addition, a large amount of oxalates and urea in the human body can provoke a decrease in the value, which occurs in the presence of stones in the kidneys and urinary tract.

Symptoms of high and low values

As a rule, an increase or decrease in the level of lactate dehydrogenase is not accompanied by specific symptoms. Depending on what could provoke a change in values in a patient, there may be symptoms such as:

pain in the region of the heart;
unstable blood pressure and pulse;
headache;
drowsiness;
general weakness, decreased performance;
heat.

Required tests

To determine the concentration of LDH in the composition of the blood fluid, a biochemical analysis is carried out. Biomaterial is taken directly from a vein. However, in order for the results to be the most truthful, it is necessary to prepare well for the procedure.

Preparation

Before conducting a study, experts advise you to perform some simple steps that will increase its accuracy and information content. As numerous practice shows, it is not difficult to change the test results, but the consequences can be the saddest.

When inaccurate information is received, as a rule, an incorrect diagnosis is made and inadequate therapeutic measures are taken that do not bring an effective result. We can say that the preparatory stage is a mandatory procedure before analysis.

do not eat for 12 hours before the study;
do not smoke for at least an hour;
avoid physical activity;
eliminate emotional upheaval and stress.

In addition, the distortion of the results can also be caused by such pathological conditions as:

hemodialysis;
dermatological diseases of the skin;
the use of medications;
thrombocytosis;
stress associated with physical activity.

Immediately before taking an analysis, the presence of such factors must be reported to a specialist who will decide whether to do tests or not, and also consider all possible options for error.

Holding

In adults, blood is taken from a vein in the place where the arm is bent. To do this, use a special needle. In children, blood fluid is taken with the help of a lancet.

It is also possible to take it from the heel, earlobe or thumb of the lower limb. After the procedure, a pressure bandage is applied to the site of the fence.

The resulting blood is placed on a special glass or in a test tube. Under laboratory conditions, the material is lowered into a special device - a centrifuge, where the serum is isolated. Thus, the concentration of LDH is determined.

Decryption

The interpretation of the results is carried out exclusively by a specialist. Doing it yourself is not recommended.

It is worth remembering: to confirm the presence of any pathological process, determining only LDH is not enough. To create a complete picture, all indicators of the blood fluid must be evaluated.

How to normalize values

If lactate dehydrogenase is elevated, first of all, it is necessary to establish the cause that could provoke such a condition. Only after the elimination of the underlying disease can the level of the enzyme be normalized.

Features of therapeutic measures:

With myocardial infarction, treatment begins immediately after the first signs of the disease appear or after a diagnostic examination. First of all, the patient needs to reduce the load on the heart muscle, ensure the supply of oxygen, and administer a medicine that normalizes blood circulation. During the entire period of therapy, the patient needs to constantly donate blood for analysis, which will allow monitoring the effectiveness of treatment. With correctly appointed measures, the value of LDH and other indicators will begin to decline.
If an increase in the concentration of the enzyme was provoked by iron deficiency anemia, then the doctor prescribes a special diet, which involves the use of foods that contain Fe and vitamin C, special medications that restore the norm of this element, and walks.
For oncological diseases, complex treatment is carried out, which includes the use of special drugs, chemotherapy and radiation therapy.
With an increase in LDH against the background of acute pancreatitis, painkillers, droppers with albumin or plasma, and digestive enzymes are prescribed. In the absence of a positive result, washing the abdominal cavity is done. In severe cases, surgery is performed, during which the pancreas is removed.

It is important to remember that only the attending physician can prescribe any drug.. Under no circumstances should you do this on your own.

Why is it important to keep the indicator normal

A significant increase in the level of the enzyme always indicates the development of a pathological process. In the absence of therapeutic measures or untimely diagnosis, any disease can provoke unpleasant consequences for the patient:

transition to a chronic form;
complication of the course of the disease;
increases the likelihood of developing a heart attack or stroke;
cancer processes;
cirrhosis of the liver;
fatal outcome.

Low LDH values are most often not an indicator of the development of pathology.

The analysis, as a result of which the level of lactate dehydrogenase is determined, makes it possible to timely diagnose the presence of any serious disease even at the initial stage of its development. Therefore, even for preventive purposes, it is necessary to conduct a blood test regularly.

The LDH (lactate dehydrogenase) test is a non-specific test that is used when a number of diseases and conditions are suspected. The enzyme enters the blood plasma during the destruction of almost any cell in the body, including bacterial cells. Therefore, the level of LDH in the blood is a general indicator of tissue and cellular damage. Sometimes an assessment of the concentration of a substance is carried out on the cerebrospinal or pulmonary fluid in the presence of certain diseases.

The importance of the enzyme in the body

Interest in what LDH is in a biochemical blood test is associated primarily with myocardial infarction. Previously, this test was used to diagnose and monitor damage to cardiac tissue, but now the troponin test is considered more accurate and informative. Lactate dehydrogenase (LDH) is not a specific indicator of heart cell damage and is no longer used in patients with suspected acute coronary syndrome. Usually, the decoding of a biochemical blood test contains this indicator. Lactate dehydrogenase in the blood is an important enzyme involved in the reactions:

Glucose oxidation;

Production of lactic acid.

A feature of the enzyme is that it does not accumulate in cells, but is completely cleaved and excreted. LDH is needed to convert glucose into energy for the life of all cells in the body. The mediator of the reaction is oxygen, which helps to break down glucose into water, carbon dioxide and energy. Without oxygen, energy production decreases by a factor of 20 and lactic acid builds up. The enzyme LDH is necessary for its oxidation and return to glucose metabolism. Unlike healthy cells, cancerous tumors feed without oxygen.

When is an analysis ordered?

The test is used for suspected acute and chronic tissue damage, as well as for assessing progressive diseases. In rare cases, the analysis helps to identify the target organ damage.

The enzyme is determined in a venous blood sample. After an injury, LDH is elevated, rises over 48 hours and reaches a maximum after 2-3 days, then gradually decreases. The normal indicator is restored in 10 days.

Studies show that a biochemical blood test for LDH is an indicator of the development and progress of cancer. Even after taking into account the factor of age, stage of the disease in patients, a strong association with the risk of death persisted. This relationship was true for all types of malignant tumors.

An LDH blood test can be used to detect and evaluate:

Acute or chronic tissue damage;

Progression of anemia and severe infection;

The course of oncological diseases after chemotherapy for lymphoma, leukemia, melanoma, neuroblastoma. High values indicate poor prognosis of patient survival.

The doctor prescribes the determination of the level of LDH in other body fluids:

To distinguish between bacterial and viral meningitis by analysis of cerebrospinal fluid.

To identify the cause of the accumulation of exudate in the chest or abdomen (pleural, peritoneal and pericardial fluids) due to trauma and inflammation or due to an imbalance of pressure within the blood vessels and the amount of protein in the blood.

A blood test for LDH (biochemistry) is taken on an empty stomach from a vein.

The last meal 8 hours before the examination should not contain too fatty and protein foods.

Be sure to tell if you need to take medications regularly. Aspirin, hormonal contraceptives, and antidepressants affect clotting and may show elevated values.

Intensive training the day before can lead to an increase in the enzyme, as it increases energy expenditure and the need to break down glucose.

Many factors affect the results of the analysis, and they are not always a cause for concern and further examination:

Hemolysis of blood samples leads to false positive results. Violation of the rules for storing samples, rough processing affect accuracy.

With an increased number of platelets, the serum level of LDH also rises and does not show a real picture.

When hospitalized with suspected myocardial infarction and acute pancreatitis, LDH analysis is performed without taking into account recommendations. Often, the LDH indicator is used to assess the dynamics of the disease and the patient's recovery.

Norm of LDH in the body and decoding of the analysis

When analyzing blood, the norm is usually indicated in units / l, which means one per liter. The decoding of the analysis takes into account the age and gender of the patient. In the blood of a healthy adult, a relatively small amount of the enzyme is found. In a child under two years old, an indicator within 430 units / l is considered the norm.

An increase in lactate dehydrogenase occurs during pregnancy, in newborns, and in professional athletes.

Based on the identified marker, it is impossible to determine which cells were damaged. Therefore, it is necessary to know when deciphering LDH, what are its isoenzymes. Some laboratories conduct additional tests that determine several forms of a substance, starting with the most mobile:

The first indicates a problem with the heart, kidneys, and red blood cells;

The second is found mainly in cardiomyocytes and erythrocytes;

The third is found in the tissues of the lungs, endocrine glands and adrenal glands;

the fourth is an enzyme in white blood cells, liver, placenta and male testicles and muscle tissue;

The fifth is found in all organs containing LDH-4, as well as skeletal muscles.

Deciphering biochemistry for an increase in LDH in the blood is now considered less informative.

High values of all isoenzymes determine the pathology of several organs. Myocardial infarction with congestive heart failure causes lung damage and liver congestion. In cancers and autoimmune diseases such as lupus, lactate dehydrogenase is generally elevated. Hypoxia, shock, and burns are accompanied by cell death, which indicates an increase in LDH. Caffeine also affects the amount of the enzyme in the blood.

The dynamics of the first isoenzyme is more sensitive and specific than the increase in LDH in general. Usually the level of the second isoenzyme is higher than the first. If the concentration of LDH-1 rises relative to LDH-2, a heart attack is diagnosed. Usually, the norm of LDH in the blood is exceeded 12-24 hours after damage to the heart tissue and for two days in 80% of cases. A normal LDH-1/LDH-2 ratio is reliable evidence that there was no attack. The ratio of total LDH and LDH-1 is called hydroxybutyrate dehydrogenase. Therefore, with a heart attack:

the LDH/HBDG figure is lowered (less than 1.30);

the LDH-1/LDG-2 ratio approaches 1 and sometimes exceeds this value.

On the first day, myocardial infarction is diagnosed in terms of creatine kinase, and a day later, according to the enzymatic study of LDH. The activity of the substance is directly related to the area of damage to the heart muscle.

Other severe diseases reflect on the ratio of isoenzymes and coefficients:

Hemolytic anemia is characterized by low LDH / HBDG - up to 1.3 and below;

In megaloblastic anemia, LDH-1 is significantly higher than LDH-2;

the overall level increases with acute necrotic processes and cell death, such as damage to the kidney parenchyma;

tumors in the sex glands (ovaries and testicles) are accompanied by an isolated increase in LDH-1.

Most often, LDH is elevated due to the destruction of the tissues of the hepatic and renal parenchyma, and the death of platelets and erythrocytes.

LDH in a blood test is considered in relation to other indicators:

In anemia, red blood cells are destroyed, which releases large amounts of LDH into the blood. The disease is diagnosed against the background of low hemoglobin. Weakness, pallor, shortness of breath may be indications for examination.

Blood cancer is associated with the production of abnormal blood cells, which is reflected in the levels of many indicators: LDH, aspartate aminotransferase, bilirubin, urea. At the same time, there is a decrease in the level of glucose and the blood coagulation factor fibrinogen. A biochemical blood test allows you to suspect a pathology and refer the patient to identify tumor markers.

Along with the LDH indicator in the blood, which indicates the death of pancreatic cells, bilirubin and glucose will increase. The primary indicator is the level of the pancreatic enzyme amylase.

Reasons for the increase

Elevated levels of LDH can be caused by various diseases:

stroke;
some types of anemia (pernicious and hemolytic)
kidney and liver diseases;
muscular dystrophy;
pancreatitis;
Infectious mononucleosis;
some forms of cancer.

The concentration of the enzyme increases after the introduction of anesthetics and taking aspirin, as well as after intense physical exertion. Normal and low LDH levels are not pathological. A factor that reduces the rate is the consumption of a large dose of ascorbic acid (vitamin C).

The reasons that lactate dehydrogenase is elevated are varied: HIV infection, sepsis, acute kidney disease, infarction of the intestines and lungs, bone fractures, rash on the body.

LDH is low when transudate accumulates in body cavities, such as the abdomen, which is usually caused by congestive heart failure or cirrhosis.

LDH in the blood - what is it, the reasons for the increase in the biochemical blood test

Blood lactate dehydrogenase (LDH) is a laboratory test with low specificity. However, its deviation from the norm is a sufficient condition for a comprehensive examination of the patient. It is necessary for the primary diagnosis of pathologies in the work of the heart, lungs, kidneys, various oncopathologies and destruction of muscle tissue in humans.

What is LDH in the blood?

In order to understand the purpose for which the analysis is prescribed, you should first understand - what is LDH in a biochemical blood test?

Lactate dehydrogenase (LDH) in the blood is an enzyme localized inside cells. The composition necessarily includes zinc ions. Its main function is to catalyze the oxidation of lactic acid to pyruvate. Almost all cells in the human body contain the enzyme LDH. The maximum concentration is observed in skeletal (9000 units/g) and cardiac (25000 units/g) muscles, as well as in the kidneys (15000 units/g), lungs (9500 units/g) and liver (9000 units/g).

In case of cell damage, an active release of the enzyme into the bloodstream occurs. Blood cells also contain LDH, however, their content is negligible. That is why even with a slight destruction of the tissues of any of the organs, there is a sharp increase in the level of LDH in the blood serum, which is used to diagnose various diseases. This fact makes it possible to attribute the blood test for LDH to highly sensitive, but low specific criteria.

Enzyme isoforms

From the point of view of the information content of the obtained results, LDH isoforms are more preferable due to an increase in the level of specificity. There are 5 isoforms of the enzyme with characteristic physicochemical properties.

Isoform

The organ that produces

Indications for the study

A doctor can write out a referral for a biochemical analysis of blood serum in order to determine the level of LDH if:

the patient has symptoms of chronic or acute damage to the integrity of cells and tissues;
a person feels severe pain in the chest area, which may be caused by myocardial infarction or angina pectoris;
it is necessary to control the course of chronic pathologies, including oncology;
large-scale screening of human health.

The norm of LDH in the blood

Any interpretation of the results should be carried out exclusively by a specialist. In view of the low specificity of the criterion under consideration, its isolated use for the final diagnosis of the disease is prohibited. Indicators of the normal concentration of LDH in adults and children in the blood are shown in the table.

Normal values, U/l

It should be noted that LDH levels are normally higher in men than in women. Deviation from the reference (normal) values up or down indicates the development of the pathological process.

The value of indicators of LDH isoenzymes

The activity of isoenzymes is determined by the degree of inactivation by urea. It has been established that the level of inhibition of the enzymatic activity of human serum by urea ranges from 26 to 36%. This indicator is considered as a standard value for comparing the inhibitory properties of the five fractions of isoenzymes.

Isoenzyme

The level of inactivation from the total activity of urea, %

The table shows that each fraction has its own level of inhibition. Based on the known data on the priority organ for the synthesis of each isoenzyme, and the results of the analyzes, it is possible to determine with a high degree of probability the organ in which the disease develops.

Deciphering the results: reasons for the downgrade

It is noted that the level of LDH is lowered in the following cases:

the presence of oxalates (salts and esters of oxalic acid) and urea in the patient, which weaken the enzymatic activity of LDH;
taking medications that reduce the work of the enzyme (antibiotics, ascorbic acid);
the effectiveness of the chosen treatment tactics, leading to the normalization of the value of the criterion under consideration.

Causes of an increase in LDH in a biochemical blood test

The criterion under consideration may deviate from normal values in a number of different diseases. The reasons for the increase in the concentration of lactate dehydrogenesis may be:

myocardial infarction, accompanied by ischemic necrosis of the middle layer of the muscular tissue of the heart;
blockage of a lung artery by a thrombus or pulmonary infarction;
blood pathologies, which are characterized by the destruction of red blood cells (various types of anemia, hemolysis, severe intoxication);
malignant tumors affecting various organs and tissues, often accompanied by metastasis;
violations in the liver against the background of chronic and acute hepatitis, Gospel disease or alcohol intoxication;
kidney pathology (glomerular nephritis, pyelonephritis);
atrophy or injury of muscle tissue;
open and closed fractures;
congestive heart or coronary insufficiency;
inflammation of the heart muscle tissue;
mononucleosis, viral etiology;
acute attack of pancreatitis;
convulsive seizures;
alcoholic delirium (mental abnormalities against the background of a sharp withdrawal of alcohol);
burn disease;
abruption of the placenta ahead of time;
hyperthyroidism.

When identifying the causes of an increase in LDH in women and men, it is necessary to exclude the influence of factors that can lead to unreliable results:

incorrect blood sampling, as a result of which erythrocytes are destroyed in the test tube (hemolysis);
neglect of the rules for preparing for the delivery of biomaterial: physical and emotional stress, smoking, alcohol, improper diet;
the use of treatment methods, accompanied by electrical stimulation of the patient a week before the analysis;
an excess of platelets in the blood;
taking medications that activate the enzyme system.

Normalization of LDH levels in the blood

Patients often ask the question - how to reduce the level of the enzyme? To do this, it is necessary to initially establish the exact cause of the increase in LDH. Only when the disease that was the cause is eliminated, it is possible to return the indicator to normal values. Therapy for each of the pathologies has its own characteristics:

after the first signs of myocardial infarction, a person needs first aid. Any delay in treatment can lead to death and serious complications. In order to assess the risk of relapse, a control measurement of the level of LDH is carried out, which, with adequate therapy, should return to normal;
in case of anemia provoked by iron deficiency, the patient's nutrition is corrected, and iron-containing preparations are prescribed. A favorable outcome is considered to be an increase in hemoglobin levels and a decrease in LDH;
in oncopathology, large-scale patient screening is necessary to assess the size of the tumor, the presence of metastases, and the degree of organ damage. At the same time, the evaluation of the effectiveness of treatment includes an analysis for LDH and the main tumor markers. The lack of positive dynamics, expressed in a decrease in the considered criteria, is the reason for transferring the patient to more aggressive methods of treatment;
in the case of acute pancreatitis, it is necessary to place the patient in a round-the-clock hospital. Treatment includes droppers with painkillers, antibacterial and anti-inflammatory drugs. As the patient's condition improves, all biochemical parameters return to normal.

How is LDH analyzed?

To assess the level of LDH and its enzymatic activity, 2 groups of methods are used:

spectrophotometric, the essence of which is to determine the difference in the absorption spectra of the oxidized form of NAD (a coenzyme of all living cells) from the reduced one;
colorimetric, subdivided into dinitrophenylhydrazine - determining the concentration of pyruvate, and redox indicator - identifying certain molecules using indicators that change color.

An optical test is used as standards for determining the enzymatic activity of LDH, and electrophoresis is used for isoenzymes. When issuing the results of the analysis, the laboratory must indicate the chosen method.

How to prepare for the study

Preparation for the delivery of the analysis is necessary to obtain the most reliable and accurate results. The biological material is venous blood collected from the cubital vein at the elbow. Recommendations before analysis:

blood is given strictly on an empty stomach, for 1 day it is necessary to exclude fatty and fried foods from the diet;
it is strictly forbidden to drink juice, tea and coffee 12 hours before sampling the biomaterial, pure water without gas is allowed;
no smoking for 30 minutes;
Avoid alcohol and drugs for at least 48 hours. If it is impossible to cancel any drugs, notify the laboratory employee about their intake;
limit physical and emotional stress in 1 hour.

Summing up, it must be emphasized:

LDH in a biochemical blood test is a low-specific criterion that suggests a number of diseases. To clarify the diagnosis, it is necessary to conduct additional laboratory and instrumental examinations;
when deciphering the results, it is important to take into account that the reference value for a child and an adult is different;
in the case of necrosis and infarction, which are characterized by cell destruction, it is recommended to repeat the analysis after the acute stage. This is necessary to assess the degree of tissue destruction and the severity of the pathology;
identification of the degree of activity of enzyme isoforms allows you to clarify the location of the pathology.

Yulia Martynovich (Peshkova)

Graduated specialist, in 2014 she graduated with honors from Orenburg State University with a degree in microbiology. Postgraduate graduate of FGBOU VO Orenburg State Agrarian University.

In 2015 at the Institute of Cellular and Intracellular Symbiosis of the Ural Branch of the Russian Academy of Sciences, she underwent advanced training in the additional professional program "Bacteriology".

Laureate of the All-Russian competition for the best scientific work in the nomination "Biological Sciences" in 2017.

LDH is elevated in a child Komarovsky

Hello. The child is 2'5 years old. Height 102, weight 17.7 kg. I don't know where to write anymore, I read similar topics here. Mums with a similar problem can be otkltknutsya.

At 4 months the problem was discovered. The child was admitted to an infectious disease with suspected pneumonia. They took a picture, everything was fine, but they started to inject Ceftriaxone for safety, and then on the second day it turned out that in biochemistry, asat and alat were increased by about three times asat and alat by two times. This is what I remember. Ceftriaxone was abruptly canceled, the child was under a dropper of rehydron, in my opinion. For three days they poked around and kicked us off, so they didn’t figure out what was what. Ceftriaxone was thought to have caused hepatoxicity. But something about it bothered me. In a year, we retake blood tests twice as high as normal, asat is above normal, alt is normal. Lots of questions for doctors with no answers. They passed all the hepatitis and infections that the gastroenterologist prescribed ... all negative. I was worried about myopathy, but thank God it's not. At the age of 2, I decided to act independently in search of an answer, but also looked closely at the behavior and development of the child. I hoped it would outgrow, I didn’t go into depression much. Biochemistry at two years showed asat within the highest normal range, alt was normal, CK was normal, LDH was 680. As for LDH, the question of the liver immediately hung, but I wanted to see CK-MB. And at 2.5 degrees, he was shrunk to take him to where they do this analysis, he turned out to be upgraded. 40 at a rate of up to 20. As if before pregnancy, I had a good encounter with this isoenzyme and with tonsillogenic myocardial dystrophy I had a periodically elevated CK-MB. Myocardial cells were destroyed, fortunately my condition was reversible, I removed the tonsils. Shortness of breath, pain in the heart and kfc that is common, that mv returned to normal after the operation, as well as my terrible condition. What now we have kfk mv 40, ldg550. I must say that my grandmother with coronary heart disease has the same biochemistry as my child. Imagine what the baby is going through. Asat is in the upper bound, which is also suggestive. The general CK has become normal, perhaps he also jumps occasionally, he just didn’t catch it. Ultrasound of the abdominal cavity from 07/18/18 shows hepatomegaly., i.e. enlargement of the liver, as the ultrasound specialist said, is slightly above the norm, supposedly it’s not scary, mommy. But where then to sew analyzes tell or say. I understand that it is necessary to pass troponins I, T, C, in order to understand whether cardiomyocytes are destroyed and to do an ultrasound of the heart. By the way, in the maternity hospital, the ultrasound was normal, without pathologies. It is not so easy to get on the ultrasound of the heart in our Muhosransk, as it is to find a good doctor. But I think we’ll do an ultrasound in early September, but troponins, even in Minsk, our capital, they don’t make them, it’s only to Moscow, I’m not sure that we will get there together. I study a lot of information and understand that we can talk about xp. Heart failure, congenital heart disease or acquired after a string of viruses, which we had a lot during this time. But ... the liver is also in question ... this is an ultrasound, where the liver is more than normal, then hemoglobin is low from birth, a reaction to fatty in the form of the smell of acetone and ketone bodies in the urine. They put him on a diet, nothing fatty, a minimum of chocolate, we feed him cereals. The reaction to Maltofer, at 4 months was prescribed, I fell for our stupid pediatrician and gave. On the second day, the child screamed so that the grandmother was taken away with a heart attack. Maltofer was canceled, and the next day they got into an infectious disease, the child was lethargic, apathetic, pneumonia was suspected, Ceftriaxone was also slapped after him, then tests surfaced. You can sin for an infection, you can for drug poisoning, you can be vaccinated against hepatitis in the maternity hospital, or for breastfeeding a month old, and at that time I was injected with Ceftriaxone for endometritis in the hospital. I do not know what caused such problems, the diagnosis is important to me and the treatment is important in order to improve or prevent the prognosis. And the prognosis, as I understand it, can be disappointing (((I’ll say about the child: he always ate well, developed and gained weight normally. hemoglobin is normal, thyroid hormones are normal, complete biochemistry a month ago.

hepatitis;
jaundice;
liver pathology (cirrhosis);
blood diseases;
leukemia;
wasting of muscle fibers;
kidney disease;
acute pancreatitis;
some medicines;
burns.

Normal LDH in children

from 1 to 4 days of life - But important rules should not be missed:

Blood is taken early in the morning, on an empty stomach.
In terms of nutrition, you can leave everything as it is.
You can do sports exercises in the same rhythm, but do not overwork much.

Otherwise, there are no special instructions. Despite the fact that the procedure is painless, it is still something unknown and unusual for children. So before the upcoming procedure, it is worth preparing him: talk to him calmly, tell everything the way it will happen. When the child is ready, then the procedure will seem normal.

The analysis for lactate dehydrogenase may exceed normal standards, be reduced, or equal to the norm. With an increase in LDH, we can talk about the presence of certain types of anemia, hepatitis, hypoxia, or carcinomatosis.

Also, the child has not yet had time to get used to all manifestations of the external environment. The body only adapts to all sorts of changes. This is how many doctors explain the frequent diseases of the younger generation. Over time, the immune system, knowing this or that irritant, is able to give its answer, then infection will not occur. But preventive measures should not be forgotten, they will help increase immune protection.

Thank you for the answer, indeed the rest of the indicators are normal (therefore I didn’t write them), I cited the norms from the form, as I understand it, they are indicated for this laboratory (done in the clinic)

I understand that this is not a medical forum, but it takes a long time to wait for a doctor's appointment.
I hope that not only mothers, but also doctors look here
Maybe something else to investigate for now, so as not to waste time

Of the diseases in the past, DZHVP was diagnosed, ultrasound in December was the norm, and in April - dyspancreatism.

Why is LDH elevated in a child, what are the consequences?

If in the analyzes LDH is elevated in a child, doctors are wary. It is necessary to respond to any changes in the body, especially in childhood. This enzyme is present in almost all human organs. The smaller the child, the higher this figure will be. It should decrease with age. Lactate dehydrogenase can increase in women during gestation, infants, and athletes.

Causes and consequences of an increase in LDH

The reasons for elevated lactate dehydrogenase are varied.

Various diseases can affect the concentration of LDH. In most cases, the diagnosis is muscle wasting, pulmonary infarction, or anemia.

Diseases in which LDH rises include:

hepatitis;
jaundice;
liver pathology (cirrhosis);
blood diseases;
leukemia;
wasting of muscle fibers;
kidney disease;
acute pancreatitis;
some medicines;
burns.

An analysis to determine the level of LDH is carried out:

To determine how affected the patient's tissues are.
To find out the cause of pain in the chest area.

In order to find the cause of the destruction of red blood cells.
To monitor the progress of cancer.
To conduct an examination of the liver with kidneys.
After receiving serious muscle injuries.

The obtained material for research is stored for no more than 48 hours, while the temperature should be from 18 to 25 ° C. If the sample is removed in the cold or freezing, then the concentration of LDH will begin to decline rapidly, the result will be false.

Normal LDH in children

Consider the LDH levels established by the norm in childhood:

LDH is elevated in a child

Lactate dehydrogenase is an essential isoenzyme found in the blood through which lactic acid is produced in the body and the process of glucose oxidation occurs. If there is a norm on LDH, such a component is absent, since it is independently destroyed and excreted from the body. But, in medical practice, there are cases when the level of LDH is increased or decreased and this reveals certain diseases in the human body. And so what is LDH in a biochemical blood test?

What it is

Blood test for LDH, what is it and what are its indicators? With the development of medicine, many have appeared whose names require decoding.

With the help of the enzyme lactate dehydrogenase, which is found in the liver, kidneys and skeleton, the patient is diagnosed with various pathological conditions, if any.

Lactate hydrogenase is divided into:

Isoenzymes differ in their composition.
Isoenzymes that are found only in a particular organ.
There are special research methods that determine the amount of these components. These are electrophoretic, chromatography, kinetic, immunological.
Movement speed is important. LDG1 are the fastest of them, LDG5 are slow.

In the heart muscle, for example, there are LDH1 and LDH 2, the slowest - LDH5, researchers observe only in the liver.

Decryption

But the following causes of an increase in the lactate dehydrogenase enzyme in adults and children are also distinguished:

Cirrhosis of the liver.
Acute pancreatitis.
There are certain medications that cause it to increase or contain large amounts of caffeine.
mechanical jaundice.
, burns and shock of varying severity. All diseases that accompany the breakdown of cells.

An increase in lactate dehydrogenase is detected in coronary insufficiency, congestion in the liver or. It happens that a patient has arrhythmia of the heart - all indicators are normal, but if it is treated with electrical impulses, the level of the enzyme will increase.

It should be remembered that LDH is also elevated in newborns, but this is their peculiarity and in the future it returns to normal. A fairly rare occurrence is a decrease in this enzyme, which indicates genetic abnormalities or its absence in the blood at all.

Additional tests

Like all procedures related to the circulatory system,. But the doctor can give you a referral to other procedures in order to correctly diagnose:

General blood analysis.
ALT (alaninominotransferase) this analysis also involves donating blood from a vein.
Alkaline phosphatase is also determined by the composition of the blood.
(aspartate aminotransferase) - a component that determines biochemistry.
Direct bilirubin level.
GGT is one of the components of blood and is detected using biochemistry.

Diagnostics

The doctor gives a referral for such a study when:

If the specialist suspects that tissue is damaged in the patient's body. But this analysis for LDH is carried out only in combination with other studies that make it possible to judge the nature of the anomaly.
If the patient is tormented by pain in the chest of a sharp nature, then one of the reasons may be angina pectoris, pulmonary infarction or myocardial infarction. To identify what exactly caused the pathology and conduct this study.
With various tumors of a cancerous nature, when the doctor examines their development.
If kidney and liver disease is detected and its stage needs to be established.
Examine to identify abnormalities in red blood cells.
If the analysis of the state of muscle tissue is carried out.

Blood taken for analysis of lactate dehydrogenase is stored for two days at a temperature of eighteen to twenty degrees Celsius. In no case should the result be frozen, because the enzymes disappear at low temperatures.

Preparation

Here, with preparation, everything is much stricter, preparation for a blood test for LDH. For twelve hours before the study, you should not eat anything. Also, experts do not advise smoking and drinking drinks containing alcohol, actively exercising and eating a lot. Also, don't ruin your mood.

The patient needs to calm down before the examination and sit in the corridor in front of the office in order to bring his pulse to normal and calm the heart.

You should also consider the following:

Stop taking ascorbic acid, anti-seizure medications, and certain medications four days before the test.
You do not need to take hemodialysis before the procedure.

Doctors warn that the heart valve and possible hematological abnormalities affect blood tests.

Important facts about the enzyme and its properties

A blood test for LDH is usually prescribed along with other necessary procedures that make it possible to judge the presence of a particular disease in the patient's tissues and organs.

With tissue necrosis or infarction, patients pass the study several times after a certain time. If you have an increased blood test for LDH, then, most likely, the doctor will tell you with accuracy in which organ the anomaly is observed.

Lactate dehydrogenase (Lactate dehydrogenase) or LDH (LDG) is an enzyme containing zinc and located inside the cell.

Its main functions are the transformation of lactic acid into pyruvic acid (pyruvate), and its important function is to prevent the reverse reaction of the previous process.

The concentration of this enzyme is noted in all tissue formations of the human body. The tissues of the liver, heart, skeletal muscles, kidneys, as well as erythrocytes have the highest concentration.

In the latter, it is presented in the form of five isozymes, which are numbered from one to five, respectively.

In a healthy state of the body, the value of LDH does not accumulate. This enzyme is excreted from the body in the same amount as it is formed. The value of lactate dehydrogenase does not indicate the development of pathological conditions of the body. It determines the consequences of the disease - the deformation of cells and tissues in the human body.

LDH in the blood, what is it?

A laboratory blood test for LDH is an additional diagnostic method. The analysis is not the main one for diagnosing diseases, and is used to confirm or refute the diagnosed individual diseases.

The information content of the analysis allows you to determine the effectiveness of the applied courses of therapy, track the progression of the disease and determine its stage.

The concentration of LDH in the human body consists of five fractions of isoenzymes. They are classified based on the structure of the cell and location in different organs of the human body.

It is with the help of this classification that doctors quickly determine in which organ tissue deformation occurs, which greatly simplifies the diagnosis of pathological conditions.

These isozymes are presented in the following fractions:

LDH-1. The first fraction is also referred to as the HHHH tetramer and is localized, in its predominant set, in the myocardium and brain. The index of the first fraction increases significantly with the deformation of the tissues of the heart muscle,
LDH-2. The highest concentration of this enzyme is recorded in the liver tissues and biological material,
LDH-3. These isoforms are concentrated in the thyroid gland, lung, renal and pancreatic tissues, as well as in all smooth muscle tissues of the body,
LDH-4. It is located, for the most part, in the same organs as the third isoenzyme, as well as in the liver tissues, placenta and reproductive system of men,

An active increase in the above three fractions occurs in pathological conditions in which platelets die in large numbers. One of the most dangerous pathological conditions leading to massive death of platelets is thrombosis of the pulmonary trunk.

LDG-5, its characteristic is the source of the enzyme, which lies in the liver tissues, skeletal muscles, placenta and the male reproductive system. The enzyme increases significantly in the acute stages of viral hepatitis.

The distribution of different types of lactate dehydrogenase occurs depending on the types of tissues in which they accumulate. This means that different quantitative indicators of the fraction are recorded in different parts of the body.

The results are shown in the table below.

FractionQuantitative indicator in serum % (relative units)

LDH-1	17 – 27% (0,17 – 0,27)
LDH-2	27 – 37% (0,27 – 0,37)
LDH-3	18 – 25% (0,18 – 0,25)
LDH-4	3 – 8% (0,03 – 0,08)
LDH-5	0 – 5% (0,00 – 0,05)

What are the normal levels of LDH?

Normal values for LDH of a healthy person fluctuate in women and men. In adults and children, the levels are different, and the indicators also vary by gender.

LDH rates are shown in the table below.

In newborns, lactate in the blood is always elevated. Deciphering the analysis is the business of a qualified doctor, since when analyzing the results, it is necessary to take into account the age category of the child and his physical indicators.

Also, indicators are calculated depending on physical activity. With active child sports, the level of LDH is increased, which is the norm. And for women, the indicator shows below the norm than for men.

The definition of units of measurement and indicators of the norm may vary, depending on the laboratory in which the study is carried out. .

For an accurate interpretation, you need to drown these factors directly in the place where the analysis is carried out.

Indications for analysis

A blood test for lactate dehydrogenase is a biochemical one, and is prescribed for suspicion of the following diseases:

Severe forms of anemia. Such pathological conditions lead to the death of red blood cells from an insufficient amount of iron in the body. This leads to an increase in LDH,
Suspicions of tumor formations. The biochemistry of LDH is not a means of diagnosing cancer. To do this, doctors use a tumor marker,
Death of heart tissue. The LDH compound is released into the blood during myocardial tissue necrosis,
All pathological conditions in which any tissue of the human body dies.

Any suspicion of necrotic changes in tissues within the human body contributes to the direction of LDH for a biochemical blood test.

In addition to taking indicators of this enzyme, additional types of blood tests may be prescribed.

These include:

alanine aminotransferase (ALT),
Aspartate aminotransferase (AST),
creatine kinase total,
Creatine kinase MB,
Lactate dehydrogenase 1, 2 (LDH 1, 2 fractions),
Phosphatase alkaline total,
Troponin I

myoglobin

Preparation for analysis

After a patient has been scheduled to undergo an LDH study, some preparatory measures should be taken. They are observed in order to obtain the most accurate result, since some third-party factors can affect the composition of the blood.

The actions that must be performed in preparation for the analysis of LDH are:

The analysis is given on an empty stomach. Eating must be stopped at least eight hours before blood donation,
At least one day prior to blood sampling, you need to stop eating fatty, highly salty, spicy or spicy foods in the diet,
At least 7 days (!) give up alcoholic beverages,
Strong physical activity,
If the patient is taking medications (vitamin C), stop taking them at least 48 hours before blood sampling. With the continuous use of drugs, you need to notify the attending physician about this, so that he takes into account all the amendments in the test results, which will contribute to accurate diagnosis,
Avoid stressful situations, nervous breakdowns and everything that loads the nervous system.

Reasons for the increase

Provoking an increase in LDH levels in a biochemical blood test occurs under the influence of inflammatory processes, in which tissue cells are deformed and die.

Factors affecting the increase in LDH levels may be the following:

All diseases in which any body cells die will lead to an increase in LDH levels. So in such pathological conditions, their role in the diagnosis is great.

The discrepancy between the indicators to the norm may also be under the influence of physiological factors that are not associated with pathological conditions, in which the value can be increased.

These include:

The period of bearing a child (a test for LDH is done without fail),
The first months of a baby's life
Great physical activity
Age category,
gender,
The impact of certain drugs.

All these factors must be taken into account in order to correctly diagnose the disease.

The interpretation of the analysis should be entrusted to a qualified doctor.

Since the correct diagnosis will occur after determining the indicators of each LDH fraction, and not its general indicator.

How to lower the LDH level?

The use of actions to reduce the level of LDH is allowed only after the final diagnosis by a qualified doctor.

Determination of LDH levels is necessary in the treatment of the following diseases:

Why do LDH levels drop?

If the level of this enzyme is lowered, then it is easier to determine the cause, since this is facilitated by a small range of factors. Registration of low rates is noted in very rare cases. Doctors do not consider a decrease in LDH levels to be an indication of a pathological condition.

In most cases, the indicator is low with the use of vitamin C, or increased glucose oxidation. In the most rare cases, LDH is lowered in hereditary diseases, but such cases are rare.

LDH index and myocardial tissue death

The study of this indicator is an important diagnostic value in structural disorders of the myocardium. This analysis refers to the main studies of enzymes that determine the death of heart muscle tissue in the first 24 hours of myocardial progression.

The LDH level will be increased already after the first ten hours from the onset of the pain syndrome and the progression of necrotic changes in the heart muscle, first of all, the indicator of the first fraction (LDH-1) increases, and indirectly increases the second fraction.

In addition to the growth of the total indicator of lactate dehydrogenase, a special role in the death of cardiac tissues belongs to the first fraction, which is also referred to as hydroxybutyrate dehydrogenase, and the ratio between the first and second fractions.

Hydroxybutyrate dehydrogenase

With necrotic changes in the myocardium, the total LDH will be lowered in relation to LDH-1. With such processes, the overall level will tend to a smaller number, while the first fraction will only grow.

Changes in the indicators of the first fraction and the total indicator, similar to necrosis of the tissues of the heart, may also indicate the following diseases:

Death of tissue in the kidneys
Tumor formations in the female and male reproductive systems,
Pathological conditions, which are accompanied by severe destruction of cells,
Megaloblastic anemia. With such a disease, the level of the first fraction is many times higher than the second,
Various hemolytic anemias.

Diagnosis of diseases is confirmed with the help of additional hardware studies prescribed by a doctor based on the inherent symptoms and laboratory tests.

Prevention

In order for the LDH indicator to be within the normal range, it is recommended to follow preventive actions aimed at countering the progression of many diseases:

Proper nutrition. A balanced diet is needed, with the exclusion of harmful foods, heavily fried, salty, spicy dishes. Eat more fresh vegetables and fruits, as well as lean meats and foods rich in vitamins and nutrients,
Healthy lifestyle is an essential factor in the prevention of most diseases. Sports are recommended to maintain the tone of the body, as well as preventing excess weight, and increased cholesterol deposits,
Stress avoidance. Limit yourself as much as possible from nervous tension, stressful influences and strong emotional stress. All of these are detrimental to overall health.
Take your medications regularly if your doctor has prescribed them. Failure to comply with the course of therapy can lead to the death of tissues in the body and death,
Maintain water balance. Drink at least one and a half liters of pure water per day,
Stop drinking alcohol and cigarettes
Once a year, go to the doctor for a check-up, take a blood test and fully explore the body. This will help to detect diseases at an early stage of development, which will greatly facilitate the course of therapy and the possibility of burdens.

This list of actions is aimed at preventing a large number of diseases, and will help minimize the chance of damage to the body.

Forecast for life

Since the growth of LDH levels occurs under the influence of dying tissues, the prediction depends on several factors. Namely, the extent of necrotic changes, the localization of dying tissues, the degree of damage, the presence of concomitant diseases and the effectiveness of the course of treatment.

When diagnosing deaths in the early stages and not in vital organs, the prognosis is favorable, with the appointment of effective treatment and compliance with all recommended preventive actions.

If the tissues of the heart, liver, brain, or other important organs die, the prognosis worsens significantly. The scale of death, as well as the speed and effectiveness of the prescribed treatment, play an important role here.