Blood test for liver tests: what does it include?

A screening study aimed at evaluating the functional state of the biliary excretory system and the liver is an assay for hepatic assays. Diagnosis is carried out using blood sampling. It includes a number of mandatory indicators: AST, ALT, GGT, alkaline phosphatase, protein, bilirubin. In addition to these indicators, it is possible to check the lipid spectrum, which shows the state of fat metabolism in the body.

[1], [2], [3]

Indications for conduction

The analysis for hepatic tests is carried out with clear criteria:

• Failures in the functioning of the digestive tract.
• Dyspeptic Syndrome.
• Exchange violations.
• Hepatitis.
• Endocrine pathologies.
• Chronic diseases of the liver and biliary tract.
• Increased serum iron level.
• Excess body weight.
• Changes in the hepatobiliary system by ultrasound.
• Intoxication.
• A recent transfusion of blood or its components.
• Evaluation of ongoing treatment.

Preparation

To obtain reliable results of the analysis, it is necessary to prepare for the delivery of blood. 48 hours before the test should be abandoned fatty foods, stop drinking alcohol, smoking. The last meal should not be earlier than 8-10 hours before blood donation.

What tests are included in the liver tests?

Biochemical tests check the blood for various pathologies on the part of the liver, allow you to determine the causes of the painful condition, put the right diagnosis and choose the treatment. In this case, there are diseases in which liver tests are performed in conjunction with other studies: cancer of the liver, acute hemolysis, acute medicamentous hepatitis AE.

GOLD

Alanine aminotransferase is an enzyme that is contained in the liver parenchyma cells - hepatocytes. ALT is in the kidneys, skeletal muscles and heart muscle. It is involved in the metabolic processes of protein. Its increased value is a specific sign of the disintegration of hepatocytes. The enzyme acts as a catalyst for reversible transfers of alanine from the amino acid for alpha-ketoglutarate.

Alanine is an amino acid that quickly transforms into glucose. Thanks to it, the energy potential of the brain and the central nervous system increases. The substance strengthens the immune system, promotes the production of lymphocytes, regulates the exchange of sugars and acids. The greatest concentration of ALT is observed in the liver and kidneys, then in skeletal muscles, spleen, pancreas and heart.

The level of alanine aminotransferase is determined by a biochemical blood test. ALT indices can reveal problems with the liver before the appearance of their severe symptoms. As a rule, the diagnosis is carried out with suspicions of hepatitis, to check the condition of the body after long-term use of medications and other toxic substances. There are mandatory indications for this study:

• Increased fatigue and weakness.
• Jaundice of the skin.
• Painful sensations and discomfort in the abdomen.
• Flatulence for an extended period of time.
• Nausea and vomiting.

Hepatic tests on ALT are used to monitor the dynamics of treatment, in time to identify improvements or worsening of the patient's condition. Also, the analysis is necessary in the presence of risk factors for liver damage, for example: diabetes, overweight, the abuse of alcoholic beverages or drugs that destroy hepatocytes.

For the analysis, a venous or capillary blood sampling is performed. The study is on an empty stomach, the last meal should be 12 hours before it is taken. Failure to comply with this rule leads to false results.

The rate of marker enzymes for the liver depends on the age of the patient:

• Newborns under 5 years - no more than 49 units / liter.
• Children under 6 months of age - 56 units / l.
• Children from 6 months to a year - 54 units / liter.
• Children from 1 to 3 years old - 33 units / liter.
• Children from 3 to 6 years - 29 units / liter.
• Over 12 years - 39 units / liter.
• Men - up to 45 units per liter.
• Women - up to 34 units per liter.

But often the results on ALT differ from the norm. This happens with inflammatory processes in the body, taking medications at the time of the analysis and because of a number of other factors. Also unreliable results can be caused by intramuscular injections or increased physical exertion.

There are three main stages of increasing enzymes:

• Easy - in 1,5-5 times.
• The average is 6-10 times.
• Heavy - 10 or more times.

Elevated values of alanine aminotransferase are observed in such liver diseases: hepatitis, cancerous lesions, cirrhosis, pancreatitis, myocarditis, myocardial infarction. The method of restoring the normal level of enzymes depends on the reasons that led to their change. In some cases, special medications are used to reduce ALT: Hephitol, Dufalac, Heptral. Also, all patients are prescribed a therapeutic diet.

It is

Aspartate aminotransferase (AST, AST, AST) is an enzyme of protein metabolism in the body. The substance is responsible for the synthesis of amino acids that are part of the tissues and cell membranes. In this case, ACT does not function in all organs, but it exists in the liver tissue, heart muscle, neurons of the brain, as well as in muscular tissue of skeletal musculature. The enzyme participates in metabolic processes and helps maintain normal cell structure.

If the structure of cells with this enzyme is not broken, then the amount of substance is minimal and corresponds to the norm. The increase in activity of aspartate aminotransferase indicates a narrow range of disorders. In this case, there is a relationship: the more active the cytolysis (cell destruction), the higher the AST values.

For the analysis, venous blood sampling is performed. The biological fluid is centrifuged, separating the plasma from the enzyme elements. The study on the AST index is mandatory for such somatic pathologies:

• Any liver disease or disorder in her work.
• Poisoning and intoxication.
• Infectious diseases.
• Diseases of the circulatory system and heart.
• Kidney damage and kidney failure.
• Purulent-septic states.
• Disorders of bilirubin metabolism.
• Autoimmune diseases.
• Ascites and portal hypertension.
• Endocrine disorders.
• Evaluation of the dynamics and effectiveness of treatment of the liver, heart.

When evaluating the enzymatic activity of plasma relative to AST, the normal values of this substance are taken into account:

• Children - up to 50 ME
• Women - 34-35 IU
• Males - 40-41 IU

If in the analysis for liver tests or in the biochemical blood test of AST does not exceed the normative values, this indicates normal functioning of the enzyme systems of the liver and heart. Elevated values may indicate such pathologies:

• Viral hepatitis (acute, chronic).
• Fat and alcoholic hepatosis.
• Endogenous intoxication.
• Toxic liver damage.
• Cholestasis.
• Violation of hepatic blood flow and portal hypertension.
• Cirrhosis of the liver (decompensated form).
• Malignant metastases in the liver.
• Primary liver cancer.
• Disorders of the cardiovascular system.

If the increase in AST is different by several units from the norm, then this does not indicate a pathology. Diagnostic value has an increase in the enzyme two or more times. Since in addition to hepatocytes, the enzyme is contained in other organs, its isolated determination for estimating the state of baking is not reliable. For this, AST is determined in relation to ALT. The study of the two indicators more accurately reflects the state of the organ.

Bilirubin

The chemical compound and the decay product of red blood cells is bilirubin. Bile pigment red-brown color is continuously formed in the body.

Types of bilirubin:

1. General - all the pigment of blood circulating in the systemic bloodstream.
2. Indirect - part of the substance that is formed during the decay of red blood cells to the compound in the liver.
3. Direct - part of a substance that binds to glucuronic acid and is excreted from the liver.

Initially, blood and tissues form indirect bilirubin, that is, a toxic compound that does not dissolve in water and is not excreted from the body. Together with the blood flow, he enters the liver, transforming into a straight form. The task of the liver is to neutralize and bind bilirubin in the blood plasma, protecting the brain from the toxic effects of this substance.

Rates of bilirubin exchange for adults:

• The total is 8-20.5 μmol / l.
• Direct - 0-5,1 mkmol / l.
• Indirect - 16.5 μmol / l.

Jaundice of the skin and mucous membranes is the main sign of the violation of bilirubin metabolism in the body. It is also possible the appearance of headaches and dizziness, attacks of nausea, deterioration of general well-being and increased weakness. Similar symptoms occur with a total bilirubin level of more than 50 μmol / l. A painful condition is called hyperbilirubinemia and has such causes:

1. Increased direct bilirubin - cholangitis, obstructive jaundice, concrements of intrahepatic ducts, atresia of the biliary tract, Mirisia syndrome, choledocholithiasis, tumor lesions, pancreatitis, pancreatic necrosis.
2. Increased indirect bilirubin - hemolytic jaundice or anemia, infectious diseases, intoxication, transfusion of incompatible blood, splenomegaly.
3. Hyperbilirubinemia due to both its fractions - parenchymal and mixed jaundice, cirrhosis, cancerous tumors, hepatosis, hepatitis, congenital defects of bilirubin metabolism, pylephlebitis, sepsis.

The causes of the change in the bilirubin rate can be associated with any stage of its metabolism: yield during the decay of red blood cells, inadequacy of the liver or excessive secretion of bile. The danger of this condition is that the metabolic products are toxic to the body tissues. Increase of enzyme more than 170 μmol / l is dangerous by hepatic encephalopathy, renal and cardiovascular insufficiency. Bilirubin more than 300 μmol / l can cause death.

Treatment of elevated bilirubin values depends on the causes that triggered hyperbilirubinemia. Patients are prescribed detoxification therapy, infusions, diuretics, hepatoprotectors, glucocorticoid hormones. In especially severe cases, surgery is performed.

[4], [5], [6], [7], [8], [9]

GHGP

Gamma-glutamyl transpeptidase is a protein of the liver and pancreas. GGTP increases with diseases of these organs, as well as with alcohol abuse. The enzyme is a catalyst for biochemical reactions. It is not contained in the bloodstream, but is present only in cells, in the destruction of which all the contents enter the blood.

GGTP is a membrane-bound enzyme with high sensitivity. The main indications for the analysis:

• Diagnosis of the liver, pancreas, biliary ducts and bile ducts.
• Complaints of increased fatigue, loss of appetite, abdominal pain, nausea and vomiting.
• Monitoring the effectiveness of treatment for alcoholism and other diseases.

Protein allows you to identify various pathologies at the earliest stages. The enzyme increases in such cases:

• Infectious hepatitis.
• Stasis of the secretion of the bile.
• Metastatic lesions of the liver.
• Diabetes.
• Diseases of the pancreas.
• Diseases of the cardiovascular system.
• Medicinal degeneration of the liver.
• Hepatosis
• Alcohol abuse.

With hypothyroidism, that is, a decrease in the functions of the thyroid gland, GGTP is below the norm. In comparison with ALT, AST and alkaline phosphatase, the enzyme is more sensitive to disorders in the liver cells. Venous or capillary blood is used for the analysis.

Renal and hepatic tests

Complex diagnostics for the detection of pathologies in the functioning of the kidneys and liver, as well as violations in the work of other organs and systems are renal and hepatic tests.

Indications for analysis:

• Diseases of the kidneys and liver of any severity and stage.
• Pain in the right hypochondrium and in the lumbar region.
• Deterioration of general well-being.
• Swelling of the face and lower limbs.
• Yellowing of the skin and mucous membranes.
• Endocrine disorders.

This profile of laboratory studies includes such analyzes:

• GOLD
• It is
• GHGP
• Bilirubin (general, direct, indirect)
• ФЩ
• Total protein
• Albumen
• Uric acid
• Creatinine
• Urea

Base substances-metabolites that reflect the work of the kidneys:

1. Creatinine - takes part in cellular energy metabolism in muscle tissues. It is released from myocytes, then transported to the kidneys and excreted with urine. With renal damage, the excretion of creatinine decreases, as it accumulates in the blood. A change in the level of this substance may indicate an acute inflammation.
2. Urea is a product of protein breakdown. Indicates the excretory capacity of the kidneys. Abnormalities often indicate a disease with a chronic course.
3. Uric acid - occurs when splitting complex nucleotides and is completely excreted in the urine. An increase in this indicator is observed in acute renal failure.

When evaluating the results of analyzes, not only the parameters of renal and hepatic samples are taken into account, but also the general condition of the organism, the presence of clinical symptoms.

Hepatic urine samples

The liver performs a variety of functions that support the normal functioning of the entire body. It is responsible for the filtration and elimination of toxic substances. A change in the color of urine in combination with pain in the right upper quadrant indicates abnormalities in the functioning of the organ.

A set of laboratory and instrumental studies is carried out to diagnose a morbid condition. Particular attention is paid to hepatic urine samples. Urine is tested for the presence of biliary segments: bilirubin, urobilinogen. In a healthy body, they are not found.

Urobilinogen and urobilin

These are important bile enzymes that can be detected in urine analysis. With their help, the process of diagnosing various pathologies associated with the liver, bile ducts and bladder, the hematopoiesis system is simplified. This indicator is optional, although it is included in the general analysis of urine.

Urolilinogen is an enzyme that forms after the disintegration of bilirubin. Along with bile, it enters the intestine, part of it is absorbed into the blood and back enters the liver tissue, and the remnants are removed together with urine. The enzyme is always present in the assay, but its values are small - 5-10 mg / l. The increased level or absence of this substance is a deviation from the norm.

The analysis for urobilinogen has such indications for carrying out:

• Violations of urination - frequent or rare desires in the toilet, pain and abdominal pain.
• Nausea and vomiting, icterus of the skin.
• Urine of dark color.

Elevated indices indicate violations of the liver, which can be caused by various pathologies: cirrhosis, hepatitis, intoxication, spleen lesions, enterocolitis. In some cases, abnormalities arise from physiological factors.

Normalization of the enzyme is to restore healthy liver function and normal bilirubin. Treatment depends on the severity of the disease state. Patients can be assigned hepatoprotectors, choleretic preparations, dietary nutrition. Diagnosis of liver samples is carried out on the basis of a fresh morning portion of urine. To more accurately determine the level of enzymes, a blood test is necessary.