Increased analysis of alt. An increase in ALT in the blood: causes and treatment

Modern man undergoes many medical studies, including blood tests. Sometimes the names of diagnostic tests are completely unfamiliar. One of these little-known, but increasingly prescribed, tests is the ALT blood test. Let's consider what is this analysis and why should it be submitted.

ALT

ALT or alanine aminotransferase is an intracellular enzyme that breaks down keto acids and amino acids. It belongs to the group of aminotransferase enzymes, which are the main enzymes of protein metabolism in the human body. In addition, aminotransferases bind protein and carbohydrate metabolism. A biochemical blood test for the level of concentration of this enzyme is a marker in the diagnosis of many diseases.

The largest amount of the enzyme alanine aminotransferase is found in the cells of the liver, muscles, kidneys, heart, pancreas. In the case when these organs are damaged, a significant amount of ALT comes out of the destroyed cells, due to which the level of this enzyme in the blood increases.

Indications for the appointment of this analysis is the diagnosis of certain liver diseases, skeletal muscles, myocardium. Besides, biochemical analysis alanine aminotransferase is prescribed for monitoring patients with viral hepatitis, examination of blood donors.

Deciphering the analysis

The interpretation of a blood test for ALT, like any other analysis, should be done by a doctor. At the same time, to establish an accurate diagnosis, he will take into account many other studies and the results of examinations. But you can consider the main indicators.

When deciphering a biochemical blood test for this enzyme, one must take into account the fact that the norms and values ​​\u200b\u200bof the amount of alanine aminotransferase may differ depending on the equipment of the laboratory in which the study was conducted. Therefore, only a doctor who knows these values ​​​​can accurately interpret the results.

Elevated ALT

A high level of ALT indicates the pathological conditions of those organs in the cells of which its content is greatest. The main reasons for the increase in this enzyme are the following diseases:

  1. Liver disease. Most often, these diseases include hepatitis A, B, C, E, D. In addition, it can be cirrhosis of the liver (a disease associated with the death of liver cells), liver cancer, fatty liver (a disease in which liver cells are replaced by fat cells ), obstructive jaundice. Usually, the degree of increase in the content of ALT in the blood is proportional to the severity of the liver pathology. Often, an increase in the content of this enzyme appears before all other symptoms of the disease. With hepatitis in the blood, in addition to an increase in the content of ALT, as a rule, an increase in the content of the blood pigment bilirubin is also observed.
  2. myocardial infarction. This disease is characterized by the death of some parts of the heart muscle. As a result, an increased amount of the enzyme alanine aminotransferase is released into the blood.
  3. Heart failure, myocarditis(inflammation of the heart muscle), myodystrophy (progressive muscle dystrophy), myositis (inflammatory process in skeletal muscles). In these diseases, due to the destruction of the cells of the heart muscle and other muscle groups, the concentration of this enzyme in the blood increases.
  4. Acute pancreatitis- inflammation in the pancreas.
  5. Burns and major injuries resulting in muscle damage.
  6. hypoxia(lack of oxygen in brain tissues), shock.

Decreased ALT

A reduced concentration of alanine aminotransferase in a blood test occurs with an acute deficiency in the body of vitamin B6 and serious illnesses liver, in which the number of hepatocytes producing ALT is greatly reduced. Most often this occurs with cirrhosis of the liver.

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It is a mandatory indicator included in the biochemical blood test. It, along with the ALT enzyme, is also called liver tests, but these indicators indicate not only liver disease.

Despite the prevalence of biochemical analysis, not everyone knows what the increase in the level of this enzyme means and how to decipher this indicator correctly. The doctor should decipher, since AST is considered in conjunction with other blood indicators.

AST - enzyme functions and assignment for analysis

AST, or aspartate aminotransferase, is involved in protein metabolism. It performs many important functions, one of which is participation in the construction of cell membranes, the synthesis of amino acids.

Helps to know the level of AST blood biochemistry. This enzyme is considered specific. Its increase indicates disturbances in certain tissues in which it is found in the greatest amount. The largest amount of AST is found in tissues, muscles, and nervous tissue. This is due to the fact that metabolic processes in these tissues are more active, and the cells need constant renewal and maintenance of their structure.

As soon as the cells of these organs begin to break down, the enzyme is actively released into the blood, so its level in the blood serum rises. If the cells remain intact and function normally, then the level of AST remains at a minimum level.

AST is found in the body in two forms: cytoplasmic and mitochondrial.

To release a cytoplasmic enzyme into the blood, it is enough to destroy the outer shell of the cell, therefore, an increased level of this form of AST indicates less serious damage to cells and tissues than an increased level of mitochondrial AST, the release of which requires total destruction of the cell and its organelles.

Since a large amount of the AST enzyme is located in the tissues of the liver and heart, its elevated level most often indicates the pathology of these organs, although it is necessary to assess the state of the body taking into account all indicators.

More information about blood tests for AST and ALT can be found in the video:

Blood for AST is prescribed during pregnancy (a biochemical analysis is given regularly to check the operation of all systems and organs), in the presence of any diseases and the heart, as well as to check the effectiveness of their treatment.

An AST test is indicated for any suspected liver disease, nausea, hepatic colic, or contact with a carrier to check the integrity of the liver cells.The level of AST is determined in various injuries and chest to detect microdamages in the tissues of the heart and liver, as well as when taking various drugs showing a devastating effect on the tissues of the heart and liver (cancer drugs and strong antidepressants).

Biochemical analysis for AST: preparation and procedure

If a myocardial infarction is suspected, the patient is hospitalized and carefully monitored. At first, this condition may be asymptomatic or accompanied by a feeling of heaviness in the chest, pain radiating to the right arm. Treatment of this condition should begin as early as possible to avoid.Treatment, as a rule, is aimed at improving blood flow and blood supply to the myocardium, and eliminating pain. In severe cases, angioplasty is prescribed (replacement of a thrombosed vessel with a healthy one). By following all the doctor's recommendations and timely treatment of serious complications, serious complications can be avoided, and the AST level will return to normal.

In the treatment of viral hepatitis, drug therapy is aimed at removing toxins from the body, improving the outflow of bile, protecting and restoring liver tissue cells.

In the treatment of myocarditis, it is important to limit physical activity, good nutrition, healthy sleep and bed rest for several months.If all the recommendations of the doctor are followed, myocarditis ends with recovery, restoration of the heart muscle, and the level of AST in the blood returns to normal.

Serious diseases such as cirrhosis and liver cancer are difficult to treat. The effectiveness of therapy largely depends on the stage at which the disease is detected. With cirrhosis, it is important to observe a diet and rest, give up alcohol completely, and also take all possible preventive measures to protect against viral infection. Medical therapy prescribed depending on the characteristics of the disease and the presence of complications. Hepatoprotective drugs are often prescribed, and indicators are also regularly checked.

Possible Complications

A directly elevated level of AST has no complications, since this is a consequence of the disease, the body's reaction to it, and not the disease itself and not its cause. Pathological conditions that cause elevated blood levels can lead to severe and complications.

Among the most common complications of cardiac and hepatic pathologies with increased level AST are the following:

  • Acute heart failure. Myocardial infarction with severe course may be complicated by heart failure, which is expressed in a violation of the contractility of the heart muscle. At the same time, the patient feels shortness of breath or suffocation, a strong cough, he has cyanotic skin, foaming from the mouth, wheezing in the chest. In the event of such a serious complication, delay in medical care fraught with death.
  • Hepatic coma. Hepatic coma can occur with active cell death in viral hepatitis. Symptoms of hepatic coma are not always associated with pain, it often begins with a feeling of anxiety, an unstable emotional state, and apathy. Then there is confusion, tremor of the hands, and finally, elevated body temperature, jaundice, complete loss of consciousness.
  • Myocardial rupture. One of the most common complications of myocardial infarction. The severity of the complication depends on where the rupture occurred. Most often, there is a rupture of the wall of the left ventricle, less often - the right ventricle, and even less often - the interventricular septum. The main symptoms are sharp pain, loss of consciousness, slow pulse, suffocation. In case of myocardial rupture, urgent surgical intervention is necessary, otherwise a fatal outcome is inevitable.
  • Aneurysm of the heart. An aneurysm can also appear as a consequence of myocardial infarction. It manifests itself in the thinning and bulging of the wall of the heart muscle. Most often, such a consequence needs surgical treatment because the aneurysm can burst at any time.
  • Liver cancer. It often develops against the background of cirrhosis. Liver cells are reborn, which can lead to the formation of malignant tumors.

Alanine aminotransferase (also ALT, ALT) is a protein enzyme that is responsible for the transport of certain molecules and the acceleration of biochemical processes involving amino acids.

ALTs are found mostly in the cells of organ tissues. In healthy people, ALT cannot be elevated in the blood, since if ALT is released into the blood, it is likely that it is occurring in some part of the body. serious illness.

Most of all, ALT is found in the liver, and it can also be found in the kidneys, heart muscle, nerve connections, and lungs. Damage to these organs and tissues can cause an increase in ALT in the blood.

Optimal value in the body

This parameter is measured in units per liter of blood. ALT is age dependent in childhood, and in adults it is gender dependent.

Children under one year old: no more than 55 units / l

Children 1-3 years old: no more than 34 units / l

Children 3-6 years old: no more than 30 units / l

Children 6-12 years old: no more than 39 units / l

Men: no more than 45 units / l

Women: no more than 35 units / l

The norm in this case is not a strict and only possible value, but an approximate evaluation criterion. In some laboratories, the devices may have a different degree of sensitivity, which means that the results of the analysis should be discussed with the attending physician of this medical institution.

Alanine aminotransferase is elevated, what does this mean?

According to the degree of difference between the actual result of the analysis and the value taken as the norm, they distinguish:

  • Slight increase (by 200-500%);
  • Moderate increase (up to 1000%, that is, 10 times more);
  • Pronounced (more than 10 times the norm).

The second and third stages most likely indicate that elevated ALT in the blood is a consequence of the disease, and the third case occurs in those patients who have already begun serious destruction of the organ.

In addition to the diseases that we will discuss below, elevated ALT may be associated with the following distorting factors:

  • muscle injury;
  • burns;
  • Intramuscular injections made the day before;
  • Large weight (body mass index greater than 30);
  • Reception medicines(estrogens, antibiotics, cholestatics, heparin, oral contraceptives, anti-epilepsy drugs, warfarin, echinacea, valerian, etc.);
  • Mononucleosis;
  • Pregnancy (third semester), provided that ALT is slightly elevated;
  • Chemotherapy;
  • drug use;
  • lead intoxication;
  • laboratory inaccuracies.

In order to get a reliable result, it is necessary to donate blood on an empty stomach, 12 hours after the last meal. Refrain from alcohol a week before going to the clinic, and an hour before donating blood - from smoking. Try not to worry and not to be physically overloaded. If you doubt the reliability of a blood test, take it to another laboratory.

To determine whether ALT is normal or elevated in the blood, blood is often taken from a vein, but in some cases also from capillaries.

Causes and diseases when ALT is elevated in the blood

Since the enzyme under study may be retained in various bodies, it may indicate problems with their health. Consider what it means "ALT increased" in each case.

  1. Liver disease

The largest amount of ALT, as already mentioned, is located here, it is not surprising that this analysis is recognized in time to notice and cure liver diseases.

  • Steatosis

The accumulation of fat in the liver cells affects the fact that ALT is increased by 2 times. But if the disease condition worsens to steatohepatitis, ALT will increase much more, and bilirubin levels will also increase.

  • Hepatitis

If ALT is elevated in the blood test, and the symptoms of the disease have not yet appeared, it may be from hepatitis A. Usually, the symptoms are delayed, and due to the timely donation of blood for analysis, the recovery process can be accelerated.

With hepatitis B and C, ALT increases even 100 times, since the toxic effect of the virus common in the liver is especially great on its cells.

Chronic hepatitis causes an increase in ALT during an exacerbation, but the increase usually occurs no more than 3-4 times.

Other symptoms of hepatitis include pain and discomfort in the right side, under the ribs, a bitter taste in the mouth, yellowing of the skin, mucous membranes, whites of the eyes, and impaired stool.

  • cirrhosis

A very high ALT in the blood may not be observed in cirrhosis. ALT will rise, but 1-5 times the norm. This is due to the replacement of liver cells with connective tissue.

  • Liver cancer

Usually malignant tumors in the liver appear in people with hepatitis. The level, how much alanine aminotransferase is increased, helps to make a decision on further surgical treatment of cancer. For example, if ALT is very high, the operation has a great risk of complications.

  • autoimmune hepatitis

A disease more common among women than among men. To clarify its presence or absence, the doctor may prescribe a biopsy.

  1. A heart

Diseases of the heart, or rather the heart muscle, are primarily indicated by another analysis - AST, but along with it, ALT is also used for diagnosis.

  • myocardial infarction

The death of a part of the heart muscle, as a result of which a certain amount of AST and ALT enters the bloodstream. If the analysis of AST is greatly increased and alanine transaminase is increased by 5 times, the reasons should be sought in the possibility of myocardial infarction.

Other symptoms: sharp pain in the region of the heart, radiating to the left upper side of the body, the pain can last half an hour or more, the patient has shortness of breath, dizziness, panic fear of death, weakness.

  • Myocarditis

As with other diseases of the heart muscle, myocarditis cannot be established solely on the basis that ALT is elevated. The reasons for this may be varied. Often, to clarify the diagnosis, an analysis of AST is also considered and the de Ritis coefficient is calculated equal to ALT / AST.

Symptoms include shortness of breath, weakness, fatigue of the patient.

Heart failure, rheumatic heart disease, recent heart surgery can also cause an increase in ALT in the blood.

  1. Pancreas
  • pancreatitis

The disease can occur in acute or chronic form. An increase in ALT indicates the stage of exacerbation. It is advisable for people with pancreatitis to donate blood regularly for ALT analysis.

AlAT elevated in a blood test can be an alarming bell for any serious and even destructive diseases, or it can be a common mistake or a normal reaction of the body. Your further examination depends on the early diagnosis and possible treatment.

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In the course of a preventive examination, monitoring of chronic patients or diagnosing the causes of certain disorders, patients are often prescribed a blood biochemistry test. The content of ALT and AST, the norm of which indicates the absence of severe pathologies of internal organs, is a valuable diagnostic criterion.

What it is

Alanine and aspartate aminotransferase are enzymes that are present in the cells of visceral organs and blood plasma. They take an active part in the exchange of individual amino acids (alanine and aspartic acid). An increase or decrease in ALT and AST in the blood indicates the destruction of functional cells due to a necrotic, cancerous or inflammatory process.

Alanine transferase is found predominantly in hepatocytes (liver cells) and myocardiocytes (heart cells), but is also present in the kidneys, skeletal muscle, and pancreas. Its main function is the transfer of the amino group of alanine acid to ketoglutaric acid with the further formation of pyruvic and glutamic acids, which play an important role in the biochemical reactions of the body.

Aspartic transferase is found in hepatocytes, cardiomyocytes, muscle and kidney tissues, etc. Its function is the formation of aspartate and ketoglutarate by transferring the amino acid group. The metabolism of these acids is necessary for the implementation of the urea cycle and the endogenous formation of glucose.

Aspartic transferase is present in the same tissues as the first enzyme, but due to a different functional purpose found in them in different concentrations. This means that not only the nature of the deviations from the norm, but also the ratio between AST and ALT helps to make a correct diagnosis for violations in biochemistry.

Analysis for AST and ALT is mandatory when checking liver function (liver tests), investigating the causes of dyspepsia, diagnosing the condition of the myocardium, muscle fibers and other internal organs.

Norms and deviations

Norms of ALT and AST in the blood differ depending on gender and age. A change in the normal concentration of enzymes is noted with large sports loads and bearing a child.

Due to the large number of influencing factors, a slight deviation upward or downward from the norm is not a pathology.

In adults

In patients over 18 years of age, AST and ALT are normally:

  1. Alanine aminotransferase: up to 31 U / l in adult women outside the period of bearing a child, up to 32 U / l in pregnant women, up to 45 U / l in men.
  2. Aspartate aminotransferase: up to 31 U / l in non-pregnant women, up to 30 U / l in expectant mothers, up to 47 U / l in men.

Reference values ​​depend on the sensitivity of the laboratory equipment. Normal level AST and ALT in the blood are given in the analysis form next to the patient results column.

A valuable diagnostic indicator is the ratio of ALT to AST: normally it is 0.77. More common is the Ritis coefficient, which is the inverse ratio (AST to ALT): its value ranges from 0.88 to 1.72 (1.3 s possible deviations no more than 0.42).
In other words, ideally, if AST is 1.5 times higher than ALT.

In children

The norm of ALT and AST in the blood of children is determined mainly by their age, and not by gender.

In adolescents over 15 years of age, the norm of aminotransferases gradually comes into line with adult indicators.

Causes and symptoms of an increase

The reason for the abnormal concentration of alanine and aspartic aminotransferases are pathological processes in the internal organs, proceeding with the massive decay of functional cells. The amount of excess enzyme content indicates the nature of the course of the disease and the localization of the lesion.

Small deviations in the blood test for ALT and AST are allowed only with normal other blood parameters: urea (2.8-7.2), bilirubin (3.4-17.1), alkaline phosphatase (up to 38 in women, up to 55 in men) and albumin (32-52). They are measured in mmol/l, µmol/l, U/l and g/l, respectively.

Increased only AST

An isolated increase in the blood test for AST is observed under the following conditions:

  • acute myocardial infarction (increase in enzyme concentration);
  • myocarditis;
  • angina pectoris of high severity;
  • acute heart failure;
  • rehabilitation after cardiological operations;
  • recent angiocardiography;
  • thrombosis of the pulmonary artery;
  • acute rheumatic heart disease;
  • cardiomyopathy of various etiologies.

A change in the biochemical index may be accompanied by shortness of breath, chest pain, cyanosis of the lips and other symptoms characteristic of heart pathologies.

In addition, an increase in AST with normal ALT can talk about destruction muscle mass. The reason for this may be the problem of digestion of proteins, difficulties in obtaining energy. As a result, muscles are destroyed as a source of energy.

Elevated only ALT

A pathological blood test for ALT is observed in diseases such as:

  • acute and chronic viral hepatitis;
  • alcohol and toxic injury hepatocytes, incl. medications (sulfonamides, antibiotics, NSAIDs, psychotropic drugs, cytostatics, etc.);
  • oncological processes in the liver;
  • fatty hepatosis;
  • pancreatitis;
  • infectious mononucleosis, complicated by damage to the spleen and liver;
  • burns;
  • shock etc.

An isolated increase in the concentration of alanine aminotransferase is observed in rare cases. Most often, in lesions of the liver and other areas with a high concentration of the enzyme, an increase in the content of both transferases is observed with a sharp decrease in the Ritis coefficient.

An increase in ALT may be accompanied by pain in the right and left hypochondria, a feeling of heaviness in the abdomen, yellowness of the skin and whites of the eyes, darkening of the urine, loss of strength, weakness and dyspeptic symptoms (diarrhea, flatulence, appetite disorders). On the early stages hepatitis without jaundice, a change in the concentration of alanine enzyme may be the only sign of the disease.

joint enhancement

A simultaneous increase in ALT and AST is typical for the following conditions:

  • gestosis of pregnant women;
  • extensive injuries and inflammatory processes in muscle tissue;
  • active heavy sports;
  • diseases of the kidneys, liver and heart.

An increase in the concentration of transaminases can be observed in children and adolescents during the period of active growth.

How to prepare and donate blood

The concentration of liver enzymes can be affected by physical activity, food intake, medications and other toxic substances (ethanol, nicotine, etc.). To obtain the most reliable result, you should follow the rules of preparation, excluding the influence of these factors.

You need to know how to properly take a blood test for AST and ALT:

  • within 8 hours before taking the biomaterial (blood from a vein), use only non-carbonated water, exclude meals;
  • 2-3 days before the examination, reduce the intensity sports loads, eliminate strength exercises and avoid stress;
  • 3 days before taking blood, refuse fatty foods, smoked meats, industrially processed meat, fast food and other harmful products;
  • within a week before the test, refrain from smoking and drinking alcoholic beverages;
  • for 8-9 days, stop taking dietary supplements and medications (antibiotics, NSAIDs, etc.), if therapy suggests the possibility of a break.

Before taking the biomaterial, you should inform the doctor about medications taken for a long course.

In order to prevent the latent course of diseases, a biochemical blood test must be taken annually during a preventive examination.

How to reduce performance

Depending on the reasons for the increase in ALT and AST in blood tests, the patient may be recommended a diet, correction of the daily regimen (excluding heavy physical exertion and bad habits), drug treatment and folk remedies.

A diet with an increased concentration of liver enzymes suggests:

  • refusal of alcoholic and carbonated drinks, fatty meats, sausages, smoked meats, spicy and fried foods, marinades;
  • limiting salt intake;
  • active consumption of plant foods, lean meats and fish, dairy products.

In the treatment of pathologies that cause an increase in the content of enzymes in the blood, the following drugs are used:

  • antispasmodics (Drotaverine, No-shpa, Spazmalgon);
  • hepatoprotectors (Heptral, Phosphogliv, Karsil);
  • enzymatic agents (Creon, Pancreatin, Mezim);
  • glucocorticosteroids (Prednisolone, Dexamethasone, Hydrocortisone);
  • antiviral agents (Entecavir, Telaprevir, Sofosbuvir);
  • interferons (Viferon, Pegasys);
  • anticoagulants (sodium heparin);
  • antianginal and antihypertensive drugs (Amlodipine, Timolol, Nitroglycerin);
  • vitamin complexes (vitamins of groups B, C and E).

For liver pathologies, decoctions of burdock root, immortelle and St. John's wort, as well as milk thistle seeds are used. If the cause of the increase in transferases is heart disease, the patient is recommended to take an infusion of Adonis.

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