Increased alt: possible reasons for the increase. ALAT and ASAT in a biochemical blood test: what is it, norm, decoding What does AST and ALT mean in a biochemical blood test

Each person needs to know what ALT is in a blood test, as this is an important indicator in biochemical research lymph. The result shows either the norm or the presence of pathology in the body. The full name of the endogenous enzyme - alanine aminotransferase (ALT, alat or alt), belongs to the group of transferases and to the section of aminotransferases.

What is alt in the blood

In the study of lymph, ALT is an important indicator. The synthesis of the enzyme occurs exclusively in the cells, but a small amount enters the lymph.

This may be due to cell destruction:

• liver;
• kidneys;
• brain.

ALT is found in almost every organ, as well as in skeletal muscle mass. Promotes the exchange of amino acids and is a kind of accelerator for the transduction of alanine. During transportation, glutamic and pyruvic acids are formed.

The substance alanine is necessary for the human body, as it is an amino acid that is almost instantly converted into glucose.

In addition to the exchange of amino acids, alanine aminotransferase performs several other auxiliary functions:

• strengthens the immune system;
• helps in the production of lymphocytes;
• regulates the production of acids and sugars.

alanine activity in human body different due to gender. In men, it is stronger than in the fairer sex.

The highest concentration of alanine is observed:

• in the kidneys;

• in the liver;
• in muscle mass;
• in the spleen;
• in the pancreas;
• in erythrocytes;
• in the lungs;
• in the heart.

Any violation in the presented components of the human body leads to an increase in the content of transaminase in the blood.

ALT transcript

Alt in the study is determined along with other transaminases. AST (aspartate aminotransferase) and ALT are closely related to each other, deviations in the parameters of these two indices help to determine exactly which organ has a pathology:

1. If alt is greater than ast, this indicates the presence of abnormalities in the liver.
2. If there is an increase in AST, then most often there is a problem in the cells of the heart muscle.

You can find out the exact indicators by doing a biochemical blood test. The decoding of ALT in this case implies an indicator of alanine transaminase in the blood. It is determined not by the amount of the ejected enzyme, but by its activity.

In a healthy body, the activity norm is 6-37 IU / l (IU / l is an international value that determines the dose of activity of a particular substance).

AT biochemical analysis blood ALT is most often examined to determine liver dysfunction. In this case, even for early dates it is possible to accurately determine in which particular area of ​​\u200b\u200bthe liver there are deviations. This allows you to accurately determine the diagnosis and predict the further development of the disease. Moreover, an increase in transaminase can occur asymptomatically.

If the study has not been conducted, then the first sign of an increase in ALT will be the same as with jaundice.

Rules for passing the analysis and results

For exact definition ALAT indicators in biochemical analysis follow certain rules:

• donate blood only on an empty stomach (at least 8 hours after eating);
• drink only plain unsweetened and non-carbonated water;
• give up alcohol a week before donating blood;
• stop taking any medications seven days before the test;
• half an hour before donating blood, do not smoke and do not be nervous;
• to give up physical activity for a while;

• a day before the biomaterial is taken, it is better to refuse fried or spicy foods, ideally, eat all food boiled without salt;
• the day before the analysis, do not drink coffee, tea or any carbonated drink;
• do not eat chocolate or products containing cocoa.

Compliance with the requirements guarantees accurate test results. Worth knowing: usually the sampling of material for the study of ALT indicators is taken from a vein, this is called a biochemical analysis, but in some cases it is enough to do the usual clinical analysis to detect the presence of pathologies (destruction of cells, viral infections, malignant tumors).

An increase in erythrocytes and leukocytes may indicate inflammatory processes in human body.

Norma ALAT

The norm of transaminase indicators differs by gender:

1. In a healthy man, the rate of alanine aminotransferase is considered to be no more than 45 U / l.
2. In women, the same enzyme will be less - up to 34 U / l.

In children under six months, the ALT indicator is more than 56 U / l, over time the number becomes smaller and after twelve years a constant norm is established.

The reason for the increase in the enzyme can be various factors. It depends not only on the development of pathologies, but also on the intake of certain drugs (for example, Aspirin or Paracetamol).

Based on the study, there are three main degrees of transaminase elevation in the human body:

1. A slight degree of increase in alt can be considered a deviation from the norm by one or one and a half times. Often occurs due to long-term use of drugs that affect liver cells. Or as a result of human infection with Botkin's disease.
2. Average excess occurs when the index increases by 6-10 times. This happens due to acute hepatitis or toxic poisoning of liver cells (alcohol abuse), as well as myocardial infarction.
3. A high increase is when the performance level is exceeded ten times or more. As a rule, such a sharp jump in ALT occurs in the presence of malignant tumors and metastasis (their focus is the liver or heart). In the second case, the cells of the skeletal muscle mass are destroyed. In this case, the process is already irreversible.

Speaking about the increase in ALT, one should not forget that in the presence of any deviation, not only alt increases, but also ast, and the amount of bilirubin.

Low ALT is very dangerous, as well as high. A decrease in transaminase in the blood indicates necrosis (necrosis) of the cells of the liver gland, that is, a person can observe atrophy of the liver.

Even a banal (at first glance) lack of vitamin B6 or folic acid leads to negative and irreparable consequences.

If any abnormalities in the blood are detected using a conventional biochemical analysis, a liver test is prescribed. In this case, the alanine aminotransferase index would indicate hyperthyroidism, the presence of hepatocellular destruction, and muscle tissue damage. Blood serum is taken as a material for research.

ALAT in a blood test - what is it?

The alt enzyme in the human body, performs a complex function of maintaining healthy work all systems and organs. Knowing what ALT is in biochemical analysis, you can find out about the deviation from the norm.

But even in this case, you should not panic, because the index can increase not only due to the presence of pathologies, but also due to physiological abnormalities:

• drug abuse;
• overeating fatty foods;
• excessive passion for physical activity;
• systematic use of alcohol.

A biochemical blood test and ALT decoding should be done only by a specialist who will accurately diagnose and prescribe adequate treatment. An ordinary person, knowing what alt is, will not be able to figure out why there was a deviation from the norm.

Alanine aminotransferase and aspartate aminotransferase are endogenous enzymes and are significant markers in biochemical blood tests.

Although elevated levels of ALT do not unambiguously indicate the occurrence of health problems, nevertheless, both enzymes are simply not present in the blood in large volumes.

Yes, both ALT and AST levels can be elevated in liver disorders (such as cirrhosis or hepatitis), but other markers need to be carefully monitored as well. By the way, the level of ALT can be increased if myocardial infarction is diagnosed.

Aminotransferases are a group of enzymes capable of catalyzing transamination reactions, playing a leading role in protein metabolism, and also maintaining the link between protein and carbohydrate metabolism. The most significant natural catalysts for transamination reactions in the human body are alanine aminotransferase (otherwise ALT, ALT) and aspartate aminotransferase (otherwise AST, AsAT).

These enzymes are present in the tissues of many organs. Normally, aminotransferases are practically not found in the blood. The minimum activity of enzymes is due to natural regenerative processes in the body. An increase in the levels of ALT and AST are highly sensitive markers of damage to the tissues in which they are contained.

The method for determining aminotransferases in a biochemical blood test has found wide application in clinical practice due to its high sensitivity and specificity.

ASAT and ALT. Norm

Normally, aspartate aminotransferase does not exceed 31 U/l in women and 37 U/l in men. In newborns, the indicator should not exceed 70 IU / l.

AlAT in women normally does not exceed 35 U / l, and in men - 40 U / l.

Also, the results of the analysis can be presented in mol/h*L (from 0.1 to 0.68 for ALT and from 0.1 to 0.45 for AST).

What can affect transaminases

Distortion of the results of the analysis can lead to:

• the use of certain medications:
  • a nicotinic acid,
  • immunosuppressants,
  • choleretics,
  • hormonal birth control, etc.),
• obesity,
• pregnancy,
• hypodynamia or excessive physical activity.

How the study is done

For analysis, blood is taken from a vein. The results of an urgent study are provided within 1-2 hours. With standard diagnostics - within a day.

To obtain the most reliable results, you must:

• exclude admission medicines a week before the test (if this is not possible, it is necessary to notify the doctor about the drugs taken);
• donate blood exclusively on an empty stomach;
• the day before the study, physical activity, smoking, alcohol, fatty and fried foods are excluded - two days before.

What can the analysis for ALaT and ASAT tell about

Selective tissue activity is characteristic of alanine aminotransferase and aspartate aminotransferase. If considered in
in descending order of the content of these enzymes in organs and tissues, the list will look like this:

• alanine aminotransferase: liver, kidneys, myocardium, muscles;
• aspartate aminotransferase: myocardium, liver, muscles, brain, kidneys.

ALT, alanine aminotransferase. It is a specific enzyme involved in the production and breakdown of proteins. Synthesized by cells of various organs: liver, spleen, kidneys, lungs, heart muscles. Normally, a small amount enters the bloodstream. Blood ALT testing is a common diagnostic test.

Diagnosis based on ALT analysis

The detection of the level of alanine aminotransferase is carried out as part of a general biochemical blood test. Complaints for which a blood test for ALT is prescribed are:

• Increased fatigue;
• Decreased appetite;
• The appearance of weakness in the body;
• Pain on the right side of the abdomen;
• change in the color of urine;
• Yellowness of the skin;
• Pain in the region of the heart;
• Inclination to nausea.

It is mandatory to identify the level of aminotransferase in patients suffering from obesity, diabetes, liver disease.

Important! Blood donation is done in the morning on an empty stomach. It is not recommended to consume alcohol and fatty foods the day before the analysis.

It is also worth refraining from taking strong medications. The results of the study can be affected by the psycho-emotional state of a person and physical stress.

Exceeding the threshold of normal

In medical research, the upper limit of normal ALT is important. The limit for adult men is 45 units / l, for women 34 units / l. An increase in ALT in a blood test indicates inflammatory process in the body. The following are the diseases that cause such a pathology.

1. Pancreatitis. Severe damage to the pancreas. It occurs due to the appearance of a tumor that blocks the enzyme ducts. As a result, the accumulated digestive enzymes begin to digest the pancreas itself. Possible lethal outcome;
2. Hepatitis. Liver disease. It is characterized by inflammation of the tissues of the body. It is divided into several types. Hepatitis C is considered the most dangerous. The latter often turns into chronic form and can cause cirrhosis of the liver. Common causes of hepatitis are: toxic damage to liver cells (for example, alcohol), viral infection;
3. Myocardial infarction. Most serious disease hearts. It is characterized by the death of some parts of the heart muscle, due to a critical decrease in blood circulation. There are many reasons for pathology. Major: smoking, hypertension, obesity, diabetes, sedentary lifestyle.

There are reasons for exceeding the ALT norm in a blood test, not associated with the listed diseases:

• Chemotherapy;
• Injuries accompanied by damage to the muscles of the body;
• Taking strong drugs;
• Physical and emotional overstrain;
• Eating fatty fried foods
• Taking drugs.

Important! The main recommendations aimed at reducing the likelihood of these diseases will be: proper nutrition, refusal to use narcotic drugs (including alcohol, nicotine), moderate physical exercise reducing stress in life.

De Rittis ratio

One of the most important research methods is considered to be the comparison of the level of ALT with the level of AST - aspartate aminotransferase. The latter is also an endogenous enzyme involved in the synthesis of amino acids. Aminotransferases have similar threshold levels in the blood. The diagnosis of a particular pathology depends on the balance of ALT and AST. The AST/ALT ratio is characterized by the de Rittis coefficient.

Important! The normal value of the de Rittis coefficient is 1.33-1.75 units / l.

A decrease in the rate below 1 unit / l will mean viral liver damage. An increase in the coefficient to 2 units / l and above, subject to an increased content of albumins, indicates myocardial infarction.

Normal levels of ALT / AST in the body:

• Alalnin aminotransferase: men - up to 45 U / l, women - up to 34 U / l;
• Aspartate aminotransferase: men - up to 41 units / l, women - up to 31 units / l.

Independent interpretation of analyzes

Often, patients, having read medical information, try to independently decipher a blood test for ALT levels. After receiving the results in the laboratory, some people, seeing the deviation of the indicators from normal values self-diagnose serious illnesses.

Doctors know that exceeding ALT thresholds is not always a sign of pathology. Results from different laboratories may differ from each other. It depends on the equipment, on the research methods, on the materials used in the analysis. Also, other factors can influence the results, whether it is the patient’s wrong lifestyle, medication, emotional state, and others.

Only a doctor can correctly decipher the results of the research. He also prescribes medication.

To date, physicians do not use ALT analysis as a means of accurate diagnosis. An excess of ALT in a blood test indicates only the possibility of a disease. To make a final diagnosis, additional studies are used, specialists of a narrow profile are involved: urologists, cardiologists and others.

Normalization of ALT levels with folk remedies

After the examination, a patient with a high ALT level is prescribed medication. But for prevention, the doctor may recommend herbal medicine. The following are examples of the use of folk remedies to reduce the level of alanine aminotransferase.

• Milk thistle decoction. To prepare a teaspoon of chopped herbs, pour a glass of boiling water, wrap and let it brew for 20 minutes. Then filter the infusion. Take a decoction in small sips, half an hour before meals twice a day, for three weeks;
• Herbal collection. Immortelle, St. John's wort and celandine are mixed. The proportion of herbs is 2-2-1 respectively. The collection is poured with 1 liter of hot water, wrapped and infused for 12 hours. Then you need to strain the infusion. Take half a cup 4 times a day for two weeks;
• Dandelion infusion. For cooking, take 200 g of crushed dandelion flowers. Pour 100 ml of vodka. The remedy is insisted during the day. Take 2 tablespoons three times a day for three weeks;
• A decoction of corn stigmas. To prepare the product, dried crushed stigmas are taken. Pour 200 ml of boiling water and leave for 15-20 minutes. Take the infusion twice a day in a glass. The course of treatment can be six months.

Important! Folk remedies are not a cure! They are used for the prevention of diseases and general strengthening of the body.

State of the art modern medicine allows you to accurately diagnose most known diseases. One of the generally accepted research methods is a biochemical blood test. It contains many indicators, one of which is the level of alanine aminotransferase.

Excess normal level ALT indicates the possibility of development in the body serious illnesses. But only a doctor can accurately determine the disease. We strongly recommend that you do not engage in self-diagnosis, and even more so self-treatment. If you experience anxiety symptoms, contact the clinic immediately. Everyone will be there necessary examinations and help you solve the problem.

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

What are the norms for the content of ALT and AST in the blood?

Do not self-medicate, be sure to consult a specialist before taking medication. Choose a reliable doctor in an area of ​​Moscow that is convenient for you.

Why is ALT elevated?

High ALT indicates diseases of those organs in the cells of which it is contained in the greatest quantities. There are the following main reasons:

1. Hepatitis and other liver diseases (liver cirrhosis, fatty hepatosis - replacement of liver cells with fat cells, liver cancer, etc.) In viral hepatitis A, B, C, D and E, as well as other forms of hepatitis (drug-induced, alcoholic hepatitis, etc. ) many liver cells are destroyed, causing ALT to pass from the liver cells into the blood. Other symptoms of hepatitis are: pain and discomfort in the right hypochondrium, jaundice (yellowing of the skin of the body, sclera of the eyes and mucous membranes), bitter belching, bloating, constipation, diarrhea, etc. In a biochemical blood test, against the background of hepatitis, in addition to ALT, as a rule , there is an increase in the level of bilirubin (blood pigment). Often, an increase in ALT precedes the onset of other symptoms of the disease. The degree of elevation of ALT blood levels in hepatitis is generally proportional to the severity of the liver disease.
2. Myocardial infarction is the necrosis (death) of a section of the heart muscle, as a result of which ALT and AST are released into the blood. Thus, with myocardial infarction, the level of both enzymes in the blood increases. Other symptoms of myocardial infarction are: sharp pain in the region of the heart, radiating to the left side of the body (left side of the neck, inner surface of the left arm, etc.), prolonged pain (lasting more than 30 minutes), shortness of breath, feeling of weakness, fear of death, dizziness, etc.
3. Other heart diseases (myocarditis, heart failure, etc.) that occur with the destruction of myocardial cells (heart muscle) are also accompanied by an increase in ALT in the blood. Other symptoms of these diseases are: shortness of breath, palpitations, decreased blood pressure and etc.
4. Extensive injuries with muscle damage, as well as burns, cause an increase in ALT in the blood.
5. Acute pancreatitis is inflammation of the pancreas. With pancreatitis, the level of ALT in the blood rises. Other symptoms of the disease are: pain around the navel, diarrhea, bloating, weight loss, etc.

Why is AST elevated?

An increase in the level of AST, as a rule, indicates diseases of the heart, liver, pancreas, etc. There are the following main causes:

1. Myocardial infarction is the most common cause increase in the level of AST in the blood. At the same time, AST, as a rule, is increased several times, while the level of ALT is slightly increased. Other symptoms of myocardial infarction: an attack of acute prolonged pain in the region of the heart, weakness, shortness of breath, dizziness, etc.
2. Other heart diseases (myocarditis, rheumatic heart disease - inflammation of the heart with rheumatism), as well as conditions after a recent operation, cause an increase in the level of AST in the blood.
3. Liver diseases (viral hepatitis, alcoholic, drug, toxic hepatitis, cirrhosis of the liver, liver cancer, etc.) are often the cause of an increase in the blood level of both enzymes.
4. Major injuries, burns.
5. Acute and chronic pancreatitis.

Decrease in the level of ALT and AST in the blood.

Increased ALT during pregnancy.

How to lower the level of ALT and AST?

The most common opinion, which is partly correct, is that with liver diseases, with the appearance of jaundice, doctors prescribe a study of the ALT enzyme, or alanine aminotransferase, and in patients with chronic liver damage, most often this enzyme is elevated. This is exactly the case, but if we open serious laboratory reference books, we will be surprised to find that a dozen and a half reasons for an increase in the concentration of this enzyme in the blood are listed, and almost never we will find under what conditions the level of ALT is lowered.

Why is this so, and what prevents lowering the level of the enzyme? After all, it is known that for almost every analysis there is a certain corridor of reference values, for which you can go both in one direction and in the other. Let's figure out whether a decrease in this enzyme in the blood serum is a diagnostic marker, and why it is so difficult to find the cause of the decrease.

Alanine aminotransferase, or ALT for short, is an enzyme that is locked inside cells in a healthy organ and appears in the blood only in residual quantities. It is found in the liver, myocardium, and skeletal muscles. It is in these tissues that a process occurs in which ALT is involved, namely, the transfer of an amino group from one amino acid to another acid, the so-called transamination.

As a result, metabolites important for the body are formed, and this process cannot occur without vitamin B6, or without pyridoxal phosphate. The highest activity of this transferase is in the liver tissue, since it is the liver that is the "kitchen of chemical reactions" of the whole organism.

Almost the same concentration of the enzyme is found in the liver, but there is little of it in the heart and muscles. Similarly, a small concentration of the enzyme is found in red blood cells, in lung tissue and in the spleen.

Due to the fact that men have more developed muscles, women have a slightly lower level of this enzyme in the blood. In any organ and at any second, thousands of cells age, and throughout the body, millions of cells decay every second, and usually it is this “scheduled disposal” that is the cause of the low, “basic” level of the enzyme in the blood.

In the organs listed above, its concentration is more significant. And in the event that there is a pronounced destruction of the tissues in which this enzyme is "locked", then it immediately appears in significant quantities in the peripheral blood. This is possible with myocardial infarction, with damage to the skeletal muscles, with kidney infarction.

Since this enzyme is “general”, it is not always clear where it came from in the event of a sharp change, and its high concentration does not always indicate the severity of the condition. Thus, it becomes clear why there is an increase in concentration. But it turns out that this enzyme cannot occur below the norm at all, because the planned decay of cells cannot be stopped? If ALT is lowered, can there be reasons for this, or not? They are, but first we will find out when an examination is usually scheduled.

When do you need to be examined, and how to prepare?

It can be said that in almost 100% of cases, situations that require examination and determination of the concentration of ALT in the blood plasma are suspected to be elevated, not reduced values. For example, this is an extended donor survey, as a slight increase in concentration may indicate signs of viral hepatitis.

With muscle pathology, diseases such as myasthenia gravis, myopathy, muscular dystrophy, this examination is also prescribed. Finally, almost 90% are patients with various forms viral hepatitis and symptoms of liver disease. There is also an emergency indication for the determination of this enzyme, for example, if a heart attack is suspected, but there are much more diagnostically significant tests that can more accurately confirm the presence of a zone of necrosis of the heart muscle, for example, the determination of the AST enzyme. Alanine aminotransferase also increases, but at the same time shows a lower value.

How to prepare for analysis?

The study of this enzyme is carried out when taking a biochemical blood test, and usually other indicators are also determined, for example, such as AST, or an enzyme responsible for a similar function, glucose levels, total protein, and so on. Rarely, an isolated examination exclusively for this enzyme is prescribed.

In this case, the blood is taken in the morning, strictly on an empty stomach, preferably after an 8-hour overnight fast. In extreme cases, you can take an analysis during the day, but not earlier than 4-5 hours after a light meal, because during the day a person is awake, and the blood plasma quickly takes on a “hungry” look.

Since the level of muscle load can change the value of the analysis, as well as the intake of alcohol, which destroys liver cells, it is recommended to exclude increased sports, psycho-emotional stress and the use of alcoholic beverages before the study.

Normal values ​​and reduction

Normal, reference values ​​for alanine aminotransferase depend on age, and to a greater extent on gender. So, in adult women over 17 years old, the level of this enzyme should not exceed 31 U / l, and in men 41 U / l. In adolescents, boys and girls, the enzyme level is approximately 25 U / l, and in children, when there is still no difference in muscle mass, because there is no puberty, the level fluctuates from 54 units at the age of up to a year, and then gradually decreases to adult levels .

The reasons for the decrease in this case are purely physiological - it’s just that the child’s enzyme systems and cellular reactions begin to work more perfectly, and the breakdown of blood cells containing fetal hemoglobin stops.

Why is ALT lowered?

But still, in some diseases, ALT in the blood is lowered, and what does this mean? Yes, two conditions can be deduced that contribute to a decrease in the concentration of this enzyme.

In the first case, we are really talking about the fact that the “scheduled utilization” of cells is decreasing. In the event that a person has severe cirrhosis of the liver, symptoms of severe liver failure, and normal hepatocytes, in which the process of transamination with the participation of these enzymes, is simply very small, then there will be a general decrease in the level of the enzyme in the blood plasma, since the liver is its main source . And "reducing the decline" further is a fatal outcome.

But in this case, signs of severe liver damage will appear much earlier, such as a decrease in total protein, a prothrombin index, an increase in bilirubin levels and other signs.

The second case in which a diagnostically significant decrease in the level of this enzyme can be observed is the lack of its "helper", pyridoxal phosphate, or vitamin B6, which helps to carry out the transfer of the amino group.

In this case, a decrease may be diagnostic evidence of beriberi, which specifically indicates a lack of vitamin B6.

If you dream up, then with a sharp decrease in the mass of the pancreas, with the development of hemorrhagic or fatty pancreatic necrosis, this enzyme will also cease to enter the blood as planned, since there is no gland tissue left. But since the pancreas makes a relatively small contribution to the overall picture, nothing can be found here.

Thus, a decrease in the concentration of ALT is not diagnostically significant in most conditions that are important in the clinic, perhaps with the exception of confirming the diagnosis of avitaminosis B6. But in the conditions of a modern varied diet, such cases of isolated beriberi