What does alanine aminotransferase mean in the blood. What are ALT and AST? What does the level of liver enzymes indicate and what are the normal values ​​for women? How to prepare for the analysis

Cells of the liver, heart and some other organs produce special enzymes involved in metabolic processes. Normally, they practically do not enter the bloodstream, and are not detected during the analysis or are contained in very small quantities. However, diseases that cause destruction of the cellular structure of tissues contribute to the release of these enzymes into the bloodstream. The most significant in the diagnosis of pathological processes are substances abbreviated as AlAt and AsAt.

This is the abbreviation for one of the main enzymes that ensure the metabolism of amino acids - alanine aminotransferase. It is produced mainly by hepatocytes - liver cells. In smaller quantities, it is synthesized in skeletal and cardiac muscle tissue, the pancreas. Usually in the blood of a healthy person in a laboratory biochemical study, alanine aminotransferase is not detected or is detected in very small quantities. At the same time, ALT is increased in men due to accelerated amino acid metabolism (in women, it is carried out less intensively).

Most often, a complex laboratory analysis is carried out with the determination of the concentration of another substance - aspartate aminotransferase (abbreviated AsAt). It is produced by the same cells and also participates in amino acid metabolism. The content of the enzyme in the blood plasma also changes in certain diseases of the liver and muscles of the heart, indicating necrotic processes.

But the main diagnostic value is the ratio of these two enzymes, the value of which is called the de Ritis coefficient and allows you to reliably establish the localization of the pathological process. If the reference (permissible) indicators are exceeded, and the value of the coefficient is less than 0.91 or more than 1.75, one can assume liver problems in the first case or heart pathology in the second.

The norm of ASAT and ALT in a biochemical blood test

The concentrations of these enzymes change over time, which is normal in childhood. For example, in infants, the level is higher than in adults due to the characteristics of the period of childbirth. Due to the massive release of erythrocytes into the blood and their subsequent transformation into bilirubin, jaundice, characteristic of newborns, develops and, accordingly, an increase in the amount of ALT.

For ASAT and ALT, the norms for children of different ages and adults can be found in the table:

As can be seen from the table, normal indicators constantly fluctuate in childhood and adolescence, and from the age of 12 they also differ according to the sex of the subject. In addition, a slight increase in the level of Alat is the norm in women in the blood during early pregnancy. However, in the last trimester, an increase in the concentration of the enzyme indicates gestosis, which threatens the health of the mother and fetus.

Aspartate aminotransferase is also determined in different amounts according to sex and age. In adult men, the upper limit of the norm is 37 units per liter, in women - 31. The highest level is observed in children of the first days of life (up to 97 units / l), decreasing to 82 by the year, and to 36 by six. For adolescents, 12 -17 years old, values ​​​​not exceeding 29 and 25 IU / l for boys and girls, respectively, are considered normal.

In the blood test, AlAt and AsAt are elevated - what does this mean, what are the reasons?

An increase indicates a pathological destruction of hepatocytes, heart cells, and pancreas. Normally, they enter the blood in a minimal amount, as a result of natural tissue renewal and the death of old cells. Extensive organ damage and massive cell death lead to a sharp increase in their volume in the bloodstream. Thus, an increase in ALT levels in the blood serum is characteristic of the following diseases and conditions:

• hepatitis, liver cirrhosis, fatty degeneration;
• acute pancreatitis;
• extensive burns, shock;
• viral infections;
• lymphoblastic leukemia;
• shocks of various etiologies;
• violations of hematopoiesis;
• muscular dystrophy;
• mononucleosis.

Increased AsAt in the blood or aspartate aminotransferase appears in the blood plasma in large quantities during necrotic processes in the body. Exceeding the maximum allowable values ​​by several times (from 2 to 20) is a sign of diseases of the following organs:

• Heart - coronary insufficiency, myocardial infarction, pulmonary thrombosis, angina attacks, postoperative condition, rheumatic heart disease.
• Gallbladder and liver - cholestasis, cholangitis, amoebiasis, liver cancer, hepatitis, cirrhosis.
• Pancreas - acute inflammation or phlegmon.
• Skeletal muscles - damage or dystrophy;

The plasma concentration of the amount of the enzyme also increases with such systemic and infectious pathologies as vasculitis, mononucleosis, and hemolytic syndrome.

Can an increase in the content of alanine aminotransferase and aspartate aminotransferase be caused by other reasons, not associated with diseases? Yes, enzyme levels rise in women early in pregnancy, which is normal. The same phenomenon can be observed with the use of certain drugs: antibiotics, antitumor and sedative drugs, barbiturates, oral contraceptives, and others. The level of physical activity, the intake of sports nutrition, and alcoholic beverages also affect the growth of indicators.

Who needs research

Referral for a biochemical blood test of AsAt and AlAt is mandatory given to all donors before the blood sampling procedure, as well as to persons with identified pathologies of the liver, heart, pancreas.

The results of this study are also used for hepatitis, cirrhosis, as they allow to determine the degree of damage to the organ. In addition, it is necessary to control the amount of enzymes during treatment with certain antibiotics, as well as after ingestion of toxic compounds.

The basis for a biochemical blood test is also a deterioration in general well-being in the form of constant weakness, fatigue, loss of appetite. Common symptoms such as abdominal pain, nausea and vomiting, yellowing of the whites of the eyes, dark urine, and digestive problems are reasons to see a doctor for a referral for an examination immediately.

How to prepare for the analysis for ALT, ASAT

You need to take blood from a vein for research, which is done in state clinics by referral or on a paid basis in private laboratories. A sample for AlAt and AsAt in the blood is taken in the morning and strictly on an empty stomach: at least 12 hours must pass after the last meal. On the day of the visit to the laboratory, you should not smoke, drink any liquids other than water. All week before the test, it is strictly forbidden to drink alcoholic beverages.

In addition, the result may distort the intake of any drugs - antimicrobial, contraceptive, choleretic, sedative and others. So the question of their cancellation or temporary suspension of treatment should be discussed with your doctor in advance. The term for the analysis is a day, that is, the very next day you can go for the results. For an additional fee, the process can be accelerated: an express test is done in just 2 hours.

Deciphering the analysis

The results of the study must be provided to your doctor. The specialist draws attention to the quantitative indicators of the content of both enzymes, the degree of excess of the maximum allowable value and their ratio. For example, the concentration of Alat allows us to draw conclusions about the nature of liver diseases. Thus, hepatitis A, B, C cause a 20-fold excess of the norm, and alcoholic - 6 times. With fatty degeneration, an increase of 2 or 3 times is observed.

As for oncological diseases (liver cancer, in particular), then attention should be paid to aspartate aminotransferase and its concentration.

With carcinoma, it rises several times, and progresses over time. At the same time, the values ​​of alanine aminotransferase increase slightly. In the late, inoperable stages of cirrhosis, the opposite phenomenon is observed.

Of particular importance is the so-called de Ritis coefficient - the numerical ratio of elevated values ​​of AlAt and AsAt, especially if the localization of the pathological process has not yet been accurately established. With liver damage, elevated ALT in the blood is usually observed, and the content of aspartate aminotransferase decreases. If the myocardium is damaged, the inverse proportion is obtained. Normally, the de Ritis coefficient has a value from 0.91 to 1.75, that is, with the destruction of hepatocytes, it is much less than 1, and with a heart attack - more than 2.

In addition, the concentration of enzymes is reduced. For AlAt and AsAt in the blood test, this is typical in the case of repeated sessions of hemodialysis, liver rupture, necrosis or cirrhosis, as well as with a pronounced lack of B-group vitamins in the body or taking anticoagulants. In any case, a specialist should deal with the decoding, taking into account external factors that could affect the final result of the study, since it is not always determined by pathological causes. It is unacceptable to draw conclusions and make diagnoses without having a special education.

How to lower ALT in the blood?

If quantitative deviations of indicators from the norm were revealed, first of all it is necessary to exclude the influence of such factors as the intake of dietary supplements and alcohol, excessive physical activity. A diet that includes too many fatty and “heavy” foods also needs to be adjusted. Often it is food that provokes inflammation of the pancreas, and diet promotes recovery.

When drug therapy becomes the cause, the doctor must adjust the course or replace the drug with a less toxic one. However, the effectiveness of such a measure should be continuously monitored through regular reviews. If the concentration of enzymes has changed due to liver disease or other pathological process, it must be identified and cured. For this, a complete examination with hospitalization is usually prescribed.

Alanine aminotransferase, as well as aspartate aminotransferase, are enzymes that are among the most active participants in amino acid metabolism. ALT and AST are present in the cells of the liver, kidneys, in the muscles of the heart and other vital organs.

As soon as these substances enter the bloodstream, this may be evidence that certain problems occur in the work of the organs associated with serious cell destruction.

With an increased level of these enzymes, it is worth immediately deciding how to reduce ALT and AST in the blood with folk remedies. It is possible to determine the presence of this pathology only with the help of a competent blood test.

If we talk about a more precise location of these enzymes, it can be noted that ALT is present in the kidneys, in the liver, in the heart, as well as in muscle mass and pancreas.

The AST enzyme is present in the muscles, liver, nerve fibers, heart, kidneys, and lungs. With certain violations of these important organs, the substance immediately begins to spread through previously damaged cells, after which it enters the blood vessels. This is what leads to an increase in AST and ALT in the blood.

To determine the increased amount of enzymes in the blood, a biochemical blood test is performed.

To get the most accurate result, the analysis is taken strictly on an empty stomach, and food has not entered the stomach for eight hours.

Blood is taken from a vein and the level of neglect of the problem is determined by the indicators.

You should immediately know that the level of indicators in women is slightly lower than in the male body:

1. Women ALT and AST - 31 U / l.
2. Men — ALT not higher than 45 U/l, AST 47 U/l.
3. Children - ALT is not higher than 50 U / l, AST in infants is about 149 U / l, in a child under one year old is about 55 U / l.

It is worth knowing that in childhood, enzyme levels may deviate from the norm. This is due to the uneven development of the child's body.

The results of the study are directly dependent on what equipment was used in the process of passing and deciphering the analysis, therefore the analysis should be taken exclusively by professional doctors in modern clinics.

The result obtained can be influenced not only by the food taken the day before, but also by the intake of medications, herbal infusions, as well as excessive physical activity.

If nothing provocative has happened, the doctor conducts a study, which means elevated levels of AST and ALT. There are many different reasons for this.

If, during the examination, the analyzes showed that ALT and AST are elevated, what does this mean - this is an issue that is resolved without fail.

Doctors in such a situation conduct a special additional examination.

Elevated levels of enzymes in vital organs indicate that there are certain problems in it.

Deviations depend on which of the enzymes is elevated:

1. Reasons for the increase in ALT- all forms of liver disease, myocardial infarction and other heart problems, inflammation of the pancreas.
2. Reasons for increasing AST- previous heart attack, operations on the heart and blood vessels, pancreatitis, the presence of serious injuries and burns.

ALT and AST levels may also be elevated in pregnant women. A similar problem very often occurs in the first months of pregnancy. This circumstance does not require treatment, since during pregnancy it is the norm.

If the indicator has been exceeded at least once, it is checked throughout the pregnancy. If the results during pregnancy are significantly exceeded, additional treatment will be prescribed for women.

Elevated levels of enzymes in almost all cases indicate that there are certain problems with the liver in the body.

It is recommended to take an analysis for ALT and AST indicators immediately if there are such symptoms and signs as:

• constant weakness and fatigue;
• regardless of nutrition, severe nausea and vomiting pursues;
• there is pain in the liver;
• many secrete yellowness of the skin;
• feces become light and urine dark;
• in more advanced cases, there is bleeding from the nose and stomach.

If it was seriously increased, it is very important to achieve a rapid decrease in these indicators. As a rule, it is enough just to restore the functioning of the liver, and the levels of enzymes quickly return to normal.

With elevated rates, it is necessary to immediately decide how to quickly lower ALT and AST. To effectively reduce the levels of enzymes in the blood, it is initially worth getting rid of the main reasons that led to the increase in these indicators.

Doctors prescribe an additional examination, which is mostly based on an examination of the liver and its treatment.

The patient is prescribed various medical procedures, a course of medications, as well as folk remedies and a special diet. It is mandatory to give advice on changing the general lifestyle.

For the most effective treatment and obtaining a positive result, it is necessary to first undergo a thorough examination to identify the cause of the increased rates.

The main reason for the failure in the indicators of ALT and AST is one or another problem with the liver.. After relatively simple therapeutic courses, the indicators quickly return to normal.

In most cases, with elevated ALT and AST, medication is prescribed. If the indicators are slightly increased, if it became clear from the examinations that the liver and other organs were not affected severely enough, it will be enough to solve the problem with folk methods of treatment.

When deciding what to do if ALT and AST are elevated, infusions and decoctions that are quite simple in preparation and use can be used. Here are the most popular and effective, prescribed by experienced doctors, means and methods of alternative treatment:

All these are quite effective recipes of traditional medicine, which quickly bring ALT and AST back to normal.

After taking milk thistle, the enzyme levels return to normal by the secondary blood test.

Corn cob hairs have an important effect on the functioning of the liver and the whole organism, while the indicators do not decrease so quickly.

Dandelion infusion is also quite effective, but it should not be taken if a person is constantly driving.

Herbal tea deserves special attention, which in just two weeks brings the body back to normal.. The only inconvenience is that you need to drink tea at least 4 times a day, that is, you will have to take the drink with you to work.

At the beginning of treatment aimed at reducing ALT and AST enzymes, you may encounter minor pain in the liver. Do not stop treatment in this case, as this is a normal phenomenon on the path to recovery.

It is very important to monitor your well-being in the process of treatment with folk remedies and if you have questions or certain problems, immediately contact your doctor.

Treatment of the liver and the whole body as a whole should be carried out with elevated ALT and AST, as there is a risk of facing such serious and life-threatening diseases as cirrhosis of the liver, myocardial infarction, hepatitis, hepatosis, oncological diseases and so on.

All this, if left untreated, can lead to death.

In the process of treating elevated enzyme levels in an adult and a child, along with treatment, a diet with elevated ALT and AST should be followed.

To effectively reduce ALT and AST levels, it is very important to fill the diet with foods with a lot of vitamin D. It is he who effectively prevents the processes associated with liver damage.

People who do not lack this vitamin in their bodies are much less likely to experience liver problems. Every day you need to eat fish, caviar, eggs, soy dairy products, cod liver, green vegetables and herbs, as well as oranges and apples.

It is necessary in the process of treatment to adhere to a plant-based diet, which is rich in various useful substances. If you constantly eat such foods, you can quickly regulate the functioning of the liver, thoroughly cleanse it of toxins and even restore new cells in the organ.

A similar effect can be achieved through the antioxidants, vitamins and minerals that are part of plant products.

To get a quick positive therapeutic effect, you should eat daily:

1. Green leafy vegetables.
2. Carrot.
3. Broccoli.
4. Zucchini.
5. Fresh fruits of all kinds.
6. Whole grains and nuts.
7. Lean meat.
8. Dairy products are low in fat.

It is necessary to exclude foods high in fat from the diet. Such food prevents the entry of useful trace elements into the body, as it completely blocks the liver, forming fat cells in it.

Their presence in the body can lead to serious damage to liver tissue. The organ becomes damaged, causing the enzymes ALT and AST to be released into the bloodstream.

Among the most dangerous high-fat foods are all deep-fried foods, as well as butter, cheese, bacon, and all kinds of sausages.

It is also worth giving up carbonated drinks and poor quality food.

To obtain a quick positive result during the treatment, it is worth excluding foods with a lot of salt along with fatty foods. Its presence in the body can lead to water retention and edema.

For this reason, it is much more difficult for the liver to filter waste, which leads to elevated ALT and AST levels. In the process of treatment, it is very important to avoid the consumption of soy sauce, soda, cubes, pure salt, and various pickled foods.

For the normal functioning of the body without harming it, you need to consume no more than one teaspoon per day.

As you know, any disease is much easier to avoid than to treat them.

In order to avoid an increase in the blood composition of ALT and AST, it is worth observing certain preventive measures, sometimes it is necessary to completely revise the way of one's usual life.

To restore the functioning of the liver and the whole organism as a whole, you need to follow the following rules:

1. It is necessary to completely abandon the use of alcohol and smoking.
2. It is important to monitor nutrition, eliminating harmful foods and filling the diet with useful components.
3. Every morning it is advisable to have breakfast not with coffee and scrambled eggs, but with kissel or tea.
4. It is very important to avoid unnecessary stress.
5. At least two hours a day should be spent outdoors. It does not matter here the time of day - you can and should walk during the day and in the evening.
6. It is required to make a daily routine and carefully observe it.
7. It is necessary to refuse self-treatment with over-the-counter drugs.
8. It is important to have a regular sexual partner, as sexual promiscuity can lead to an increase in ALT and AST.

Even with a relatively healthy lifestyle, about once every six months after the age of 35, you need to donate blood to check the level of ALT and AST. This will help to avoid serious problems with the body in the future, which will require long-term and expensive treatment.

Summing up

People who experience liver problems should stop smoking. Cigarette smoke contains a large number of toxins, which include nicotine and ammonia.

If a person is exposed to these substances every day, they are automatically absorbed by the body and retained in it. The liver in such a state of the body will strive to rid it of toxins, working just for wear and tear.

Against the background of such work, the amount of enzymes in the blood increases, since the liver, after such a load, begins to malfunction, causing certain health problems. This is why it is so important to avoid or minimize alcohol consumption..

Compliance with such relatively simple rules will improve not only overall well-being, but also appearance. A healthy liver has a positive effect on the condition of the skin, hair and nails.

Alanine aminotransferase (abbreviated as ALT or Alt) is an enzyme that functions inside various cells of the human body. Blood contains only small amounts of this substance.

An increase in ALT levels is an important diagnostic criterion that indicates increased cell destruction due to various pathologies.

The role of Alat in the body and where it is located in the body

Alanine aminotransferase is an essential component of amino acid metabolism. In cells, the enzyme regulates the conversion of alanine, which has many functions, such as providing energy to nerve cells, strengthening immunity, and correcting the metabolism of various substances.

ALT is found in:

1. Liver (highest level).
2. Lungs.
3. The pancreas.
4. Heart.
5. Kidney.
6. Muscles.

How to take an analysis for ALT?

To obtain correct results, the following rules must be observed:

• Donating blood is best in the morning on an empty stomach.. Food intake can affect the enzymatic activity of the liver and pancreas, due to which the results will be overestimated. Therefore, it is necessary to do the analysis at least 8 hours after the last meal;
• It is necessary to exclude alcohol in any form 7 days before donating blood, because it affects the liver much more than regular food;
• Some drugs lead to a change in the level of alanine aminotransferase, these include: oral contraceptives, acetylsalicylic acid, paracetamol, warfarin. If you are taking any of this list, tell your doctor.

Normal ALT levels for men, women and children

The amount of alanine aminotransferase depends on both age and gender. The level of the enzyme is influenced by many circumstances, including the so-called "physiological crossovers" in children (changes in the ratio of blood elements), hormonal fluctuations, stress, and much more.

Normally, ALT is found in the bloodstream in the following quantities:

After confirming that the tests revealed a real increase in the enzyme, it is worth continuing further research to clarify the location of the pathology.

If alanine aminotransferase is elevated, this very often indicates damage to the liver tissue. It is this reason that is the most common and causes a significant rise in the level of a substance in the blood.

After receiving the results of biochemistry, the doctor must calculate the Retis index - the ratio of the amount of aspartate-thyalanine aminotransferase. Its norm is in the range from 0.91 to 1.75.

A lower index may indicate a liver disease, an increased index may indicate pathological changes in the heart muscle.

There are several degrees of increase in alanine aminotransferase:

Reasons for the increase in ALT

An increased concentration of alanine aminotransferase in the blood, with a correctly done analysis, shows the severity of the disease.

Even with liver tumors, the amount of ALT can be increased only slightly if the tumor is in the initial stages.
So what do you do if the numbers in your analysis go up? How to determine the cause and start treatment?

An increased level of alanine aminotransferase in the blood is observed after the release of the enzyme from damaged cells. Normally, cells in the body constantly die and are replaced by new ones, however, an excess of the level is observed only with massive pathological death, when the enzyme enters the bloodstream in significant quantities.

Diseases in which markedly increased numbers are observed in the analysis for ALT include:

1. Hepatitis (hepatitis types B, C, D are most dangerous for the liver)- diseases of a viral nature that can be transmitted both by contact (types A, E) and through the fluids of the human body (types B, C, D). This pathology is characterized by a long asymptomatic course. After infection, the first manifestations of the disease may not be felt soon.

Such a dangerous disease as hepatitis C is “famous” for the fact that the virus destroys liver cells for a long time, and when the first symptoms appear, the process is already quite difficult to treat.

In hepatitis, the amount of ALT becomes significantly higher than normal, in addition, the levels of AST (aspartate aminotransferase) and GGTP (gamma-glutamyltransferase of the liver) increase.

When analyzed in the blood, a significant amount of bilirubin, a bile enzyme produced in liver cells, is also detected:

1. Cirrhosis of the liver- total destruction of the tissue of an organ, in which the organ gradually loses the ability to perform its main functions.
2. Liver cancer.
3. pancreatitis- inflammation of the pancreas, the result of which very often is necrosis of the tissues of the organ. Chronic pancreatitis requires constant monitoring of the level of alanine aminotransferase to control the course of the disease.

The most common cause of pancreatitis is the abuse of fatty foods and alcohol. Sometimes inflammation of the pancreas is associated with blockage of the common bile duct, which can cause bile to reflux into the gland and damage its cells.

With pancreatitis in an adult, there is a less sharp jump in the level of ALT than with hepatitis. However, the determination of this enzyme by biochemical blood testing is mandatory.

1. myocardial infarction. This term refers to the death of a certain area of ​​​​the heart muscle as a result of a violation of the circulatory process in it. This pathology also leads to an increase in the amount of ALT in the bloodstream. However, it is more characteristic of an increase in the level of aspartate aminotransferase. It is this enzyme that will be key in making a diagnosis.
2. Myocarditis - inflammation of the heart muscle. It is also characterized by the detection of elevated levels of AlAt and AsAt in biochemistry.
3. Other reasons. These include pathologies such as burn lesions, frostbite, extensive muscle tissue injuries. Tumor neoplasms that destroy the tissues of the above-mentioned organs can also increase the amount of ALT.

If a biochemical analysis has determined that your ALT level is elevated, then it's time to seek the advice of a doctor.

Additional examinations will help determine the exact localization of the pathological process and start treatment in a timely manner.

What can lower the amount of ALT?

A heart attack can be recognized by the appearance of characteristic shortness of breath, chills, a change in heart rate, and a decrease in blood pressure.

How is the treatment carried out?

How to reduce the level of ALT? By curing the disease that led to his growth. By stopping the destruction of cells containing alanine aminotransferase, it is possible to return the amount of the enzyme in the bloodstream to normal.

Serious pathologies like extensive heart attacks, pancreatic necrosis, acute hepatitis should be treated only in a hospital. Without the supervision of specialists, they threaten with serious complications up to the death of the patient.

It is necessary to treat each pathology according to a certain algorithm. Since most of them are life-threatening, the choice of treatment should be entrusted to the doctor.

Here are some general tips for lowering ALT levels:

• stop abusing alcohol and drugs that affect the enzymatic activity of the liver;
• periodically take a course of hepatoprotectors;
• limit the consumption of fatty, smoked and spicy foods.

By reducing the load on your liver and the body as a whole, you will help it fight the disease.

Only the right lifestyle will help to avoid dangerous complications and maintain health for a long time.

In the human body, each organ has a certain range of enzymes - specific proteins that act as biological "accelerators" of chemical reactions. The most active participants in biochemical processes are alanine aminotransferase (ALT) and aspartate aminotransferase (AST) - without their participation, amino acid metabolism is impossible.

What does ALT and AST mean in a biochemical blood test?

As the pathological process develops, the integrity of the cellular structure of organs is damaged and enzymes leak. The diagnostic value of the increase in the activity of ALT and AST in the peripheral blood of a person was clarified as early as the 50s of the last century. In subsequent years, biochemical studies have confirmed that an increase in enzymatic activity indicates the presence of a serious disease.

Amino transferases are assigned the function of transporting molecules from one group of amino acids to another , which is why these enzymes are called transaminases.

• The largest amount of ALT (alanine transaminase) contains liver and kidneys, smaller - heart muscle, pancreas and skeletal muscles.
• AST (aspartic transaminase) distributed in all tissues of the human body, the highest level of its content is observed in the liver, muscle mass, red blood cells and the heart.

When the cell walls of organs are damaged, enzymes "leak" into the circulating blood, causing an increase in concentration.

What is ALT and AST on video

Due to the high content of transaminases in hepatocytes (liver cells), changes in the level of their content in the patient's blood are medical experts most often associate with a violation of the function of the liver and biliary tract.

Norms of AST and ALT in the blood of men, women and children

Transaminase indicators are included in a biochemical blood test, which allows you to evaluate protein, fat, carbohydrate and pigment metabolism.

Research by the Italian biochemist Fernando de Ritis showed that Of clinical importance is not only the concentration of transaminases in the patient's blood, but also the ratio of their levels.

He developed a criterion that is used for the differential diagnosis of various diseases with an increase in the content of amino-transferases:

DRr = ALT score: AST score

Reference value of the Ritis coefficient: from 0.9 to 1.75.

Why is ALT elevated in men and women? Reasons for the increase in ALT

A change in the concentration of ALT indicates the presence of an inflammatory process in the human body.

An increase in the concentration of ALT is also noted with:

• steatosis - fatty degeneration of the liver;
• muscle damage;
• abuse of alcoholic beverages;
• the use of narcotic substances;
• increased physical and psycho-emotional stress;
• gestosis in pregnant women.

Causes of increased AST in adults

An increase in the concentration of AST is a marker of diseases of the cardiac and vascular systems, liver, and pancreas.

Qualified specialists distinguish several pathological processes in which the level of aspartic enzyme in the patient's blood significantly exceeds the permissible limits:

• myocardial infarction - the main reason for the increase in level. Compared with the concentration of ALT, which rises slightly, AST levels increase tenfold.
• Biliary cirrhosis - a special type of pathology that develops with prolonged damage to the biliary tract and cholestasis.
• Pancreatitis (acute or chronic) causes a sharp increase in the concentration of the enzyme.
• Serious damage to muscle mass (burns, injuries).
• Alcohol poisoning.
• Malignant liver disease .

Why are ALT and AST elevated in the blood of children?

An increase in the concentration of enzymes in the child's body is associated with increased permeability of hepatocyte membranes when exposed to damaging factors on the liver.

Most often this is due to:

• congenital anomalies in the development of the bile ducts;
• hereditary pathologies of the liver (hematochromatosis, autoimmune hepatitis);
• acute viral or chronic hepatitis;
• medicinal lesions of the liver;
• infectious mononucleosis, which causes diffuse changes in the cells of the spleen and liver;
• cardiological pathologies - myocardial dystrophy (disturbance of metabolism in the cells of the heart muscle) or myocarditis;
• endocrine diseases - dysfunction of the pituitary gland or diabetes mellitus;
• hemorrhagic vasculitis - inflammation of the vascular walls;
• oncological pathology.

Parents should take the following symptoms very seriously and seek immediate medical attention:

• increase in the child's blood enzymatic activity;
• the baby has complaints of weakness;
• lack of appetite;
• nausea;
• the appearance of yellowness of the skin and sclera;
• darkening of urine and lightening of feces.

What to do if the results of analyzes for AST and ALT are overestimated?

To reduce transaminase levels in the blood, first of all, you need to undergo a comprehensive examination, which consists in advanced laboratory diagnostics and instrumental research. After establishing the correct diagnosis, it is necessary to eliminate the cause of the increase in the concentration of enzymes.

Most often, the opinion is widespread, which is partly correct: in case of 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, this enzyme is most often 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 only in residual amounts in the blood. 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 of 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