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Liver function tests (LFTs or LFs), which include liver enzymes, are groups of clinical biochemistry laboratory blood assays designed to give information about the state of a patient's liver. Most liver diseases cause only mild symptoms initially, but it is vital that these diseases be detected early. Hepatic (liver) involvement in some diseases can be of crucial importance. This testing is performed by a medical technologist on a patient's serum or plasma sample obtained by phlebotomy. Some tests are associated with functionality (eg. Albumin); some with cellular integrity (eg. transaminase,) and some with conditions linked to the biliary tract (gamma-glutamyl transferase and alkaline phosphatase). Chemical pathology (also known as clinical biochemistry or clinical chemistry) is the area of pathology that is generally concerned with analysis of bodily fluids. ...
The liver is the largest internal organ in the human body, and is an organ present in vertebrates and some other animals. ...
The liver is an organ in vertebrates including humans. ...
A medical technologist (MT) is a healthcare professional who performs diagnostic analytic tests on human body fluids such as blood, urine, sputum, stool, cerebrospinal fluid (CSF), peritoneal fluid, pericardial fluid, and synovial fluid, as well as other specimens. ...
Blood plasma is the liquid component of blood, in which the blood cells are suspended. ...
Venipuncture using a vacutainer. ...
For other uses, see Golden Gate Transit. ...
Ball and stick model of alkaline phosphatase Alkaline phosphatase (ALP) (EC 3. ...
Standard liver panel | Measurement | Significance | Reference range | | Alanine transaminase (ALT) | Alanine transaminase (ALT), also called Serum Glutamic Pyruvate Transaminase (SGPT) or Alanine aminotransferase (ALAT) is an enzyme present in hepatocytes (liver cells). When a cell is damaged, it leaks this enzyme into the blood, where it is measured. ALT rises dramatically in acute liver damage, such as viral hepatitis or paracetamol (acetaminophen) overdose. Elevations are often measured in multiples of the upper limit of normal (ULN). | 5 to 40 IU/L [1] | | Aspartate transaminase (AST) | Aspartate transaminase (AST) also called Serum Glutamic Oxaloacetic Transaminase (SGOT) or aspartate aminotransferase (ASAT) is similar to ALT in that it is another enzyme associated with liver parenchymal cells. It is raised in acute liver damage, but is also present in red cells, and cardiac and skeletal muscle and is therefore not specific to the liver. The ratio of AST to ALT is sometimes useful in differentiating between causes of liver damage. | 10 to 40 IU/L [1] | | Alkaline phosphatase (ALP) | Alkaline phosphatase (ALP) is an enzyme in the cells lining the biliary ducts of the liver. ALP levels in plasma will rise with large bile duct obstruction, intrahepatic cholestasis or infiltrative diseases of the liver. ALP is also present in bone and placental tissue, so it is higher in growing children (as their bones are being remodelled) and elderly patients with Paget's disease. | 30 to 120 IU/L [1] | | Total bilirubin (TBIL) | Bilirubin is a breakdown product of heme (a part of haemoglobin in red blood cells). The liver is responsible for clearing the blood of bilirubin. It does this by the following mechanism: bilirubin is taken up into hepatocytes, conjugated (modified to make it water-soluble), and secreted into the bile, which is excreted into the intestine. Increased total bilirubin causes jaundice, and can signal a number of problems: A reference range is a set of values used by a health professional to interpret a set of medical test results. ...
Alanine transaminase or ALT is an enzyme (EC 2. ...
In biochemistry, a transaminase or an aminotransferase is an enzyme that catalyzes a type of reaction between an amino acid and an α-keto acid. ...
Ribbon diagram of the enzyme TIM, surrounded by the space-filling model of the protein. ...
Sinusoid of a rat liver with fenestrated endothelial cells. ...
In medicine (gastroenterology), hepatitis is any disease featuring inflammation of the liver. ...
Paracetamol (INN) (IPA: ) or acetaminophen (USAN), is the active metabolite of phenacetin, a so-called coal tar analgesic. ...
Aspartate transaminase (AST) also called Serum Glutamic Oxaloacetic Transaminase (SGOT) or aspartate aminotransferase (ASAT) (EC 2. ...
Ball and stick model of alkaline phosphatase Alkaline phosphatase (ALP) (EC 3. ...
A bile duct is any of a number of long tube-like structures that carry bile. ...
In medicine, cholestasis is a condition where bile cannot flow from the liver to the duodenum. ...
This article is about the skeletal organs. ...
The placenta (Latin for cake, referencing its appearance in humans) is an ephemeral organ present in placental vertebrates, such as eutherial mammals and sharks during gestation (pregnancy). ...
Bold text X-ray of Pagets disease Pagets disease, otherwise known as osteitis deformans, is a chronic disorder that typically results in enlarged and deformed bones. ...
Bilirubin is a yellow breakdown product of normal heme catabolism. ...
Structure of Heme b A heme or haem is a prosthetic group that consists of an iron atom contained in the center of a large heterocyclic organic ring called a porphyrin. ...
3-dimensional structure of hemoglobin Hemoglobin or haemoglobin is the iron-containing oxygen-transport metalloprotein in the red cells of the blood in mammals and other animals. ...
Hepatocytes make up 60-80% of the cytoplasmic mass of the liver. ...
Bile is also another name for Belenus, a god in Brythonic mythology. ...
- 1. Prehepatic: Increased bilirubin production. This can be due to a number of causes, including hemolytic anemias and internal hemorrhage.
- 2. Hepatic: Problems with the liver, which are reflected as deficiencies in bilirubin metabolism (e.g. reduced hepatocyte uptake, impaired conjugation of bilirubin, and reduced hepatocyte secretion of bilirubin). Some examples would be cirrhosis and viral hepatitis.
- 3. Posthepatic: Obstruction of the bile ducts, reflected as deficiencies in bilirubin excretion. (Obstruction can be located either within the liver or outside the liver.)
| 2 - 14 μmol/L | | Direct bilirubin | The diagnosis is narrowed down further by looking at the levels of direct bilirubin. - If direct (i.e. conjugated) bilirubin is normal, then the problem is an excess of unconjugated bilirubin, and the location of the problem is upstream of bilirubin excretion. Hemolysis, viral hepatitis, or cirrhosis can be suspected.
- If direct bilirubin is elevated, then the liver is conjugating bilirubin normally, but is not able to excrete it. Bile duct obstruction by gallstones or cancer should be suspected.
| 0 - 4 μmol/L | | Gamma glutamyl transpeptidase (GGT) | Although reasonably specific to the liver and a more sensitive marker for cholestatic damage than ALP, Gamma glutamyl transpeptidase (GGT) may be elevated with even minor, sub-clinical levels of liver dysfunction. It can also be helpful in identifying the cause of an isolated elevation in ALP. GGT is raised in alcohol toxicity (acute and chronic). In some laboratories, GGT is not part of the standard LFTs and must be specifically requested. | 0 to 51 IU/L [1] | A bile duct is any of a number of long tube-like structures that carry bile. ...
A bile duct is any of a number of long tube-like structures that carry bile. ...
Gamma glutamyl transferase (GGT or GGTP, or Gamma-GT) (EC 2. ...
Other tests commonly requested alongside LFTs:
5' nucleotidase (5'NTD) 5' nucleotidase is another test specific for cholestasis or damage to the intra or extrahepatic biliary system, and in some laboratories, is used as a substitute for GGT for ascertaining whether an elevated ALP is of biliary or extra-biliary origin. A nucleotidase is a hydrolytic enzyme that catalyzes the hydrolysis of a nucleotide into a nucleoside and a phosphate. ...
Coagulation tests (e.g. INR) The liver is responsible for the production of coagulation factors. The international normalized ratio (INR) measures the speed of a particular pathway of coagulation, comparing it to normal. If the INR is increased, it means it is taking longer than usual for blood to clot. The INR will only be increased if the liver is so damaged that synthesis of vitamin K-dependent coagulation factors has been impaired: it is not a sensitive measure of liver function. This article is about the clotting of blood. ...
The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) are measures of the extrinsic pathway of coagulation. ...
Vitamin K1 (phylloquinone). ...
It is very important to normalize the INR before operating on people with liver problems (usually by transfusion with blood plasma containing the deficient factors) as they could bleed excessively.
Serum glucose (BG, Glu) The liver's ability to produce glucose (gluconeogenesis) is usually the last function to be lost in the setting of fulminant liver failure. Glucose (Glc), a monosaccharide (or simple sugar), is an important carbohydrate in biology. ...
Pyruvic acid Oxaloacetic acid Phosphoenolpyruvate Fructose 1,6-bisphosphate Fructose 6-phosphate Glucose-6-phosphate Glucose Gluconeogenesis is the generation of glucose from non-sugar carbon substrates like pyruvate, lactate, glycerol, and amino acids (primarily alanine and glutamine). ...
Lactate dehydrogenase (LDH) Lactate dehydrogenase is an enzyme found in many body tissues, including the liver. Elevated levels of LDH may indicate liver damage. Lactate dehydrogenase (LDH) is an enzyme (EC 1. ...
References - ^ a b c d
External links Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ...
Main campus in downtown Rochester, Minnesota. ...
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