We all know her by the name of ALT or SGTP, but her real name would be Alanina Amino Transferasi. It is an enzyme found mostly in the liver, striated muscles, brain, heart, kidneys and other tissues – such as bone – to a lesser extent. This value is requested very frequently if liver damage is suspected, but also as a routine test to monitor liver health. Transaminases
ALT or SGTP (Serum Glutamic Pyruvic Transaminase) belongs to the large (and famous) family of transaminases (class transferases). A recurring term when it comes to liver disorders, in fact, is the place where the enzyme is present to the greatest extent. Alanine has the task of transporting the amino groups (NH2) that are produced by the muscles following the degradation of proteins in the blood. When it reaches the liver, however, the alanine transaminase yields the groups to glutamate which releases ammonia, actually entering what is known as the urea cycle. When alanine deprived of the NH2 amino group, it is converted into pyruvic acid. ALT activity in the liver is approximately 3,000 times that of serum activity. In case of hepatocellular damage, however, the release of ALT from damaged liver cells increases the ALT activity measured in serum. It is important to note, however, that ALT levels vary from day to day, from 10% to 30%. Also in the afternoon there is an increase in activity up to 45% more than in the morning.Why the test is required
In general, your doctor requires you to measure ALT levels in order to highlight any acute or chronic liver disease. It may be required more frequently in patients who take medications or drink a lot of alcohol. High ALT Values High ALT
levels may indicate liver damage, viral or drug- and alcohol-induced hepatitis, bile duct disorders, myopathies, liver necrosis, tumor metastases, and mononucleosis infections. In some cases, it could also be heart failure, muscle trauma, thyroid disorders, or previous heart attacks. In fact, when the liver is damaged, ALT is released into the bloodstream and this happens before the appearance of typical symptoms such as jaundice.A little specific exam
Beyond what is commonly believed, ALT values cannot be considered highly specific in terms of liver function. It is more likely, however, that they are higher when the liver cells have suffered some damage and less high when it comes to obstruction due to gallstones. To get better information about the health of our liver it is important to combine such values as, for example, AST (aspartate amino transferase). If both ALT and AST are high the chances that the liver has been damaged are very high. Although – in general – it is the relationship between AST and ALT that determines whether the damage is most likely reported to the liver, heart or muscles. To obtain even more certain information about liver damage, it is also possible to associate the detection of total proteins,Symptoms that may require ALT measurement
Some symptoms may suggest liver damage. Here they are:
Nausea and vomiting
Jaundice
Abdominal pain
Loss of appetite
Unusual
itching Tiredness ALT, the right values
MEN: up to 10-55 U / L
WOMEN: up to 10-45 U / L How high are the ALT
If ALT is on average high, it is more likely that it is chronic liver disease, obstructive jaundice, gallstones, kidney damage, muscle trauma, mononucleosis, cytomegalovirus infections, kidney infarction or alcoholism. If the values are very high, liver damage could be caused by drugs, viruses, autoimmune diseases, neoplasms (metastases), hepatic ischemia. If the values are just a little high it could be pregnancy, fatty liver (fatty liver), early stage cirrhosis or hepatotoxic drugs. Low ALT
Generally, it is nothing so worrying and it could be a vitamin deficiency (especially vitamin B6) or it could happen in people who exercise constantly. Medicines that can alter the values
Cortisones
Barbiturates
Anabolics
Anesthetics
Antibiotics
Statins
Drugs
Anti
-inflammatory Aces inhibitors
Anticonvulsants
Antipsychotics
Benzodiazepines
NSAIDs
Heparin
Estrogens
Interferons
Salicylates
Thiazides How to perform the blood test
To detect the values of ALT a simple blood sample is required to be done strictly after a minimum of fasting eight hours of only drinking water. Scientific Sources
[1] ALT Blood Test – MedlinePlus
[2] CMAJ. 2005 Feb 1; 172(3): 367–379. doi: [10.1503/cmaj.1040752] PMCID: PMC545762 PMID: 15684121 Liver enzyme alteration: a guide for clinicians Edoardo G. Giannini, Roberto Testa, and Vincenzo Savarino
[3] Serum activity of alanine aminotransferase (ALT) as an indicator of health and disease W. Ray Kim Steven L. Flamm Adrian M. Di Bisceglie Henry C. Bodenheimer Jr. First published: 07 January 2008 https://doi.org/10.1002/hep.22109
[4] Fraser C. Biological variation in clinical chemistry: an update: collated data, 1988‐1991. Arch Pathol Lab Med 1991; 116: 916–923.
[5] Cordoba J, O’Riordan K, Dupuis J, Borensztajin J, Blei A. Diurnal variation of serum alanine transaminase activity in chronic liver disease. HEPATOLOGY 1999; 28: 1724–1725
