The normal ALT and AST in women and men
Of the indicators of biochemical blood analysis pay special attention to the ALT (alaninaminotransferase) and AST (aspartataminotransferase). Often doctors prescribe only to study the level of ALT and AST in the blood — liver function tests. However, these studies are performed not only to determine the functionality of the liver. Individually or in conjunction with other indicators biochemistry of AST and ALT can signal serious diseases of other organs and systems.
ALT and AST: what is it?
ALT and AST enzymes from the group of transaminases that transfer amino acids alanine and aspartate, respectively, with one biomolecule to another. Transaminase synthesized in the cells of various organs. In the liver, their number reaches the maximum concentration. Also transferase ALT and AST are found in the pancreas, heart, muscle and kidneys. From bodies only a small number of enzymes into the bloodstream, however, in various pathologies, their level and activity in the blood increases.
Norm AST and ALT
Normal liver samples varies according to gender and other physiological parameters. Thus, the norm is ALT (U/l):
- neonates (first 4 days of life) — 48;
- 4 – 6 months — 55;
- before the year is 53;
- to 3 years — 32;
- to 6 years — 28;
- to 11 years — 38;
- men (18 years) — 41;
- women (18 years) — 32.
Norm AST (U/l):
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- newborns — 25 – 75;
- to 18 years — 15 – 60;
- men — 15 – 31;
- women — 20 – 40.
A slight increase is the increase in the level of ALT and AST in 2 – 3 times higher than normal. Moderate GDP growth in activity reflected in an increase in performance up to 6 to 10 times extremely high — more than 10 times. It should be remembered that people with overweight and body mass index (kilograms divided by height in meters squared) above 28 ALT and AST are increased by 40 – 50%.
ALT and AST are: normal with the pregnancy
Liver function tests in pregnant women slightly vary depending on the duration of pregnancy. Considered normal if liver function tests are elevated is minimal. ALT in the first trimester is less than 32 U/l, and further reduced to 31 U/l Normal AST in pregnancy: the first trimester — up to 31, then to 30. Even a slight increase in ALT in the later stages often indicates the presence of toxemia (preeclampsia).
The de Ritis coefficient
This indicator plays an important role in differentiation diagnosis. Although ALT is considered a purely hepatic index, and AST — heart, the ratio of AST/ALT more clearly indicates the developing in the body pathology. The normal rate of de Ritis coefficient is 1.3. Its increase is typical for a heart attack, and decreased for diseases of the liver.
The reasons for the increase of ALT
A slight increase in the activity of the enzyme alanine aminotransferase in the blood can be physiological due to the impact of the following factors:
- medication — antibiotics, oral contraceptives, NSAID drugs (Advil, Aspirin, Diclofenac etc.), sedatives (Valerian and barbiturates), drugs, drug, Echinacea;
- consumption of alcohol or overly fatty/fried foods for the week before the test;
- serious physical stress;
- heavy stress;
- of intensive growth in adolescence;
- various traumas.
If in the biochemical analysis elevated ALT levels should alert the physician on the admission of Cordarone, Carbamazepine (antiepileptic drug), Ciprofloxacin, Fluconazole, Atorvastatin, Isoniazid (a component of some antihypertensives), Nizoral, Metformin (antidiabetic agent), Furadonina, Simvastatin (cholesterinspiegel drug), Tamoxifen, Vit. E Ursodiol.
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The inflated figure of ALT — the first sign of acute liver disease. The increased enzymatic activity observed in the incubation period (1 – 2 weeks. before the onset of symptoms) and precedes (before 7 – 10 days) maximum increase of bilirubin in the blood. The acute phase of the disease is accompanied by increased ALT levels 5 – 10 times, while the erased forms of liver function tests can remain normal. If, however, the inflated figure is not reduced for a long period of time, or is its growth, should be suspected in extensive necrosis of liver cells. High ALT is typical for the following diseases:
- acute hepatitis (hepatitis C the value is increased 10 times or more);
- obstructive jaundice due to gallstones;
- liver cancer (primary or metastatic lesions);
- pancreatitis (acute phase);
- cirrhosis (with severe level of ALT, on the contrary, decreases due to the reduction of normally functioning liver cells);
- massive antibiotic therapy or poisoning with products containing lead;
- necrosis of a large tumor focus;
- myocarditis, myocardial infarction (a slight increase on 30 – 50%);
- injuries associated with muscle damage.
Causes of increase AST
Aspartate aminotransferase may be elevated in heat stroke, burns and trauma, poisoning with mushrooms. High numbers of AST reaches for the following pathologies:
- hepatitis, hepatosis;
- cholestasis (stagnation of bile);
- developing cirrhosis and necrosis of liver cells;
- cancer of the liver;
- alcoholic and toxic liver damage;
- autoimmune disease, occurring with lesions of the muscle (e.g., Duchenne myodystrophy).
Of particular importance figure AST plays in the diagnosis of myocardial infarction and preparation of the prognosis of the disease. The AST level reaches maximum values exceeding norm by 4 – 5 times, while the incident to the necrosis of the heart muscle. If the indicator decreases or increases subsequently after a heart attack 5 days, the prognosis is very unfavorable. Increased activity of AST indicates the expansion of the zone of necrosis.
How to lower ALT and AST?
Indicators of ALT and AST is not the cause but only a consequence of the disease is often very serious. While liver function tests often indicate the disease before symptoms appear. Therefore, the detection of high values of transaminases is possible to start treatment much earlier, thereby increasing its efficiency and speed up the recovery of the patient. The reduction in liver samples also occurs on the background of deficiency of Vit. B6, which is kofermentom involved in transport of amino acids. This fact should be considered in the diagnosis. Often elevated transaminase levels is a contraindication to surgical intervention. Significant deviations from the norm can lead to serious complications in the postoperative period.
To normalize their level is possible only with the full treatment of the causal disease. For choice of therapeutic tactics it is necessary to conduct comprehensive blood tests, other laboratory and instrumental studies. The decrease in the values of transaminases indicates to stop the process of destruction of cells (liver or heart) and is a measure of the effectiveness of the treatment. Self-diagnosis and use of home remedies only aggravate the disease. Complex medical treatment, often combined with the diet (with the exception of fatty, fried) will lead to a reduction in liver samples.