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Hepatic Function Tests

Liver function tests provide information about the state of a patient's liver by evaluating its synthetic, transaminase, biliary tract, and fat metabolism functions. Tests include plasma proteins, coagulation factors, transaminases like ALT and AST, alkaline phosphatase, bilirubin, and cholesterol. Together these assays give a sense of the liver's ability to synthesize proteins and clotting factors, its response to injury, and how well it is processing and excreting bile and fats.

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41 views12 pages

Hepatic Function Tests

Liver function tests provide information about the state of a patient's liver by evaluating its synthetic, transaminase, biliary tract, and fat metabolism functions. Tests include plasma proteins, coagulation factors, transaminases like ALT and AST, alkaline phosphatase, bilirubin, and cholesterol. Together these assays give a sense of the liver's ability to synthesize proteins and clotting factors, its response to injury, and how well it is processing and excreting bile and fats.

Uploaded by

alhassanmohamed
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Hepatic Function Tests

Liver function tests

Groups of laboratory blood assays designed


to give information about the state of a
patient's liver
1) Synthetic function
A) Plasma proteins:
 Total protein = 6.5 – 8.5 g/dl
 Serum albumin = 3.5 - 5.5 g/dl
 Globulins = 2-3 gm/dl
 A/G ratio = 1.5-2 : 1
Valid in chronic not acute illness.
Synthetic function
 Coagulation factors:
Vitamin K dependant (2,7,9,10)
Tested by prothrombin time and concentration
(PT 10-13 sec, INR=1)
Valid in both acute & chronic illness.
Prolonged in vit k def.
2) Transaminases
 Alanine transaminase (ALT) = Serum
glutamic pyruvic transaminase (SGPT):

 Normal value = 5-30 IU/L.


 It is an enzyme present in hepatocytes (cytosol).
 It leaks this enzyme into the blood, when the cell
is damaged.
Transaminases
 Aspartate transaminase (AST) = Serum
glutamic Oxalacetic transaminase
(SGOT):

 Normal value = 8-40 IU/L.


 Less specific and less sensitive than ALT.
Transaminases
 Value of ALT & AST:

 Highly sensitive in acute damage.


 In chronic liver disease, cholestasis.
 Prognostic value.
 ALT level is more specific and more sensitive
than AST level.
Transaminases
 Alkaline phosphatase (ALP):
 Normal value = 40-180 IU/L.
 It is an enzyme in the cells lining the biliary ducts
of the liver in addition to bone and intestine .
 Rise markedly with large bile duct obstruction,
intrahepatic cholestasis, infiltrative diseases and
space occupying lesions of the liver .
 It show moderate elevation with acute or chronic
hepatocellular affection
Transaminases
Gamma glutamyl transpeptidase (GGT):

 Normal value = 10-50 IU/L.


 Although reasonably specific to the liver and a
more sensitive marker for cholestatic damage
than ALP, they may be elevated with even
minor, sub-clinical levels of liver dysfunction .
3) Evaluation of biliary tract
 Serum bilirubin:
 Total serum bilirubin 0.2-1 mg/dl.
 Direct bilirubin normally <0.2 mg/dl.
 Direct vs indirect hyper-bilirubinemia.
 Bilirubin in urine:
 Normally it is absent.
 It is present in cases of cholestasis and
hepatocellular affection.
Evaluation of biliary tract
 Urobilinogen in urine:
 Normally 0.5-2.5 mg/day.
 Increases in hemolysis and hepatocellular and
decreases in cholestasis.
 Strechobilinogen in stool:
 Normally 50-250 mg/day.
 Increases in hemolysis and decreases in
hepatocellular and cholestasis.
4- tests depending on fat
metabolism
 Serum cholesterol:

 Normally 150-200 mg %.
 ↑↑↑with cholestasis and ↓ in acute liver disease.

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