biochemistry presentation on LFTs

1. UNIVERSITY OF AZAD JAMMU & KASHMIR
Faculty Of Health & Medical Sciences

2. LIVER FUNCTION
TESTS
 Presented to: Ma’m Tahibia Manzoor
 Presented by: Group #01
 Subject: Biochemistry
 Date: 17 April 2017

3. Group Members:
 NAMES ROLL NO
 Saqib Hussain Darr 02
 Kh. Ahmed Ali 01
 Kiran Imtiaz 03
 Maira Khan 04
 Mahnoor Rafique 05
 Mahnoor Sadaqat 06

4. CONTENTS:
 REVIEW
 LIVER FUNCTION TEST
 SPECIAL LIVER FUNCTION TEST
 ROUTINE LIVER FUNCTION TEST
 STAGES OF LIVER DAMAGE
 HEPATITIS AND JAUNDICE

5. Review: Liver
The liver is the largest glandular organ
in the body.
It is located below the diaphragm in the
right upper quadrant of the abdominal
cavity and extended approximately from
the right 5th rib to the lower border of the
rib cage.

6. Importance of Liver
 The liver performs an astonishingly large number of tasks that
impact all body systems.
 Liver is the central station of metabolism and consequently
the body’s central metabolic clearing house.
 Due to this characteristic, liver functions are pivotal to body
health and involve interactions with most of body organ
systems.

7. Functions of Liver
① Excretory function: Bile pigments, Bile salts and cholesterol are excreted in bile into
intestine.
② Metabolic function: Liver actively participates in carbohydrate, lipid, protein, mineral
and vitamin metabolisms.
③ Hematological function: Liver produces clotting factors like factor V, VII. Fibrinogen
involved in blood coagulation is also synthesized in liver. It synthesize plasma proteins.
④ Storage functions: Glycogen, vitamins and trace element e.g. Iron.
⑤ Protective functions and detoxification: Ammonia is detoxified to urea.
 The specialized cells called “Kupffer cells” of liver perform phagocytosis to eliminate foreign
compounds.

8. Importance of Liver Function Test
 Liver does all kinds of work that’s critical to health.
 If things go wrong with it, you might have a number
of symptoms, from a yellow coloring of your skin to
slurred speech.
 That’s when you might need a liver function test.

9. Abnormalities of Liver
Different tests will show abnormalities in
response to following disorders
 Liver inflammation
 Liver injury due to drugs, alcohol, toxins,
viruses
 Liver malfunction due to blockage of the
flow of bile
 Liver cancers

10. General symptoms of liver
problems
 Dark urine or light-colored stool
 No desire to eat
 Swelling in your belly
 Weakness or feeling very tired
 Yellowish eyes or skin (jaundice)

11. Procedures of LFTs
 Liver function tests use blood samples to determine how efficiently the
liver works.
 These tests check how the liver clears blood waste, protein, and
enzymes.
 High liver enzyme levels may indicate that the liver is stressed or
damaged.
 Certain medications and foods may affect levels of these enzymes and
proteins in your blood.
 Your doctor may ask you to avoid some types of medications, or they
may ask you to avoid eating specific ingredients for a period of time
before the test.

12. Liver Function Tests
Two main types of liver function tests:
 Special tests for liver
 Routine liver function tests

13. Special liver function tests
Special LFTs include:
I. Liver Biopsy
II. Specific antibodies level
III. Alpha feto-protein
IV. Serum copper
V. Serum iron
VI. Plasma bile acid level
VII. Prothrobin time
VIII. Blood ammonia level

14. Routine Liver Function Tests
Routine LFTs include:
I. Serum bilirubins
II. Serum 5’ nucleotidase
III. Serum gamma glutamyltransferase (GGT)
IV. Serum aminotransaminases (ALT , AST)
V. Serum alkaline phosphatase (ALP)
VI. Serum albumin

15. a) Serum Bilirubin's Test
 Bilirubin is the main bile pigment that is formed from the breakdown of
heme in RBCs.
 Usually, the liver cleans bilirubin out of your body.
 A bilirubin test is used to help determine the cause of jaundice, a yellowing
of your skin and the whites of your eyes which is due to high levels of
bilirubin in blood.
 It helps diagnose conditions like liver disease, hemolytic anemia, and
blocked bile ducts.

16. b) Serum 5’ Nucleotidase test
 This enzyme is released by the liver when liver is
damage due to bile duct obstruction and impaired
flow of bile.
 Serum activity of 5’ nucleotidase elevated in
obstructive jaundice.

17. c) Serum Gamma-
glutamyltransferase (GGT) test
 Membrane bounded enzyme found on
canalicular membrane of hepatocytes.
 High levels of the GGT enzyme could point to
liver or bile duct damage.

18. d) Serum Amino transaminases Test
ALT & AST
These are most useful test for detecting hepatic cell
damage.
i. Alanine aminotransferase (ALT)
ii. Aspartate transaminase (AST) test

19. (1) Alanine transaminase (ALT) test
 ALT is an enzyme that helps break down proteins and is found mainly
in liver.
 An alanine aminotransferase (ALT) test measures the amount of this
cytosolic enzyme in the blood.
 Elevated levels of ALT indicates:
• Alcoholic liver disease
• Liver cancer
• Hepatitis
• Non cancerous tumor of liver
• Use of drugs toxic to liver
• Liver Cirrhosis

20. (2) Aspartate transaminase (AST)
test
 This enzyme found in both cytoplasm and
mitochondria of liver cells.
 High blood levels could be a sign of damage or
disease.
 Elevated level of AST indicates:
 Acute hemolytic anemia
 Cirrhosis of liver
 Hepatitis

21. e)Serum Alkaline phosphatase (ALP) test
 ALP is an enzyme found in liver, bile ducts, and bones.
 High levels of ALP indicate liver damage or disease, a
blocked bile duct, or bone disease.
 ALP is hydrolase enzyme, remove phosphate from
many type of molecules include protein and
nucleotides.
 Most effective in alkaline environment.

22. e) Serum ALP test Contd.
 Elevated ALP level indicates:
 Obstructive/ post hepatic jaundice
 Cirrhosis of liver
 Hepatic tumor
 Levels are significantly higher in children
and pregnant women.

23. f) Serum Albumin Test
 Synthesized exclusively by liver.
 Good marker to asses chronic liver disease.
 Low levels can mean damage or disease.
 Hypoalbuminemia occurs in cirrhosis,
autoimmune hepatitis and alcoholic hepatitis.

27. Any Question?????