The document provides an overview of liver function tests (LFTs), which are blood tests used to diagnose and monitor liver disease by measuring enzyme and protein levels. Key enzymes discussed include alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), total protein, albumin, globulin, bilirubin, and gamma-glutamyl transpeptidase (GGT), each with specific functions and implications for liver health. It emphasizes the liver's crucial roles in processing nutrients, regulating blood chemistry, and detoxifying the body.

1. Liver Function Test(LFT)
By: Shahid Nawaz

7. Functions
 The liver is a reddish brown wedge-
shaped organ with four lobes of unequal
size and shape.
 A human liver normally weighs
1.44–1.66 kg (3.2–3.7 lb).

8.  It’s important to remember that diagnosis of liver
disease depends on a combination of patient history,
physical examination, laboratory testing, biopsy and
sometimes imaging studies such as ultrasound scans.
What are liver function tests?

9.  Liver function tests are blood tests used to help
diagnose and monitor liver disease or damage.
 The tests measure the levels of certain enzymes
and proteins in our blood.
 Some of these tests measure how well the liver
is performing its normal functions of producing
protein and clearing bilirubin, a blood waste
product.
Definition

10.  The Role of the Liver is to keep the Body’s Complex Internal Chemistry
in balance.
 It takes Raw Nutrients From Our Digestive System
 In the form of carbohydrates, protein, amino acids
 Processes them so they can be stored and sent to different parts of
our body in the right form and quantity.
 Liver regulates the level of sugars in our blood and
manufactures bile (which breaks down fats in our stomach).
 It also helps to remove Toxins, Drugs and Hormones from our
Bloodstream.
 This brief explanation does the liver little justice - it actually carries out
over 1,500 complex biochemical functions.
Role of The Liver

11.  Liver function tests can be used to:
 Screen for liver infections, such as hepatitis
 Monitor the progression of a disease, such as viral or
alcoholic hepatitis, and determine how well a
treatment is working
 Measure the severity of a disease, particularly
scarring of the liver (cirrhosis)
 Monitor possible side effects of medications
Why it's done

12.  ALT is an enzyme made by cells in the liver.
 The liver is the body’s largest gland. It has
several important functions, including:
 making proteins
 storing vitamins and iron
 removing toxins from the blood
 producing bile, which aids in digestion
Alanine transaminase (ALT)

13.  ALT Is an enzyme produced in hepatocytes (the major type
of liver cells).
 ALT level in the blood is increased when hepatocytes are
damaged or die - all types of hepatitis (viral, alcoholic, drug
induced etc) cause hepatocyte damage.
 Levels of ALT may equate to the degree of cell damage
but this is not always the case, particularly with hepatitis C.
 An accurate estimate of liver cell damage can only be made
by liver biopsy.
Alanine transaminase (ALT)

14.  Relatively low concentrations in other tissues so more
specific than AST .
 Levels fluctuate during the day Rise may occur with
the use of certain drugs or during periods of
strenuous exercise.
Alanine Transaminase (ALT)

15.  The ALT test is usually used to determine
whether someone has liver injury or failure.
symptoms of liver disease, including:
 jaundice, which is yellowing of the eyes or skin
 dark urine
 nausea
 vomiting
 right upper quadrant abdominal pain
Alanine transaminase (ALT)

16.  Proteins called enzymes help the liver break
down proteins so the body can absorb them
more easily. ALT is one of these enzymes.
 It plays a crucial role in metabolism, the process
that turns food into energy.
 ALT is normally found inside liver cells.
 when the liver is damaged or inflamed, ALT can
be released into your bloodstream. This causes
serum ALT levels to rise.
 Normal Values : 7 to 55 (U/L)
Alanine transaminase (ALT)

17.  AST is an enzyme found in various parts of the
body.
 The highest concentrations are found in muscle,
heart, and liver.
 A small amount of AST is typically found in the
bloodstream.
 Elevated amounts of this enzyme may signal a
health problem.
Aspartate aminotransferase (AST)

18. Symptoms
weakness
loss of appetite
nausea or vomiting
swelling in the abdomen
yellow skin or eyes (jaundice)
dark urine
severe skin itching
Aspartate Transaminase (AST)

19.  AST Is similar to ALT , but less specific for liver disease
because it is also produced in body muscle cells. It
does tend to be higher than ALT in cases of alcohol-
related liver disease.
Aspartate Transaminase (AST)

20. • Occurs in two Isoenzyme, indistinguishable on standard
AST assays.
• The mitochondrial Isoenzyme is produced in hepatocytes
and reacts to membrane stresses in a similar way to ALT.
• The cytosolic Isoenzyme is present in skeletal muscle, heart
muscle and kidney tissue.
• Caution must be exercised in its use to evaluate
hepatocellular damage.
• Usually rises in conjunction with ALT to indicate
hepatocellular injury: a Hepatitic picture.
Aspartate Transaminase (AST)

21.  This test may also be ordered for people at high
risk of developing liver problems.
 exposure to viruses that cause hepatitis
 heavy alcohol use
 family history of liver disease
 diabetes
 being overweight
 Normal Values: 8 to 48 U/L
Aspartate Transaminase (AST)

22.  Alkaline phosphatase is an enzyme found in our
bloodstream.
 ALP helps break down proteins in the body and
exists in different forms, depending on where it
originates.
 It is mostly produced in our liver, but some is also
made in our bones, intestines, and kidneys.
Alkaline phosphatase (ALP).

23.  ALK Phosphatase Refers to Alkaline Phosphatase, a
family of enzymes produced in the bile ducts,
intestine, kidneys, placenta and bones. These levels
may rise when disease of the bile ducts or bone
disorders occur.
ALK Phosphatase

24. • A group of Isoenzyme that act to dephosphorylate a
variety of molecules throughout the body.
• Produced in the membranes of cells lining bile ducts and
canaliculi.
• Released in response to the accumulation of bile salts or
cholestasis.
• Non-hepatic production in the kidney, intestine,
leukocytes, placenta and bone.
• Physiological rise in pregnancy or in growing children.
• Pathological rise in Paget’s disease, renal disease and with
bone metastases.
ALK Phosphatase

25.  Higher levels of ALP may indicate liver damage
or disease, such as a blocked bile duct, or certain
bone diseases.
 Abnormal levels of ALP also indicate
malnutrition, kidney tumors, or a serious
infection.
 The normal range of ALP varies from person to
person and depends on your age, blood type,
gender.
 Normal Values: 45 to 115 U/L
ALK Phosphatase

26.  Proteins are important building blocks of all cells
and tissues.
 Proteins are necessary for our body’s growth,
development, and health.
 Total Protein contains albumin and globulin.
Albumin proteins keep fluid from leaking out of
your blood vessels.
Globulin proteins play an important role in our
immune system.
Total Protein

27. Low total protein may indicate:
 bleeding
 liver disorder
 kidney disorder, such as a nephrotic disorder or
glomerulonephritis
 malnutrition
 extensive burns
 inflammatory conditions
 delayed post-surgery recovery
Total Protein

28.  Elevated total protein may indicate:
 inflammation or infections, such as viral hepatitis
B or C, or HIV
 bone marrow disorders, such as multiple
myeloma disease
 Normal Values
Total Protein: 6.3 to 7.9 g/dL
Total Protein

29.  Albumin Provides a gauge of nutritional status. Can
be reduced due to liver damage and kidney disease.
Because albumin is made in the liver, levels tend to
drop with cirrhosis.
Albumin

30.  Globulin Describes the specific level of globulins -
which include antibodies.
 This measure can be raised when liver cells are
damaged due to autoimmune liver damage or to long-
standing liver disease of many types, particularly
when cirrhosis exists.
Globulin

31.  Bilirubin is a substance produced during the
normal breakdown of red blood cells.
 Bilirubin passes through the liver and is excreted
in stool.
 Elevated levels of bilirubin (jaundice) might
indicate liver damage or disease or certain types
of anemia.
Bilirubin

32.  In an adult, high bilirubin may be due to
problems with the liver, bile ducts, or
gallbladder. Examples include:
 drug toxicity
 liver diseases like hepatitis
 cirrhosis (scarring of the liver)
 cancer of the gallbladder or pancreas
 Gallstones
 Normal Values : 0.1 to 1.2 mg/dL
Bilirubin

33.  GGT test measures the amount of the enzyme
GGT in our blood.
 Enzymes are molecules that are necessary for
chemical reactions in our body.
 GGT functions in the body as a transport
molecule, helping to move other molecules
around the body.
 It plays a significant role in helping the liver
metabolize drugs and other toxins.
gamma-Glutamyl transpeptidase (GGT)

34.  GGT is concentrated in the liver.
 it’s also present in the gallbladder, spleen,
pancreas, and kidneys.
 GGT blood levels are usually high when the liver
is damaged.
gamma-Glutamyl transpeptidase (GGT)

35. The symptoms of liver problems include:
 decreased appetite
 vomiting or nausea
 lack of energy
 abdominal pain
 jaundice, which is a yellowing of the skin
 unusually dark urine
 light-colored feces
 itchy skin
 Normal Values : 9 to 48 U/L
gamma-Glutamyl transpeptidase (GGT)

36. Normal Values & Changes

38. Thank You