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sgot and sgpt
The document discusses the clinical significance of enzymes in diagnosing and monitoring various diseases, particularly focusing on liver enzymes such as ALT and AST. Elevated levels of these enzymes can indicate liver damage, myocardial infarction, and other conditions, with specific enzyme levels helping to differentiate between various diseases. The document also highlights the normal ranges for these enzymes and their relevance in medical assessments.
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sgot and sgpt
- 1. CLINICAL SIGNIFICANCE OF ENZYMES SHELVYS. 2011-09-123 KERALA AGRICULTURAL UNIVERSITY
- 2. GOALS • Helps inmaking the diagnosis/differential diagnosis/ early • Detection of a disease • Helps in ascertaining prognosis of a disease • Helps in ascertaining the response to drugs in a disease • Also help in ascertaining the time course of disease.
- 3. WHERE Helpful in the diagnosis of MyocardialInfarction Liver Diseases GI Tract Diseases Muscle Diseases Bone Disesases Cancer
- 4. DIAGNOSTIC ENZYME Tissue damageor necrosis resulting from injury or disease is generally accompanied by increases in the levels of several nonfunctional plasma enzymes.
- 5. Enzymes routinely measured NAMEOF THE ENZYME PRESENT IN Aspartate Amino transferase (AST) Serum glutamate-oxaloacetate transaminase (SGOT) Heart and Liver Alanine Amino transferase (ALT) Serum glutamate-pyruvate transaminase (SGPT) Heart and Liver Alkaline Phosphatase (ALP) Bone, intestine and other tissues Acid Phosphatase (ACP) Prostate glutamyl Transferase ( GT) Liver Creatine kinase (CK) Muscle Including cardiac muscle Lactate Dehydrogenase (LDH) Heart, liver, muscle, RBC Amylase Pancreas
- 6.
- 7. ALT or sGPT(Serum Glutamate Pyruvate Transaminase) ALT GPT (ALT) catalyses the transfer of amino-groups from alanine to 2-oxoglutarate and thus the formation of glutamate and pyruvate. Alanine Transaminase
- 8. ALT is anenzyme produced in hepatocytes and is highly concentrated in the liver. organ GOT GPT heart 156000 7100 liver 142000 44000 skeletal 99000 4800 kidney 91000 19000 organ GOT GPT pancrease spleen lung serum 28000 2000 14000 1200 10000 700 20 16
- 9. GPT (ALT) iswidely distributed in cells throughout the body. GPT (ALT) is found predominantly in the cytoplasm and is widely considered to be specifically for the liver. In addition, it is also active in the heart, skeletal muscle, pancreas, and the kidney. GPT (ALT) activity in the liver is about 3,000 times higher than its activity in the serum. Only if cells are damaged GPT (ALT) will be excreted into the blood. In the plasma, GPT (ALT) has no biological function because the necessary substrates and co-substrates are lacking there. Source & biological action
- 10. Elevated levels ofALT may indicate : Alcoholic liver disease Cancer of the liver Cholestasis or congestion of the bile ducts Cirrhosis or scarring of the liver with loss of function Death of liver tissue Hepatitis or inflammation of the liver Noncancerous tumor of the liver Use of medicines or drugs toxic to the liver Therefore, when the liver is injured, ALT is released into the bloodstream.
- 11. • Normal level:- 0-41 IU/L. • The Aminotransferases are normally present in the serum in low concentrations. These enzymes are released into the blood in greater amounts when there is damage to the liver cell membrane resulting in increased permeability. • Levels of up to 300 U/L are nonspecific and may be found in any type of liver disorder. • Striking elevations i.e., aminotransferases > 1000 IU/L occur almost exclusively in disorders associated with extensive hepatocellular injury such as – viral hepatitis – Ischemic liver injury (prolonged hypotension), • In most acute hepatocellular disorders, the ALT is higher than or equal to the AST.
- 12. AST or sGOT(Serum Glutamate Oxaloacetate Transaminase) AST Aspartate aminotransferase (AST)
- 13. organ GOT GPT heart156000 7100 liver 142000 44000 skeletal 99000 4800 kidney 91000 19000 organ GOT GPT pancrease spleen lung serum 28000 2000 14000 1200 10000 700 20 16 Both these enzyme are found in most tissues, but the relative amounts vary. heart muscles are richer in AST, whereas liver contains both but more of ALT. Aspartate aminotransferase (AST)
- 14. • AST alsoreflects damage to the hepatic cells and is less specific for liver disease. It can also be released with heart, muscle and brain disorders. • Therefore, this test may be ordered to help diagnose various heart, muscle or brain disorders, such as a myocardial infarct (heart attack).
- 15. Elevated levels ofAST may indicate: Acute hemolytic anemia, Acute pancreatitis or inflammation of the pancreas. Acute renal failure or loss of kidney function. Cirrhosis of the liver. Hepatitis Heart attack Primary muscle disease Recent surgery Severe burns Muscle injury
- 16. The levelis significantly elevated in Acute MI. Normal Value:- 0-41 IU/L at 37°C In acute MI- Serum activity rises sharply within the first 12 hours, with a peak level at 24 hours or over and returns to normal within 3-5 days. The rise depends on the extent of infarction.
- 17. Levels> 350IU/L are due to massive infarction (Fatal), > 150 IU/L are associated with high mortality and levels, < 50 IU/L are associated with low mortality. Other diseases- The rise in activity is also observed in muscle and hepatic diseases. These can be well differentiated from simultaneous estimations of other enzyme activities like SGPT etc, which do not show and rise in activity in Acute MI.
- 18. In infectious hepatitisand other inflammatory conditions affecting the liver, ALT is characteristically as high as or higher than AST, and the ALT/AST (De Ritis) ratio becomes greater than unity, >1.5. sALT/sAST (De Ritis) ratio, normally is less than 1, about 0.7~0.9. Ratios between ALT and AST are useful to physicians in assessing the etiology of liver enzyme abnormalities.
- 19. 19 Serum enzymes inliver diseases:- In viral hepatitis:- Rapid rise in transaminases (AST & ALT) in serum occurs even before bilirubin rise is seen
- 20. LEVELS OF ENZYMESIN MYOCARDIAL INFARCTION CK-MB CK AST LDH HBDH AST and CK rise in 6 hours following acute myocardial infarction HBDH and LDH are elevated much later and remains high for a longer period of days
Editor's Notes
- #5 1. Yalow and Berson refused to patent the assay, because they felt that it should be freely available to the field of medicine
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