Reading And Interpreting Your Liver Function Test - A Guide To Commonly Used Liver Tests
The liver is a vital organ responsible for numerous metabolic functions in the body, including detoxification, protein synthesis, and bile production. Monitoring liver health is crucial for early detection and management of liver diseases. One of the primary tools for assessing liver function is the Liver Function Test (LFT). In this guide, we will delve into the commonly used liver tests, how to interpret the results, and what they indicate about your liver health.
Understanding Liver Function Tests
Liver Function Tests (LFTs) are a group of blood tests that provide valuable insights into the health and function of the liver. These tests measure various enzymes, proteins, and substances in the blood that are indicative of liver health.
Key components of Liver Function Tests
Alanine Aminotransferase (ALT): Elevated levels suggest liver damage, commonly caused by conditions like hepatitis or fatty liver disease.
Aspartate Aminotransferase (AST): Similar to ALT, elevated AST levels indicate liver damage but may also be elevated in conditions affecting the heart or muscles.
Alkaline Phosphatase (ALP): Elevated ALP levels may suggest liver or bone disease.
Total Bilirubin: Increased levels may indicate liver dysfunction or obstruction of bile ducts.
Albumin and Total Protein: These are measures of liver synthetic function; decreased levels may suggest liver disease.
What are the causes of abnormal liver function test results?
Causes of abnormal liver function test results can vary and may indicate different underlying conditions. Some common causes include:
1. Build-up of Fat in the Liver:
* Non-alcoholic fatty liver disease (NAFLD) can lead to abnormal liver function tests, especially in overweight or obese individuals.
2. Liver Inflammation and Damage:
* Infections, toxic substances like alcohol or certain medications, and immune conditions can cause liver inflammation and subsequent abnormal test results.
3. Liver Overworking:
* When the liver is under stress from processing medicines or toxic substances like alcohol or paracetamol, it can result in abnormal liver function tests.
4. Bile Duct Blockage:
* Blockages in the bile ducts, such as by gallstones, can lead to abnormal liver function test results.
5. Liver Conditions and Diseases:
* Underlying conditions like Wilson's disease, haemochromatosis, or Gilbert's syndrome can affect liver function and result in abnormal test values.
6. Liver Injury:
* Physical injury to the liver, trauma, or presence of abscesses or tumors within the liver can cause abnormal liver function tests.
7. Medications and Supplements:
* Certain medications, over-the-counter drugs, herbal remedies, and traditional medicines can also impact liver function test results.
8. Other Factors:
* Factors like high alcohol intake, viral infections, autoimmune conditions, metabolic liver diseases, heart problems, and tumors in the liver can contribute to abnormal liver function tests.
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Definitions – Nonalcoholic fatty liver disease (NAFLD) refers to the presence of hepatic steatosis when no other causes for secondary hepatic fat accumulation (eg, heavy alcohol consumption (figure 1)) are present. NAFLD may progress to cirrhosis and is likely an important cause of cryptogenic cirrhosis. (See 'Definitions' above.)
NAFLD is subdivided into nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). In NAFL, hepatic steatosis is present without evidence of significant inflammation, whereas in NASH, hepatic steatosis is associated with hepatic inflammation that may be histologically indistinguishable from alcohol-associated steatohepatitis.
●Clinical manifestations – Most patients with NAFLD are asymptomatic, although some patients with NASH may complain of fatigue, malaise, and vague right upper abdominal discomfort. Patients are more likely to come to attention because laboratory testing revealed elevated liver aminotransferases or hepatic steatosis was detected incidentally on abdominal imaging. (See 'Clinical manifestations' above.)
Patients with NAFLD may have mild or moderate elevations in the aspartate aminotransferase and alanine aminotransferase, although normal aminotransferase levels do not exclude NAFLD. (See 'Laboratory findings' above.)
Radiographic findings in patients with NAFLD include increased echogenicity on ultrasound, decreased hepatic attenuation on computed tomography, or an increased fat signal on magnetic resonance imaging. (See 'Radiographic findings' above.)
●Diagnosis – A definitive diagnosis of NAFLD requires all of the following (see 'Diagnosis' above):
•Demonstration of hepatic steatosis by imaging or biopsy
•Exclusion of significant alcohol consumption
•Exclusion of other causes of hepatic steatosis
•Absence of coexisting chronic liver disease
Radiologic findings are often sufficient to make a diagnosis of NAFLD, provided other causes of hepatic steatosis have been excluded. However, liver biopsy may be indicated if the diagnosis is not clear or to assess the degree of hepatic injury. (See 'Radiographic examinations' above and 'Role of liver biopsy' above.)
●Differential diagnosis – Other causes of hepatic steatosis include (see 'Differential diagnosis' above):
•Significant alcohol use
•Hepatitis C (particularly genotype 3)
•Wilson disease
•Lipodystrophy
•Starvation
•Parenteral nutrition
•Abetalipoproteinemia
•Medications
•Reye syndrome
•Acute fatty liver of pregnancy
•HELLP (hemolytic anemia, elevated liver enzymes, low platelet count) syndrome
•Inborn errors of metabolism
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Liver Function Test: A Detailed Guide for Accurate Reports and Health Awareness
Unlock insights into liver health with our comprehensive guide on liver function tests. Learn about their importance, common tests, result interpretation, and debunked myths. Discover why Dr. Vaidya’s Laboratory in Borivali offers the best, hassle-free liver function tests with free home blood sample collection services. Prioritize your well-being today!
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