AST, ALT, GGT, ALP in the daily practice 49

General Medicine,2023, 25(1), 49-54.

L. Kirov

Medical Faculty, Sofia University “Sv. Kliment Ohridski”

Abstract. Some of the liver tests most oftenly used in daily clinical practice, together or separately, are serum AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyl transferase), followed by bilirubin, and ALP (alkaline phosphatase). Often, not quite precisely, they are called “indicators of liver function”, although except for bilirubin, they primarily indicate damage, necrosis of hepatocytes or cholestasis, as a rule, but do not reflect disturbance of liver function. They are an extremely important „first step“, by which the presence of a problem is initially detected (presented with minimal or no symptoms and signs), the circle of clinical hypotheses in the diagnostic process narrows, and in some cases even final diagnosis is established based on them. This makes the knowledge, understanding, clinically tailored use and interpretation of these liver tests particularly important in the daily practice of every physician. In this paper, AST, ALT, GGT and ALP, which point primarily to damage, necrosis of hepatocytes or cholestasis, and also a convenient and quick way to interpret them are briefly presented.

Key words: transaminases, alkaline phosphatase, liver tests

Address for correspondence: Assoc. Prof. Lyubomir Kirov, MD, PhD, e-mail: kirov.lyubomir@gmail.com; lkirov@uni-sofia.bg