We often encounter patients or friends who are puzzled or even worried about the elevated transaminases on the checklist and come to us for consultation. There are a lot of people who find elevated aminotransferases in medical checkups, so we would like to briefly share some knowledge about aminotransferases with you.
What is aminotransferase?
Aminotransferases are intracellular “catalysts” that are found mainly in liver cells. It comes from the cells and does the job of maintaining nutrient metabolism. After cell death or damage, transaminases are released into the bloodstream. The two most common clinical tests are alanine aminotransferase (ALT) and aspartate aminotransferase (AST).
Does aminotransferase refer to liver function?
No. The liver has many functions, mainly substance metabolism, bile secretion, detoxification, and immune defense. Aminotransferases are only an indicator of liver cell damage, and liver function will only be abnormal if the cells in the liver are damaged to a certain extent and proportion. If liver cells are extensively necrotic, there may even be a decrease in aminotransferases and deepening jaundice.
Elevated aminotransferases are directly related to the metabolic functions of the liver, including metabolism, bile secretion, and detoxification.
What does elevated aminotransferases mean?
Elevated transaminases indicate liver cell damage or death. There are many reasons behind liver cell damage or death, including viral hepatitis, fatty liver, and drug-related hepatitis.
A mild rise in aminotransferases generally does not have obvious accompanying symptoms, while a large rise in aminotransferases (several hundred) will generally result in symptoms such as loss of appetite. If it exceeds the normal range, it is recommended to check again to rule out the possibility of physiological high transaminases. If the aminotransferase level is still high and much higher than the reference value (tens or even hundreds) it is most likely due to viral hepatitis or other liver diseases.
In addition, aminotransferases are not only found in the liver, but also in the heart and muscles, and lesions in these areas may also cause an increase in aminotransferases.
Common causes of elevated aminotransferases
Fatty liver is the most common type of liver damage, including steatosis, steatohepatitis and cirrhosis. Peroxidative damage occurs during lipid metabolism, leading to steatosis, ballooning and necrosis of hepatocytes, thus becoming a fatty liver. High transaminases in obese and alcoholic people are usually caused by fatty liver.
Viral hepatitis is the most common cause of high aminotransferases, and the development of chronic hepatitis (hepatitis B and C), cirrhosis and liver cancer is almost always accompanied by high aminotransferases. Aminotransferases and viral load are two important indicators for monitoring chronic hepatitis.
A large proportion of drugs are metabolized and eliminated in the liver, and liver injury due to drugs is very common, accounting for almost 20-30% of all liver injuries. If you have no history of hepatitis, you should pay attention to whether you have recently taken any drugs that damage the liver, and if so, you must pay attention to exclude the possibility of drug-induced hepatitis first; transaminase elevation caused by drugs can generally return to normal after stopping the drugs.
Other common causes of pathological aminotransferase elevation
1, biliary tract diseases such as “gallstone” acute attack, in addition to fever, abdominal pain, nausea, vomiting, jaundice and other conditions, but also can cause high blood bilirubin and transaminases.
2, heart disease acute myocardial infarction, myocarditis, heart failure, can cause high aminotransferases.
3, certain other infectious diseases: In addition to the liver, other organ tissues in the body such as heart, kidney, lung, brain, testes and muscle also contain this enzyme. Therefore, elevated blood transaminases can be seen in patients with myocarditis, pyelonephritis, lobar pneumonia, tuberculosis, polymyositis, hyperthyroidism, acute sepsis, enteric typhoid, rheumatoid fever, malaria, leptospirosis, influenza, measles, schistosomiasis, extrusion syndrome, etc.
Physiological elevation
Aminotransferases are very sensitive and many factors can cause them to fall outside of the reference range, so an elevated aminotransferase does not necessarily mean that there is a health problem (normal values range from 0-40).
Many human behaviors and lifestyles can lead to elevated hepatocyte permeability and subsequently to abnormalities in that one test: strenuous exercise, overexertion, alcohol consumption, greasy diet, irregular work and rest, and even anger are all possible, physiologically elevated but generally not more than 2 times.
Summary
Elevated aminotransferase alone does not represent any disease, but requires a comprehensive analysis of what causes it and whether it is persistent or transient. If it is abnormal or sharply elevated, it is important to be alert.
If a physical examination reveals a rise in transaminases, you should consider whether you have recently been drinking too much alcohol, eating too much fatty food, or not controlling your fatty liver well? We need to pay attention to adjust the habits of life, adjust the habits of life after the review may return to normal.
After the review or long-term high, you should pay attention to whether you have taken any drugs that can damage your liver recently, whether viral hepatitis is under control, etc.
Elevated aminotransferases suggest the possibility of physical disease, to find out the cause also need to do combined with medical history, symptoms, further examination, clear cause