Liver Function Test (LFT) - without GGT

Liver profile is done to check the overall health of your liver. Different parameters are often tested at the same time on a single blood sample and may include the following:

• Bilirubin total, direct and indirect
• Proteins like Albumin, globulin, A:G Ratio, serum total protein
• Various enzymes like Aspartate Aminotransferase (AST/SGOT), Alanine Aminotransferase (ALT/SGPT), alkaline phosphatase, Lactate Dehydrogenase (LDH)

Other names: LFT, Liver Panel, Liver Profile, Liver Function Profile

Liver function test is a group of blood test parameters that provide information about the state of the liver. These parameters include -

ASPARTATE AMINOTRANSFERASE: Aminotransferase (AST) is an enzyme found in various parts of the body. AST is found in the liver, heart, skeletal muscle, kidneys, brain and red blood cells, and it is commonly measured clinically as a marker for liver health.

ALANINE AMINOTRANSFERASE: Alanine aminotransferase (ALT) test measures the amount of this enzyme in the blood. ALT is found mainly in the liver, but also in smaller amounts in the kidneys, heart, muscles, and pancreas. It is commonly measured as a part of a diagnostic evaluation of hepatocellular injury, to determine liver health.

ALKALINE PHOSPHATASE: Alkaline phosphatase (ALP) is a protein found in almost all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts and bone.

LACTATE DEHYDROGENASE: SERUM LDH is an enzyme that helps in energy production. It is present in almost all of the tissues in the body and its levels rise in response to cell damage. LDH levels help to diagnose lung disease, lymphoma, anemia and liver disease. They also help determine how well chemotherapy is working.

BILIRUBIN (TOTAL, DIRECT, INDIRECT): Bilirubin is a yellowish pigment found in bile and is a breakdown product of normal heme catabolism. Bilirubin is excreted in bile and urine and elevated levels may give yellow discoloration in jaundice.

TOTAL PROTEIN, ALBUMIN, and GLOBULIN: Serum total protein, also known as total protein, is a biochemical test for measuring the total amount of protein in serum. Protein in the plasma is made up of albumin and globulin.

Why Liver Function Test(LFT)?

The Liver Function test package contains a range of tests that assess Liver health. The Liver Function test may be ordered when Liver Conditions are suspected.

Liver function tests are most commonly used to:

• Screen for liver conditions like hepatitis
• Is used to monitor treatment outcomes and prognosis
• Liver Function tests are used to monitor disease progression – examples include viral or alcoholic hepatitis
• Liver function tests can also give an indication of how severe a liver disease is and most importantly it can give an indication of the severity of scarring of the liver as seen in cirrhosis
• Monitor possible side effects of medications

Who should get tested for Liver Function Test (LFT)?

Your doctor will advise you to do Liver function Panel if he suspects any signs of liver damage. Some of the symptoms are as follows:

• Jaundice, a condition that causes your skin and eyes to turn yellow
• Nausea and vomiting
• Diarrhea
• Abdominal pain
• Dark-coloured urine
• Light-coloured stool
• Fatigue

You may also be asked to do this test if:

• You have a family history of liver disease
• Alcohol consumption is very high
• Previous infection or have signs of hepatitis infection
• Taking any treatment that may cause liver damage

 Requirement: You are required to fast (not eat or drink anything) 8-12 hours before the test.

What are the Reference Values for Liver Function Tests?

Interpretation of Liver Function test values

AST levels increase during chronic viral hepatitis, blockage of the bile duct, cirrhosis of the liver, liver cancer, kidney failure, hemolytic anemia, pancreatitis, and hemochromatosis. AST levels may also increase after a heart attack or strenuous activity.

ALT levels increase during acute hepatitis, sometimes due to a viral infection, ischemia to the liver, chronic hepatitis, obstruction of bile ducts, cirrhosis.

Elevated Alkaline Phosphatase levels are seen in biliary obstruction, Osteoblastic bone tumors, osteomalacia, hepatitis, Hyperparathyroidism, Leukemia, Lymphoma, Paget's disease, Rickets, and Sarcoidosis etc. Lower-than-normal ALP levels seen in Hypophosphatasia, Malnutrition, Protein deficiency, Wilson's disease.

A higher-than-normal level of LDH may indicate Blood flow deficiency (ischemia), Heart attack, Hemolytic anemia, Infectious mononucleosis, Liver disease (for example, hepatitis),Low blood pressure, Muscle injury, muscular dystrophy, New abnormal tissue formation usually cancer, Pancreatitis and Stroke.

Elevated levels of total bilirubin results from increased bilirubin production (eg, hemolysis and ineffective erythropoiesis), decreased bilirubin excretion (eg, obstruction and hepatitis), and abnormal bilirubin metabolism (eg, hereditary and neonatal jaundice).

Conjugated (direct) bilirubin is elevated more than unconjugated (indirect) bilirubin in viral hepatitis, drug reactions and alcoholic liver disease. Conjugated (direct) bilirubin is also elevated more than unconjugated (indirect) bilirubin when there is some kind of blockage of the bile ducts like in Gallstones getting into the bile ducts, tumors & Scarring of the bile ducts.

Increased unconjugated (indirect) bilirubin may be a result of Hemolytic or pernicious anemia, Transfusion reaction & a common metabolic condition termed Gilbert syndrome, due to low levels of the enzyme that attaches sugar molecules to bilirubin.

Higher-than-normal Total Protein levels may be due to: Chronic inflammation or infection, including HIV and Hepatitis B or C, Multiple myeloma, Waldenstrom's disease.

Lower-than-normal levels of Total Proteins may be due to: Agammaglobulinemia, Bleeding (hemorrhage), Burns, Glomerulonephritis, Liver disease, Malabsorption, Malnutrition, Nephrotic syndrome, Protein-losing enteropathy etc.

Human serum albumin is the most abundant protein in human blood plasma. It is produced in the liver. Albumin constitutes about half of the blood serum protein. Low blood albumin levels (hypoalbuminemia) can be caused by: Liver disease like cirrhosis of the liver, nephrotic syndrome, protein-losing enteropathy, Burns, hemodilution, increased vascular permeability or decreased lymphatic clearance, malnutrition and wasting etc.