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Comprehensive Guide to Liver Function Tests

Liver function tests (LFTs) measure synthetic function, hepatocyte injury, and cholestasis to detect and monitor liver disease. Synthetic function tests include albumin and coagulation markers. Hepatocyte injury tests are AST and ALT, which detect liver cell damage. Cholestasis markers like bilirubin, ALP, and GGT indicate impaired bile flow. LFTs are sensitive screening tools but sometimes lack specificity. Abnormal results can be caused by liver diseases, medications, or chronic alcohol use. LFTs help distinguish liver disorder types and assess treatment response and prognosis.

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117 views28 pages

Comprehensive Guide to Liver Function Tests

Liver function tests (LFTs) measure synthetic function, hepatocyte injury, and cholestasis to detect and monitor liver disease. Synthetic function tests include albumin and coagulation markers. Hepatocyte injury tests are AST and ALT, which detect liver cell damage. Cholestasis markers like bilirubin, ALP, and GGT indicate impaired bile flow. LFTs are sensitive screening tools but sometimes lack specificity. Abnormal results can be caused by liver diseases, medications, or chronic alcohol use. LFTs help distinguish liver disorder types and assess treatment response and prognosis.

Uploaded by

Nihal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd

LIVER FUNCTION TESTS

Significance of LFT

• Detect the presence of liver disease,


• Distinguish among different types of liver
disorders,
• Measure the extent of known liver damage
• Follow the response to treatment.
• To follow the prognosis.
Types of LFT

– Synthetic function: Albumin, Coagulation panel


(prothrombin time or PT, and international
normalized ratio or INR)
– Hepatocyte injury :AST, ALT

– Cholestasis :Bilirubin, ALP, GGT


Advantages of LFT

• Sensitive, noninvasive method sof screening


liver dysfunction
• Pattern of laboratory test abnormalities to
recognize type of liver disorder
• Assess severity of liver dysfunction
• Follow cause of liver disease
Disadvantages of LFT

• Lack sensitivity—in some cases normal results


in serious liver disease
• Not always specific for liver dysfunction
• Seldom lead to specific diagnosis
Reasons for Abnormal LFT

• Diseases
• Chronic alcohol intake
• Some medications
Serum
Synthetic Liver Function Tests

• Albumin
• Coagulation panel –PT and INR
Assay for Serum Albumin
Assay for PT and INR
Hepatocyte Injury

• AST--SGOT
• ALT--SGPT
SGPT Assay

SGPT
• L-Alanine + 2-Oxoglutarate --------→ Pyruvate + L-
Glutamate
LDH
• Pyruvate + NADH + H+--------→ L-Lactate + NAD+
Reagents Test Blank Standards
Added

Enzyme 1 ml 1 ml 1 ml
Reagent

Serum 0.1 ml - -

Standard - - 0.1 ml

Water - 0.1 ml -
Calibration Curve
SGOT Assay
Working Table

Reagents Blank Standard Sample


Added
Substrate 0.5 ml 0.5 ml 0.5 ml
(Aspertrate &
α - Keto gluterate)
DNPH 0.5 ml 0.5 ml 0.5 ml

NaOH 5 ml 5 ml 5 ml

Water 0.1 ml - -

Satndard - 0.1 ml -

Serum ( sample) - - 0.1 ml


Calibration Curve
Cholestasis

• Bilirubin
• ALP
• GGT
Assay of Bilirubin

 Direct bilirubin (conjugated)


+
diazotized sulfanilic acid- > azobilirubin (blue at alkaline pH)

 Total bilirubin (conjugated +unconjugated)


+
caffeine-benzoate-acetate mixture + diazotized sulfanilic
acid ------→ azobilirubin (blue at alkaline pH)
Working Table
Reagents Blank Standards Serum
Added
Caffeine Reagent 1 ml 1 ml 1 ml

Diazo Reagent 0.5 ml 0.5 ml 0.5 ml

Cysteine Reagent 0.1 ml 0.1 ml 0.1 ml

Alkaline Tartrate 1.5 ml 1.5 ml 1.5 ml

Water 1 ml

Standard Bilirubin - 1 ml -

Serum - - 1 ml
Calculation—Calibration Curve
Assay of ALP

p-Nitrophenyl phosphate → p-nitrophenol +


phosphate
Calibration Curve
Assay of GGT

GGT
g-glutamyl-p-ntiroanilide-------→ pNA
Other LFTs

• Lactate Dehydrogenase
• 5' Nucleotidase (5'NTD)
• Serum glucose
• Platelet count

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