Total Bilirubin
A chemical compound that is formed during the breakdown of hemoglobin. Consists of direct and indirect fractions. It is used to assess jaundice and hepatobiliary diseases.
Normal range: 3–21 µmol/l
Indicators above normal: viral hepatitis, cirrhosis, Gilbert's syndrome, hemolysis, mechanical jaundice
Indicators below normal: no diagnostic value
Direct Bilirubin
Fraction of bilirubin bound in the liver with glucuronic acid. This form is water-soluble and excreted in bile.
Normal range: 0–5 µmol/l
Indicators above normal: cholestasis, liver tumors, hepatitis, biliary obstruction
Indicators below normal: no diagnostic value
Indirect Bilirubin
Fraction not bound in the liver. Formed during the breakdown of red blood cells.
Normal range: up to 16 µmol/l
Indicators above normal: hemolytic anemia, Gilbert's syndrome, neonatal jaundice
Indicators below normal: no diagnostic value
Alanine aminotransferase (ALT/SGPT)
An enzyme primarily localized in liver cells. The level increases with damage to liver cells. Used to diagnose viral and toxic hepatitis, fatty hepatosis and drug reactions.
Normal range: up to 40 U/l
Indicators above normal: acute or chronic hepatitis, fatty liver disease, toxic damage
Indicators below normal: possible with severe liver failure, decreased muscle mass
Aspartate aminotransferase (AST/SGOT)
Present in the liver, cardiac muscle and skeletal muscles. AST levels are assessed together with ALT to determine the source of cellular damage. The AST/ALT ratio helps to clarify the nature of the disease and suspect cirrhosis.
Normal range: up to 40 U/l
Indicators above normal: viral hepatitis, cirrhosis, myocardial infarction, alcoholic liver disease
Indicators below normal: rare, can be observed in muscular dystrophy
Alkaline phosphatase (ALP)
An enzyme whose level increases when bile outflow is impaired. Also produced in bone tissue. Together with GGT, it helps to identify intrahepatic or extrahepatic obstruction.
Normal range: 40–150 U/l
Indicators above normal: cholestasis, liver tumors, biliary obstruction, bone diseases
Indicators below normal: hypophosphatemia, hypothyroidism, zinc deficiency
Gamma Glutamyl Transferase (GGT)
An enzyme involved in amino acid metabolism. It is a sensitive marker of cholestasis and toxic liver damage. An increase in levels is often observed with alcohol abuse and long-term medication use.
Normal range:
- Men: up to 60 U/l
- Women: up to 40 U/l
Indicators above normal: alcoholism, medication, cholestasis, liver tumors
Indicators below normal: no clinic value
Total Protein
The sum of all protein fractions in the blood serum. The level reflects the synthetic function of the liver and the general state of protein metabolism.
Normal range: 64–83 g/l
Reasons for increased values: chronic inflammatory diseases, infections, myeloma
Reasons for decreased values: cirrhosis, nephrotic syndrome, exhaustion, malabsorption
Albumin
The main plasma protein, synthesized in the liver. Maintains oncotic pressure, participates in the transportation of hormones, bilirubin and drugs.
Normal range: 35–50 g/l
Reasons for increased values: dehydration
Reasons for decreased values: liver failure, chronic inflammation, nephrotic syndrome
Albumin/Globulin Ratio (A/G Ratio)
A coefficient characterizing the relative content of albumin and globulins.
Normal range: 1.2–2.2
Reasons for increased values: possible with dehydration
Reasons for decreased values: chronic liver diseases, autoimmune processes, infections
