What are liver values?
Liver values are a group of different laboratory parameters that provide indications of liver diseases. They can be divided into:
- Laboratory values that indicate liver cell damage
- Laboratory parameters that indicate bile stasis
- Laboratory parameters that indicate a synthesis disorder of the liver
To measure the liver values, the doctor will take blood from the patient and have it analyzed in the laboratory.
Laboratory values: Liver damage
The liver cells, the hepatocytes, contain various enzymes that carry out their metabolic tasks. If a liver cell is damaged and destroyed, these liver enzymes are released, enter the blood and can be detected there.
Another enzyme that enters the blood from destroyed liver cells is glutamate dehydrogenase (GLDH), which is also part of the amino acid metabolism.
Laboratory values: Bile stasis
A build-up of bile fluid (cholestasis) can occur as a result of various liver diseases, for example liver cirrhosis or congestive liver failure. In addition to typical symptoms such as itching and jaundice, cholestasis also causes a change in various liver values. Laboratory tests focus in particular on the following values:
- g-glutamyltransferase
- Alkaline phosphatase (AP)
- Direct and indirect bilirubin
Laboratory values: synthesis disorder of the liver
When are liver values determined?
The doctor determines the liver values primarily if liver disease is suspected. This is the case, for example, if you have the following symptoms
- Right-sided upper abdominal pain or a feeling of fullness
- Tiredness, reduced performance
- itching
- Jaundice of the skin or conjunctiva
- Increase in abdominal circumference with liver enlargement
- Liver skin signs such as dilated superficial veins around the navel (caput medusae), white nails or fine, spider or star-like, red vascular dilatations (spider nevi)
Even with a known liver disease, the liver values must be determined regularly during the course of the disease in order to assess the success of a therapy or to detect any progression of the disease.
Which liver values are dangerous?
The normal values for AST (GOT), ALT (GPT) and GLDH can be found in the following table of liver values (reference values for measurement at 37°C):
|
Laboratory value |
men |
Women |
|
AST (GOT) |
10 to 50 U/l |
10 to 35 U/l |
|
ALT (GPT) |
10 to 50 U/l |
10 to 35 U/l |
|
Glutamate dehydrogenase (GLDH) |
up to 7.0 U/l |
up to 5.0 U/l |
The following reference values apply for gamma-GT (measurement at 37°C):
|
age |
Gamma-GT normal value |
|
Premature babies |
up to 292 U/l |
|
1 day |
up to 171 U/l |
|
2 to 5 days |
up to 210 U/l |
|
6 days to 6 months |
up to 231 U/l |
|
7 to 12 months of life |
up to 39 U/l |
|
1 to 3 years |
up to 20 U/l |
|
4 to 6 years |
up to 26 U/l |
|
7 to 12 years |
up to 19 U/l |
|
13 to 17 years |
up to 38 U/l for women up to 52 U/l for men |
|
adults |
up to 39 U/l for women up to 66 U/l for men |
The following reference values apply for alkaline phosphatase (AP) (measurement at 37°C):
|
AP normal value |
|
|
up to 1 day |
< 250 U/l |
|
2 to 5 days |
< 231 U/l |
|
6 days to 6 months |
< 449 U/l |
|
7 to 12 months |
< 462 U/l |
|
1 to 3 years |
< 281 U/l |
|
4 to 6 years |
< 269 U/l |
|
7 to 12 years |
< 300 U/l |
|
13 to 17 years |
< 187 U/l for women < 390 U/l for men |
|
over 18 years |
35 – 104 U/l for women 40 – 129 U/l for men |
The following reference values apply for total bilirubin:
|
age |
Total bilirubin: Norm |
|
1st day |
< 4.0 mg/dl |
|
2nd day |
< 9.0 mg/dl |
|
3rd – 5th day |
< 13.5 mg/dl |
|
adults |
< 1.1 mg/dl |
Direct bilirubin is normally up to 0.25 mg/dl. The normal range for indirect bilirubin is 0.2 to 0.8 mg/dl.
When are the liver values low?
When are the liver values elevated?
The increase in blood count liver values occurs in different ways. For example, ALT, AST and GLDH are caused by liver cell damage, as occurs in acute viral hepatitis or fungal poisoning. The liver values g-glutamyltransferase (gamma-GT), alkaline phosphatase (AP) and bilirubin, on the other hand, are elevated in a variety of diseases that cause bile stasis (such as gallstones, liver tumors, liver cirrhosis, etc.). An increase in alkaline phosphatase and bilirubin can also indicate diseases that do not affect the liver or gall bladder. For example, certain forms of anemia increase the bilirubin value.
Elevated liver values
What to do if liver values change?
If liver values are slightly elevated in the blood test, this is not necessarily a cause for concern. However, if one value is significantly elevated or several liver values are elevated, the doctor must clarify an underlying disease. This applies in particular if the GPT is also elevated in addition to the gamma-GT.
