Liver function tests (LFTs) are groups of blood tests that provide information about the state of a patient's liver. These tests can be used to detect the presence of liver disease, distinguish among different types of liver disorders, gauge the extent of known liver damage, and monitor the response to treatment. These tests include albumin, bilirubin, the liver transaminases aspartate transaminase (AST or SGOT) and alanine transaminase (ALT or SGPT) are useful biomarkers of liver injury. these will vary depending on age, gender and his/her health, ethnicity, method of analysis, and units of measurement.

 Measurement of total bilirubin includes both unconjugated (indirect) and conjugated (direct) bilirubin. When the total bilirubin level exceeds 17 μmol/l, it indicates liver disease. When total bilirubin levels exceed 40 μmol/l, bilirubin deposition at the sclera, skin, and mucous membranes will give these areas a yellow colour, thus it is called jaundice.

Any kind of liver injury can cause a rise in ALT. Persistent ALT elevation more than 6 months is known as chronic hepatitis. AST is especially markedly raised in those with liver cirrhosis.

The AST/ALT ratio increases in liver functional impairment. In alcoholic liver disease, the mean ratio is 1.45, and mean ratio is 1.33 in post necrotic liver cirrhosis. Ratio is greater than 1.17 in viral cirrhosis, greater than 2.0 in alcoholic hepatitis, and 0.9 in non-alcoholic hepatitis. Ratio is greater 4.5 in Wilson disease or hyperthyroidism.

Alkaline phosphatase (ALP) is an enzyme in the cells lining the biliary ducts of the liver.Acute viral hepatitis usually has normal or increased ALP. Mild elevation of ALP can be seen in liver cirrhosis, hepatitis, and congestive cardiac failure.

GGT is a microsomal enzyme found in hepatocytes. Much like ALP, GGT measurements are usually elevated if cholestasis is present.

Albumin is a protein made specifically by the liver, and can be measured cheaply and easily. Albumin levels are decreased in chronic liver disease, such as cirrhosis. It is also decreased in nephrotic syndrome, where it is lost through the urine. Other tests are  also requested alongside LFT to rule out specific causes.

Liver damage is the most commonly observed disease, now-a-days. Archives of Clinical Pathology is actively publishing articles related to such topics of pathology and is inviting scientists to associate and publish with the journal.

With regards

Katherine Gray| Managing Editor

Archives of Clinical Pathology

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