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<title>Liver function tests</title>

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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Liver function tests</span></span>

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</style><div role="note" class="hatnote navigation-not-searchable">"LFTs" redirects here. For other uses, see <a href="LFT_(disambiguation)" class="mw-redirect mw-disambig" title="LFT (disambiguation)">LFT</a>.</div>

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</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Liver function tests</th></tr><tr><th scope="row" class="infobox-label"><a href="ICD-10_Procedure_Coding_System" title="ICD-10 Procedure Coding System">ICD-10-PCS</a></th><td class="infobox-data">K-70 to K-77</td></tr><tr><th scope="row" class="infobox-label"><a href="ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">ICD-9-CM</a></th><td class="infobox-data">570–573</td></tr><tr><th scope="row" class="infobox-label"><a href="Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D008111">D008111</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span class="reflink nourlexpansion"><a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/003436.htm">003436</a></span></td></tr></tbody></table>

<p><b>Liver function tests</b> (<b>LFTs</b> or <b>LFs</b>), also referred to as a hepatic panel or liver panel, are groups of blood tests that provide information about the state of a patient's <a href="Liver" title="Liver">liver</a>.<sup id="cite_ref-Lee2009_1-0" class="reference"><a href="#cite_note-Lee2009-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> These tests include <a href="Prothrombin_time" title="Prothrombin time">prothrombin time</a> (PT/INR), <a href="Activated_Partial_Thromboplastin_Time" class="mw-redirect" title="Activated Partial Thromboplastin Time">activated partial thromboplastin time</a> (aPTT), <a href="Albumin" title="Albumin">albumin</a>, <a href="Bilirubin" title="Bilirubin">bilirubin</a> (direct and indirect), and others. The liver transaminases <a href="Aspartate_transaminase" title="Aspartate transaminase">aspartate transaminase (AST or SGOT)</a> and <a href="Alanine_transaminase" title="Alanine transaminase">alanine transaminase (ALT or SGPT)</a> are useful biomarkers of liver injury in a patient with some degree of intact liver function.<sup id="cite_ref-pmid10221307_2-0" class="reference"><a href="#cite_note-pmid10221307-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-McClatchey2002_3-0" class="reference"><a href="#cite_note-McClatchey2002-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-MengelSchwiebert2005_4-0" class="reference"><a href="#cite_note-MengelSchwiebert2005-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>

</p><p>Most <a href="Liver_disease" title="Liver disease">liver diseases</a> cause only mild symptoms initially, but these diseases must be detected early. Hepatic (liver) involvement in some diseases can be of crucial importance. This testing is performed on a patient's blood sample. Some tests are associated with functionality (e.g., albumin), some with cellular integrity (e.g., <a href="Transaminase" title="Transaminase">transaminase</a>), and some with conditions linked to the biliary tract (<a href="Gamma-glutamyl_transferase" class="mw-redirect" title="Gamma-glutamyl transferase">gamma-glutamyl transferase</a> and <a href="Alkaline_phosphatase" title="Alkaline phosphatase">alkaline phosphatase</a>). Because some of these tests do not measure function, it is more accurate to call these liver chemistries or liver tests rather than liver function tests.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup>

</p><p>Several biochemical tests are useful in the evaluation and management of patients with hepatic dysfunction. These tests can be used to detect the presence of liver disease. They can help distinguish among different types of liver disorders, gauge the extent of known liver damage, and monitor the response to treatment. Some or all of these measurements are also carried out (usually about twice a year for routine cases) on individuals taking certain medications, such as anticonvulsants, to ensure that these medications are not adversely impacting the person's liver.

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<div class="mw-heading mw-heading2"><h2 id="Standard_liver_panel">Standard liver panel</h2></div>

<p>Standard liver tests for assessing liver damage include alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP). Bilirubin may be used to estimate the excretory function of the liver and coagulation tests and albumin can be used to evaluate the metabolic activity of the liver.<sup id="cite_ref-Shivaraj_2009_6-0" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>Although example reference ranges are given, these will vary depending on method of analysis used at the administering laboratory, as well as age, gender, ethnicity, and potentially unrelated health factors. Individual results should always be interpreted using the reference range provided by the laboratory that performed the test.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading3"><h3 id="Total_bilirubin">Total bilirubin</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Bilirubin" title="Bilirubin">Bilirubin</a></div>

<caption>Reference range in adults

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<th>Parameters/units

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<th>Total bilirubin

</th>

<th>Unconjugated bilirubin

</th>

<th>Conjugated bilirubin

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<th>mg/dL

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<th>μmol/L

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<p>Measurement of total <a href="Bilirubin" title="Bilirubin">bilirubin</a> includes both unconjugated (indirect) and conjugated (direct) bilirubin. Unconjugated bilirubin is a breakdown product of <a href="Heme" title="Heme">heme</a> (a part of <a href="Hemoglobin" title="Hemoglobin">hemoglobin</a> in red blood cells). The liver is responsible for clearing the blood of unconjugated bilirubin, by 'conjugating' it (modified to make it water-soluble) through an enzyme named <a href="UDP-glucuronyl-transferase" class="mw-redirect" title="UDP-glucuronyl-transferase">UDP-glucuronyl-transferase</a>. 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 <a href="Jaundice" title="Jaundice">jaundice</a>.<sup id="cite_ref-Shivaraj_2009_6-4" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>The increase in predominantly unconjugated bilirubin is due to overproduction, reduced hepatic uptake of the unconjugated bilirubin and reduced conjugation of bilirubin. Overproduction can be due to the reabsorption of a <a href="Haematoma" class="mw-redirect" title="Haematoma">haematoma</a> and ineffective <a href="Erythropoiesis" title="Erythropoiesis">erythropoiesis</a> leading to increased red blood cell destruction. <a href="Gilbert's_syndrome" title="Gilbert's syndrome">Gilbert's syndrome</a> and <a href="Crigler%E2%80%93Najjar_syndrome" title="Crigler–Najjar syndrome">Crigler–Najjar syndrome</a> have defects in the <a href="UDP-glucuronyl-transferase" class="mw-redirect" title="UDP-glucuronyl-transferase">UDP-glucuronyl-transferase</a> enzyme, affecting bilirubin conjugation.<sup id="cite_ref-Shivaraj_2009_6-5" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>The degree of rise in conjugated bilirubin is directly proportional to the degree of hepatocyte injury. Viral <a href="Hepatitis" title="Hepatitis">hepatitis</a> can also cause the rise in conjugated bilirubin. In parenchymal liver disease and incomplete extrahepatic obstruction, the rise in conjugated bilirubin is less than the complete <a href="Common_bile_duct" title="Common bile duct">common bile duct</a> obstruction due to malignant causes. In <a href="Dubin%E2%80%93Johnson_syndrome" title="Dubin–Johnson syndrome">Dubin–Johnson syndrome</a>, a mutation in <a href="Multidrug_resistance-associated_protein_2" title="Multidrug resistance-associated protein 2">multiple drug-resistance protein 2 (MRP2)</a> causes a rise in conjugated bilirubin.<sup id="cite_ref-Shivaraj_2009_6-6" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>In <a href="Acute_appendicitis" class="mw-redirect" title="Acute appendicitis">acute appendicitis</a>, total bilirubin can rise from 20.52 μmol/L to 143 μmol/L. In pregnant women, the total bilirubin level is low in all three trimesters.<sup id="cite_ref-Shivaraj_2009_6-7" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>The measurement of bilirubin levels in the newborns is done through the use of bilimeter or transcutanoeus bilirubinometer instead of performing LFTs. When the total serum bilirubin increases over 95th percentile for age during the first week of life for high risk babies, it is known as hyperbilirubinemia of the newborn (<a href="Neonatal_jaundice" title="Neonatal jaundice">neonatal jaundice</a>) and requires <a href="Light_therapy" title="Light therapy">light therapy</a> to reduce the amount of bilirubin in the blood. Pathological jaundice in newborns should be suspected when the serum bilirubin level rises by more than 5 mg/dL per day, serum bilirubin more than the physiological range, clinical jaundice more than 2 weeks, and conjugated bilirubin (dark urine staining clothes). <a href="Hemolytic_disease_of_the_newborn" title="Hemolytic disease of the newborn">Haemolytic jaundice</a> is the commonest cause of pathological jaundice. Those babies with Rh hemolytic disease, ABO incompatibility with the mother, <a href="Glucose-6-phosphate_dehydrogenase" title="Glucose-6-phosphate dehydrogenase">Glucose-6-phosphate dehydrogenase</a> (G-6-PD) deficiency and minor blood group incompatibility are at increased risk of getting haemolytic jaundice.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading3"><h3 id="Alanine_transaminase_(ALT)">Alanine transaminase (ALT)</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="Alanine_transaminase" title="Alanine transaminase">Alanine transaminase</a> and <a href="Elevated_transaminases" title="Elevated transaminases">Elevated transaminases</a></div>

<td>Reference range

</td></tr>

<tr>

</td></tr></tbody></table>

<p>Apart from being found in high concentrations in the liver, ALT is found in the kidneys, heart, and muscles. It catalyses the <a href="Transamination" title="Transamination">transamination</a> reaction, and only exists in a cytoplasmic form. Any kind of liver injury can cause a rise in ALT. A rise of up to 300 IU/L is not specific to the liver, but can be due to the damage of other organs such as the kidneys or muscles. When ALT rises to more than 500 IU/L, causes are usually from the liver. It can be due to hepatitis, ischemic liver injury, and toxins that causes liver damage. The ALT levels in <a href="Hepatitis_C" title="Hepatitis C">hepatitis C</a> rises more than in hepatitis A and B. Persistent ALT elevation more than 6 months is known as <a href="Chronic_hepatitis" class="mw-redirect" title="Chronic hepatitis">chronic hepatitis</a>. <a href="Alcoholic_liver_disease" title="Alcoholic liver disease">Alcoholic liver disease</a>, <a href="Non-alcoholic_fatty_liver_disease" class="mw-redirect" title="Non-alcoholic fatty liver disease">non-alcoholic fatty liver disease</a> (NAFLD), fat accumulation in liver during childhood obesity, <a href="Steatohepatitis" title="Steatohepatitis">steatohepatitis</a> (inflammation of fatty liver disease) are associated with a rise in ALT. Rise in ALT is also associated with reduced insulin response, reduced glucose tolerance, and increased free <a href="Fatty_acid" title="Fatty acid">fatty acids</a> and <a href="Triglyceride" title="Triglyceride">triglycerides</a>. Bright liver syndrome (bright liver on ultrasound suggestive of fatty liver) with raised ALT is suggestive of <a href="Metabolic_syndrome" title="Metabolic syndrome">metabolic syndrome</a>.<sup id="cite_ref-Shivaraj_2009_6-9" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>In pregnancy, ALT levels would rise during the second trimester. In one of the studies, measured ALT levels in pregnancy-related conditions such as <a href="Hyperemesis_gravidarum" title="Hyperemesis gravidarum">hyperemesis gravidarum</a> was 103.5 IU/L, <a href="Pre-eclampsia" title="Pre-eclampsia">pre-eclampsia</a> was 115, <a href="HELLP_syndrome" title="HELLP syndrome">HELLP syndrome</a> was 149. ALT levels would reduce by greater than 50% in three days after child delivery. Another study also shows that <a href="Caffeine" title="Caffeine">caffeine</a> consumption can reduce the risk of ALT elevation in those who consume alcohol, overweight people, impaired glucose metabolism, and viral hepatitis.<sup id="cite_ref-Shivaraj_2009_6-10" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Aspartate_transaminase_(AST)">Aspartate transaminase (AST)</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="Aspartate_transaminase" title="Aspartate transaminase">Aspartate transaminase</a> and <a href="Elevated_transaminases" title="Elevated transaminases">Elevated transaminases</a></div>

<td>Reference range

</td></tr>

<tr>

</td></tr></tbody></table>

<p>AST exists in two <a href="Isoenzymes" class="mw-redirect" title="Isoenzymes">isoenzymes</a> namely mitochondrial form and cytoplasmic form. It is found in highest concentration in the liver, followed by heart, muscle, kidney, brain, pancreas, and lungs.<sup id="cite_ref-:0_10-0" class="reference"><a href="#cite_note-:0-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> This wide range of AST containing organs makes it a relatively less specific indicator of liver damage compared to ALT. An increase of mitochondrial AST in bloods is highly suggestive of tissue <a href="Necrosis" title="Necrosis">necrosis</a> in <a href="Myocardial_infarction" title="Myocardial infarction">myocardial infarction</a> and chronic liver disease. More than 80% of the liver AST activity are contributed by mitochondrial form of the isoenzymes, while the circulating AST in blood are contributed by cytoplasmic form of AST. AST is especially markedly raised in those with <a href="Liver_cirrhosis" class="mw-redirect" title="Liver cirrhosis">liver cirrhosis</a>.<sup id="cite_ref-Shivaraj_2009_6-12" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> AST can be released from a variety of other tissues and if the elevation is less than two times the normal AST, no further workup needs to be performed if a patient is proceeding to surgery.

</p><p>In certain pregnancy related conditions such as hyperemesis gravidarum, AST can reach as high as 73 IU/L, 66 IU/L in pre-eclampsia, and 81 IU/L in HELLP syndrome.<sup id="cite_ref-Shivaraj_2009_6-13" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="AST/ALT_ratio">AST/ALT ratio</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="AST/ALT_ratio" title="AST/ALT ratio">AST/ALT ratio</a></div>

<p>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 than 4.5 in <a href="Wilson_disease" class="mw-redirect" title="Wilson disease">Wilson disease</a> or <a href="Hyperthyroidism" title="Hyperthyroidism">hyperthyroidism</a>.<sup id="cite_ref-Shivaraj_2009_6-14" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Alkaline_phosphatase_(ALP)">Alkaline phosphatase (ALP)</h3></div>

<td>Reference range

</td></tr>

<tr>

</td></tr></tbody></table>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Elevated_alkaline_phosphatase" title="Elevated alkaline phosphatase">Elevated alkaline phosphatase</a></div>

<p><a href="Alkaline_phosphatase" title="Alkaline phosphatase">Alkaline phosphatase</a> (ALP) is an enzyme in the cells lining the <a href="Biliary_tract" title="Biliary tract">biliary ducts</a> of the liver. It can also be found on the mucosal epithelium of the small intestine, <a href="Proximal_convoluted_tubule" class="mw-redirect" title="Proximal convoluted tubule">proximal convoluted tubule</a> of the kidneys, bone, liver, and placenta. It plays an important role in lipid transposition in small intestines and calcification of bones. 50% of all the serum ALP activities in blood are contributed by bone. Acute viral hepatitis usually has normal or increased ALP. For example, hepatitis A has increased ALP due to <a href="Cholestasis" title="Cholestasis">cholestasis</a> (impaired bile formation or bile flow obstruction) and would have the feature of prolonged itching. Other causes include: infiltrative liver diseases, granulomatous liver disease, abscess, <a href="Amyloidosis" title="Amyloidosis">amyloidosis</a> of the liver and <a href="Peripheral_arterial_disease" class="mw-redirect" title="Peripheral arterial disease">peripheral arterial disease</a>. Mild elevation of ALP can be seen in liver cirrhosis, hepatitis, and <a href="Congestive_cardiac_failure" class="mw-redirect" title="Congestive cardiac failure">congestive cardiac failure</a>. Transient <a href="Hyperphosphataemia" class="mw-redirect" title="Hyperphosphataemia">hyperphosphataemia</a> is a benign condition in <a href="Infant" title="Infant">infants</a>, and can reach normal level in 4 months. In contrast, low levels of ALP is found in <a href="Hypothyroidism" title="Hypothyroidism">hypothyroidism</a>, <a href="Pernicious_anemia" title="Pernicious anemia">pernicious anemia</a>, <a href="Zinc_deficiency" title="Zinc deficiency">zinc deficiency</a>, and <a href="Hypophosphatasia" title="Hypophosphatasia">hypophosphatasia</a>.<sup id="cite_ref-Shivaraj_2009_6-16" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>ALP activity is significantly increased in the third trimester of <a href="Pregnancy" title="Pregnancy">pregnancy</a>.<sup id="cite_ref-Gronowski2004_11-0" class="reference"><a href="#cite_note-Gronowski2004-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> This is due to increased synthesis from the <a href="Placenta" title="Placenta">placenta</a> as well as increased synthesis in the <a href="Liver" title="Liver">liver</a> induced by large amounts of estrogens.<sup id="cite_ref-Gronowski2004_11-1" class="reference"><a href="#cite_note-Gronowski2004-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-McCombBowersPosen1979_12-0" class="reference"><a href="#cite_note-McCombBowersPosen1979-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid14236214_13-0" class="reference"><a href="#cite_note-pmid14236214-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> Levels in the third trimester can be as much as 2-fold greater than in non-pregnant women.<sup id="cite_ref-Gronowski2004_11-2" class="reference"><a href="#cite_note-Gronowski2004-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> As a result, ALP is not a reliable marker of hepatic function in pregnant women.<sup id="cite_ref-Gronowski2004_11-3" class="reference"><a href="#cite_note-Gronowski2004-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> In contrast to ALP, levels of ALT, AST, GGT, and <a href="Lactate_dehydrogenase" title="Lactate dehydrogenase">lactate dehydrogenase</a> are only slightly changed or largely unchanged during pregnancy.<sup id="cite_ref-Gronowski2004_11-4" class="reference"><a href="#cite_note-Gronowski2004-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> <a href="Bilirubin" title="Bilirubin">Bilirubin</a> levels are significantly decreased in pregnancy.<sup id="cite_ref-Gronowski2004_11-5" class="reference"><a href="#cite_note-Gronowski2004-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup>

</p><p>In pregnancy conditions such as hyperemesis gravdirum, ALP levels can reach 215 IU/L, meanwhile, in pre-eclampsia, ALP can reach 14 IU/L, and in HELLP syndrome ALP levels can reach 15 IU/L.<sup id="cite_ref-Shivaraj_2009_6-17" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Gamma-glutamyltransferase_(GGT)">Gamma-glutamyltransferase (GGT)</h3></div>

<td>Reference range

</td></tr>

<tr>

</td></tr></tbody></table>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Gamma-glutamyltransferase" title="Gamma-glutamyltransferase">Gamma-glutamyltransferase</a></div>

<p>GGT is a microsomal enzyme found in hepatocytes, biliary epithelial cells, renal tubules, pancreas, and intestines. It helps in <a href="Glutathione" title="Glutathione">glutathione</a> metabolism by transporting peptides across the cell membrane. Much like ALP, GGT measurements are usually elevated if cholestasis is present.<sup id="cite_ref-:0_10-1" class="reference"><a href="#cite_note-:0-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> In acute viral hepatitis, the GGT levels can peak at 2nd and 3rd week of illness, and remained elevated at 6 weeks of illness. GGT is also elevated in 30% of the hepatitis C patients. GGT can increase by 10 times in alcoholism. GGT can increase by 2 to 3 times in 50% of the patients with non-alcoholic liver disease. When GGT levels is elevated, the <a href="Triglyceride" title="Triglyceride">triglyceride</a> level is elevated also. With insulin treatment, the GGT level can reduce. Other causes of elevated GGT are: diabetes mellitus, <a href="Acute_pancreatitis" title="Acute pancreatitis">acute pancreatitis</a>, myocardial infarction, <a href="Anorexia_nervosa" title="Anorexia nervosa">anorexia nervosa</a>, <a href="Guillain%E2%80%93Barr%C3%A9_syndrome" title="Guillain–Barré syndrome">Guillain–Barré syndrome</a>, hyperthyroidism, obesity and <a href="Myotonic_dystrophy" title="Myotonic dystrophy">myotonic dystrophy</a>.<sup id="cite_ref-Shivaraj_2009_6-19" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>In pregnancy conditions GGT activity is reduced in 2nd and 3rd trimesters. In hyperemesis gravidarum, GGT level value can reach 45 IU/L, 17 IU/L in pre-eclampsia, and 35 IU/L in HELPP syndrome.<sup id="cite_ref-Shivaraj_2009_6-20" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Albumin">Albumin</h3></div>

<td><a href="Reference_ranges_for_common_blood_tests" class="mw-redirect" title="Reference ranges for common blood tests">Reference range</a>

</td></tr>

<tr>

<td>3.5 to 5.3 g/dL

</td></tr></tbody></table>

<p><a href="Albumin" title="Albumin">Albumin</a> is a protein made specifically by the liver, and can be measured cheaply and easily. It is the main constituent of total protein (the remaining constituents are primarily <a href="Globulins" class="mw-redirect" title="Globulins">globulins</a>). Albumin levels are decreased in chronic liver disease, such as <a href="Cirrhosis" title="Cirrhosis">cirrhosis</a>. It is also decreased in <a href="Nephrotic_syndrome" title="Nephrotic syndrome">nephrotic syndrome</a>, where it is lost through the urine. The consequence of low albumin can be edema since the intravascular <a href="Oncotic_pressure" title="Oncotic pressure">oncotic pressure</a> becomes lower than the extravascular space. An alternative to albumin measurement is prealbumin, which is better at detecting acute changes (half-life of albumin and prealbumin is about 2 weeks and about 2 days, respectively).<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Other_tests">Other tests</h2></div>

<p>Other tests are requested alongside LFT to rule out specific causes.

</p>

<div class="mw-heading mw-heading3"><h3 id="5'_Nucleotidase">5' Nucleotidase</h3></div>

<td>Reference range

</td></tr>

<tr>

</td></tr></tbody></table>

<p>5' <a href="Nucleotidase" title="Nucleotidase">Nucleotidase</a> (5NT) is a <a href="Glycoprotein" title="Glycoprotein">glycoprotein</a> found throughout the body, in the cytoplasmic membrane, catalyzing the conversion to inorganic phosphates from nucleoside-5-phosphate. Its level is raised in conditions such as obstructive jaundice, parenchymal liver disease, liver metastases, and bone disease.<sup id="cite_ref-Shivaraj_2009_6-22" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>Serum NT levels are higher during 2nd and 3rd trimesters in pregnancy.<sup id="cite_ref-Shivaraj_2009_6-23" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Ceruloplasmin">Ceruloplasmin</h3></div>

<td>Reference range

</td></tr>

<tr>

</td></tr></tbody></table>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Ceruloplasmin" title="Ceruloplasmin">Ceruloplasmin</a></div>

<p>Ceruloplasmin is an <a href="Acute_phase_protein" class="mw-redirect" title="Acute phase protein">acute phase protein</a> synthesized in the liver. It is the carrier of the copper ion. Its level is increased in infections, <a href="Rheumatoid_arthritis" title="Rheumatoid arthritis">rheumatoid arthritis</a>, pregnancy, non-Wilson liver disease and obstructive jaundice. In Wilson disease, the ceruloplasmin level is depressed which lead to copper accumulation in body tissues.<sup id="cite_ref-Shivaraj_2009_6-25" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Alpha-fetoprotein">Alpha-fetoprotein</h3></div>

<td>Reference range

</td></tr>

<tr>

</td></tr></tbody></table>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Alpha-fetoprotein" title="Alpha-fetoprotein">Alpha-fetoprotein</a></div>

<p>Alpha-fetoprotein (AFP) is significantly expressed in foetal liver. However, the mechanism that led to the suppression of AFP synthesis in adults is not fully known. Exposure of the liver to cancer-causing agents and arrest of liver maturation in childhood can lead to the rise in AFP. AFP can reach until 400–500 μg/L in <a href="Hepatocellular_carcinoma" title="Hepatocellular carcinoma">hepatocellular carcinoma</a>. AFP concentration of more than 400 μg/L is associated with greater tumour size, involvement of both lobes of liver, portal vein invasion and a lower median survival rate.<sup id="cite_ref-Shivaraj_2009_6-27" class="reference"><a href="#cite_note-Shivaraj_2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Coagulation_test">Coagulation test</h3></div>

<p>The liver is responsible for the production of the vast majority of <a href="Coagulation" title="Coagulation">coagulation</a> factors. In patients with liver disease, <a href="International_normalized_ratio" class="mw-redirect" title="International normalized ratio">international normalized ratio</a> (INR) can be used as a marker of liver synthetic function as it includes <a href="Factor_VII" title="Factor VII">factor VII</a>, which has the shortest half life (2–6 hours) of all coagulation factors measured in INR. An elevated INR in patients with liver disease, however, does not necessarily mean the patient has a tendency to bleed, as it only measures procoagulants and not anticoagulants. In liver disease the synthesis of both are decreased and some patients are even found to be hypercoagulable (increased tendency to clot) despite an elevated INR. In liver patients, coagulation is better determined by more modern tests such as <a href="Thromboelastogram" class="mw-redirect" title="Thromboelastogram">thromboelastogram</a> (TEG) or thomboelastrometry (ROTEM).

</p><p>Prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and INR are measures of the <a href="Coagulation#Tissue_factor_pathway_(extrinsic)" title="Coagulation">extrinsic pathway</a> of <a href="Coagulation" title="Coagulation">coagulation</a>. This test is also called "ProTime INR" and "INR PT". They are used to determine the clotting tendency of blood, in the measure of <a href="Warfarin" title="Warfarin">warfarin</a> dosage, liver damage, and <a href="Vitamin_K" title="Vitamin K">vitamin K</a> status.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Serum_glucose">Serum glucose</h3></div>

<p>The serum glucose test, abbreviated as "BG" or "Glu", measures the liver's ability to produce glucose (<a href="Gluconeogenesis" title="Gluconeogenesis">gluconeogenesis</a>); it is usually the last function to be lost in the setting of <a href="Fulminant_liver_failure" class="mw-redirect" title="Fulminant liver failure">fulminant liver failure</a>.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Lactate_dehydrogenase">Lactate dehydrogenase</h3></div>

<p><a href="Lactate_dehydrogenase" title="Lactate dehydrogenase">Lactate dehydrogenase</a> (LDH) is found in many body tissues, including the liver. Elevated levels of LDH may indicate liver damage.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> LDH isotype-1 (or cardiac) is used for estimating damage to cardiac tissue, although troponin and creatine kinase tests are preferred.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup>

</p>

<ul><li><a href="Reference_ranges_for_blood_tests" title="Reference ranges for blood tests">Reference ranges for blood tests</a></li>

<li><a href="Elevated_transaminases" title="Elevated transaminases">Elevated transaminases</a></li>

<li><a href="Liver_disorders" class="mw-redirect" title="Liver disorders">Liver disorders</a></li>

<li><a href="Child%E2%80%93Pugh_score" title="Child–Pugh score">Child–Pugh score</a></li></ul>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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<li id="cite_note-McCombBowersPosen1979-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-McCombBowersPosen1979_12-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFMcCombBowersPosen1979" class="citation book cs1">McComb, Robert B.; Bowers, George N.; Posen, Solomon (1979). "Clinical Utilization of Alkaline Phosphatase Measurements". <i>Alkaline Phosphatase</i>. Springer US. pp. <span class="nowrap">525–</span>786. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2F978-1-4613-2970-1_9">10.1007/978-1-4613-2970-1_9</a>. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-1-4613-2972-5</bdi>.</cite></span>

</li>

<li id="cite_note-pmid14236214-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid14236214_13-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFMuellerKappas1964" class="citation journal cs1">Mueller MN, Kappas A (October 1964). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC289635">"Estrogen pharmacology. I. The influence of estradiol and estriol on hepatic disposal of sulfobromophthalein (BSP) in man"</a>. <i>J Clin Invest</i>. <b>43</b> (10): <span class="nowrap">1905–</span>14. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1172%2FJCI105064">10.1172/JCI105064</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC289635">289635</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14236214">14236214</a>.</cite></span>

</li>

<li id="cite_note-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-14">^</a></b></span> <span class="reference-text"><cite id="CITEREFSmith2017" class="citation journal cs1">Smith, Susan H. (April 2017). <span class="id-lock-subscription" title="Paid subscription required"><a rel="nofollow" class="external text" href="https://dx.doi.org/10.1097%2F01.NURSE.0000511805.83334.df">"Using albumin and prealbumin to assess nutritional status"</a></span>. <i>Nursing2021</i>. <b>47</b> (4): <span class="nowrap">65–</span>66. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F01.NURSE.0000511805.83334.df">10.1097/01.NURSE.0000511805.83334.df</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0360-4039">0360-4039</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28328780">28328780</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:45694428">45694428</a>.</cite></span>

</li>

<li id="cite_note-15"><span class="mw-cite-backlink"><b><a href="#cite_ref-15">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/lab-tests/prealbumin-blood-test/">"Prealbumin Blood Test: MedlinePlus Medical Test"</a>. <i>medlineplus.gov</i><span class="reference-accessdate">. Retrieved <span class="nowrap">25 February</span> 2021</span>.</cite></span>

</li>

<li id="cite_note-16"><span class="mw-cite-backlink"><b><a href="#cite_ref-16">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/lab-tests/prothrombin-time-test-and-inr-ptinr/">"Prothrombin Time Test and INR (PT/INR): MedlinePlus Medical Test"</a>. <i>medlineplus.gov</i><span class="reference-accessdate">. Retrieved <span class="nowrap">25 February</span> 2021</span>.</cite></span>

</li>

<li id="cite_note-17"><span class="mw-cite-backlink"><b><a href="#cite_ref-17">^</a></b></span> <span class="reference-text"><cite id="CITEREFKingston" class="citation web cs1">Kingston, Hannah. <a rel="nofollow" class="external text" href="https://www.letsgetchecked.com/articles/how-often-should-you-get-liver-function-check/">"Liver Function Test: How Often Should you Check Your Liver Function?"</a>. <i>LetsGetChecked</i>.</cite></span>

</li>

<li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/lab-tests/lactate-dehydrogenase-ldh-test/">"Lactate Dehydrogenase (LDH) Test: MedlinePlus Medical Test"</a>. <i>medlineplus.gov</i><span class="reference-accessdate">. Retrieved <span class="nowrap">25 February</span> 2021</span>.</cite></span>

</li>

<li id="cite_note-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-19">^</a></b></span> <span class="reference-text"><cite id="CITEREFNagehSherwoodHarrisByrne2003" class="citation journal cs1">Nageh T, Sherwood RA, Harris BM, Byrne JA, Thomas MR (2003). "Cardiac troponin T and I and creatine kinase-MB as markers of myocardial injury and predictors of outcome following percutaneous coronary intervention". <i>International Journal of Cardiology</i>. <b>92</b> (<span class="nowrap">2–</span>3): <span class="nowrap">285–</span>293. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0167-5273%2803%2900105-0">10.1016/S0167-5273(03)00105-0</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14659867">14659867</a>.</cite></span>

</li>

</ol></div>

<div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div>

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<div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Liver_function_tests" class="extiw external" title="commons:Category:Liver function tests">Liver function tests</a></span>.</div></div>

</div>

<ul><li><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?name=Liver+Function+Tests">Liver Function Tests</a> at the U.S. National Library of Medicine <a href="Medical_Subject_Headings" title="Medical Subject Headings">Medical Subject Headings</a> (MeSH)</li>

<li><a rel="nofollow" class="external text" href="http://labtestsonline.org/understanding/analytes/liver-panel/tab/test">Liver Function Tests</a> at Lab Tests Online</li>

<li><a rel="nofollow" class="external text" href="http://www.mayoclinic.com/health/liver-function-tests/MY00093">Overview</a> at <a href="Mayo_Clinic" title="Mayo Clinic">Mayo Clinic</a></li>

<li><a rel="nofollow" class="external text" href="http://www.patient.co.uk/showdoc/40024562">Abnormal Liver Function Tests</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20120411143612/http://www.patient.co.uk/showdoc/40024562">Archived</a> 11 April 2012 at the <a href="Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li>

<li><a rel="nofollow" class="external text" href="http://liverenzymes.net">Overview of liver enzymes</a></li>

<li><a rel="nofollow" class="external text" href="http://liverlearning.aasld.org/aasld/2016/FOLD/119140/aasld.html">Abnormal Liver Tests Curriculum</a> at <a href="AASLD" class="mw-redirect" title="AASLD">AASLD</a></li>

<li><a rel="nofollow" class="external text" href="https://gottliebgi.com/management-of-abnormal-liver-blood-tests-liver-function-tests-if-abnormal-act/">Further workup of abnormal liver tests: "etiology panel"</a></li></ul>

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</style><div id="Clinical_biochemistry_blood_tests250" style="font-size:114%;margin:0 4em">Clinical biochemistry <a href="Blood_test" title="Blood test">blood tests</a></div></th></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="Electrolyte" title="Electrolyte">Electrolytes</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Serum_sodium" class="mw-redirect" title="Serum sodium">Sodium</a></li>

<li><a href="Potassium_in_biology" title="Potassium in biology">Potassium</a></li>

<li><a href="Serum_chloride" title="Serum chloride">Chloride</a></li>

<li><a href="Calcium_in_biology" title="Calcium in biology">Calcium</a></li>

<li><a href="Renal_function" class="mw-redirect" title="Renal function">Renal function</a>

<ul><li><a href="Creatinine" title="Creatinine">Creatinine</a></li>

<li><a href="BUN-to-creatinine_ratio" class="mw-redirect" title="BUN-to-creatinine ratio">BUN-to-creatinine ratio</a></li></ul></li>

<li><a href="Plasma_osmolality" title="Plasma osmolality">Plasma osmolality</a></li>

<li><a href="Serum_osmolal_gap" class="mw-redirect" title="Serum osmolal gap">Serum osmolal gap</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="Acid%E2%80%93base_homeostasis" title="Acid–base homeostasis">Acid-base</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Anion_gap" title="Anion gap">Anion gap</a></li>

<li><a href="Arterial_blood_gas_test" title="Arterial blood gas test">Arterial blood gas</a></li>

<li><a href="Base_excess" title="Base excess">Base excess</a></li>

<li><a href="Bicarbonate" title="Bicarbonate">Bicarbonate</a></li>

<li><a href="CO2_content" title="CO2 content">CO<sub>2</sub> content</a></li>

<li><a href="Lactic_acid#Blood_testing" title="Lactic acid">Lactate</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="Iron_tests" title="Iron tests">Iron tests</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Ferritin" title="Ferritin">Ferritin</a></li>

<li><a href="Serum_iron" title="Serum iron">Serum iron</a></li>

<li><a href="Transferrin_saturation" title="Transferrin saturation">Transferrin saturation</a></li>

<li><a href="Total_iron-binding_capacity" title="Total iron-binding capacity">Total iron-binding capacity</a></li>

<li><a href="Transferrin" title="Transferrin">Transferrin</a></li>

<li><a href="Transferrin_receptor" title="Transferrin receptor">Transferrin receptor</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="Endocrine_system" title="Endocrine system">Hormones</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="ACTH_stimulation_test" title="ACTH stimulation test">ACTH stimulation test</a></li>

<li><a href="Thyroid_function_tests" title="Thyroid function tests">Thyroid function tests</a>

<ul><li><a href="Thyroid-stimulating_hormone" title="Thyroid-stimulating hormone">Thyroid-stimulating hormone</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="Metabolism" title="Metabolism">Metabolism</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Blood_glucose" class="mw-redirect" title="Blood glucose">Blood glucose</a>

<ul><li><a href="Glycated_hemoglobin" title="Glycated hemoglobin">Hemoglobin A1c</a></li></ul></li>

<li><a href="Lipid_panel" class="mw-redirect" title="Lipid panel">Lipid panel</a>

<li><a href="Triglyceride#Role_in_disease" title="Triglyceride">Triglycerides</a></li>

<li><a href="Cholesterol#Clinical_significance" title="Cholesterol">Total cholesterol</a></li></ul></li>

<li><a href="Basic_metabolic_panel" title="Basic metabolic panel">Basic metabolic panel</a></li>

<li><a href="Comprehensive_metabolic_panel" title="Comprehensive metabolic panel">Comprehensive metabolic panel</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="Cardiovascular_system" class="mw-redirect" title="Cardiovascular system">Cardiovascular</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Cardiac_marker" title="Cardiac marker">Cardiac marker</a></li>

<li><a href="Troponin_test" class="mw-redirect" title="Troponin test">Troponin test</a></li>

<li><a href="Lactate_dehydrogenase" title="Lactate dehydrogenase">Lactate dehydrogenase</a></li>

<li><a href="Myoglobin" title="Myoglobin">Myoglobin</a></li>

<li><a href="Glycogen_phosphorylase_isoenzyme_BB" title="Glycogen phosphorylase isoenzyme BB">Glycogen phosphorylase isoenzyme BB</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li>Proteins

<ul><li><a href="Human_serum_albumin" title="Human serum albumin">Human serum albumin</a></li>

<li><a href="Serum_total_protein" title="Serum total protein">Serum total protein</a></li></ul></li>

<li><i><a href="Transaminase" title="Transaminase">transaminases</a></i>

<li><a href="AST/ALT_ratio" title="AST/ALT ratio">AST/ALT ratio</a></li></ul></li>

<li><a href="Bilirubin" title="Bilirubin">Bilirubin</a>

<ul><li><a href="Bilirubin#Unconjugated" title="Bilirubin">Unconjugated</a></li>

<li><a href="Bilirubin#Conjugated" title="Bilirubin">Conjugated</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="Pancreas" title="Pancreas">Pancreas</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Amylase" title="Amylase">Amylase</a></li>

<li><a href="Lipase" title="Lipase">Lipase</a>

<ul><li><a href="Pancreatic_lipase" class="mw-redirect" title="Pancreatic lipase">Pancreatic lipase</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="Small_molecule" title="Small molecule">Small molecules</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Blood_sugar_level" title="Blood sugar level">Blood sugar level</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Hypoglycemia" title="Hypoglycemia">Hypoglycemia</a></li>

<li><a href="Hyperglycemia" title="Hyperglycemia">Hyperglycemia</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Nitrogenous</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Azotemia" title="Azotemia">Azotemia</a></li>

<li><a href="Hyperuricemia" title="Hyperuricemia">Hyperuricemia</a></li>

<li><a href="Hypouricemia" title="Hypouricemia">Hypouricemia</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%">Proteins</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Elevated_transaminases" title="Elevated transaminases">Elevated transaminases</a></li>

<li><a href="Elevated_alkaline_phosphatase" title="Elevated alkaline phosphatase">Elevated ALP</a></li>

<li><a href="Hypoproteinemia" title="Hypoproteinemia">Hypoproteinemia</a>

<ul><li><a href="Hypoalbuminemia" title="Hypoalbuminemia">Hypoalbuminemia</a></li></ul></li>

<li><a href="Hyperproteinemia" title="Hyperproteinemia">Hyperproteinemia</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Elevated_alpha-fetoprotein" title="Elevated alpha-fetoprotein">Elevated alpha-fetoprotein</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>

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