What are the twelve liver functions?

There are many liver function test items, and many people are not familiar with them. In fact, the most common one is the twelve liver function test. This test item can fundamentally check whether there is some kind of lesion in the liver. Therefore, people must complete all the tests before making a judgment to avoid any misdiagnosis, which will have a very bad impact.

Serum Protein

Serum total protein: 60-80 g/L (grams/liter)

Serum albumin: Normal: 40~55g/L

Serum globulin: Normal: 20~30g/L

Albumin/globulin ratio (A/G): 1.-2.:

Serum total protein and albumin testing are key indicators reflecting liver function. Because the liver has a strong compensatory ability and albumin has a long half-life, changes in serum total protein and albumin will only occur when liver damage reaches a certain extent. In acute or local liver damage, these two indicators are mostly normal. Therefore, serum total protein and albumin tests are mostly used to reflect chronic liver damage and can reflect the reserve function of liver parenchymal cells. A decrease in total protein often occurs together with a decrease in albumin, and an increase in total protein is often accompanied by an increase in globulin.

Commonly used serum enzymes

Alanine aminotransferase (ALT): 5-40 U/L (unit/liter)

Aspartate aminotransferase (AST): 8-40U/L (unit/liter)

ALT/AST≤1

Elevated levels of both are seen in: acute and chronic viral hepatitis, active liver cirrhosis, liver cancer, fatty liver, cholecystitis, cholangitis, acute myocardial infarction, myocarditis, polymyositis, alcoholic hepatitis (significant increase in AST);

Both levels can be significantly elevated in hepatitis; in the early stage of jaundice, AST is often > ALT, and soon AST < ALT; in the recovery stage, ALT generally recovers more slowly;

If both levels continue to increase, it indicates chronic hepatitis; if the AST/ALT ratio is less than 1, it may be chronic persistent hepatitis; if the enzyme activity increases and the AST/ALT ratio is greater than 1, it may be chronic active hepatitis.

Alkaline phosphatase (ALP)

ALP: 40-110 U

In various intrahepatic and extrahepatic bile duct obstructive diseases, ALP is significantly elevated; in hepatobiliary diseases such as hepatitis that affect liver parenchymal cells, ALP is only slightly elevated.

γ-transpeptidase (γ-GT)

γ-GT< 50 U

Serum bilirubin

Total bilirubin (STB): 1.71-17.1 μmol/L (micromoles/liter)

Direct bilirubin (CB): 1.71-7μmol/L (1-4mg/L).

Indirect bilirubin (UCB): 1.7-13.7 μmol/L

Serum bilirubin is an important prognostic indicator for determining the degree of liver cell damage.

1. When the bilirubin of a patient with liver disease increases significantly, it indicates that there is more serious liver cell damage; if it is abnormal for a long time, it indicates the possibility of turning into chronic liver disease; if it increases sharply in a short period of time, it indicates that the condition is critical;

2. Chronic active hepatitis, viral hepatitis, acute icteric hepatitis, primary biliary cirrhosis, obstructive jaundice, hemolytic jaundice, neonatal jaundice, cholelithiasis, pancreatic disease, blood transfusion, etc. can all increase the level.

2. TBIL can be combined with DBIL and symptoms to differentiate hemolytic jaundice, hepatocellular jaundice, obstructive jaundice or familial hypercholesterolemia.