Increased liver values
and Eva Rudolf-Müller, doctorEva Rudolf-Müller is a freelance writer in the medical team. She studied human medicine and newspaper sciences and has repeatedly worked in both areas - as a doctor in the clinic, as a reviewer, and as a medical journalist for various specialist journals. She is currently working in online journalism, where a wide range of medicine is offered to everyone.
More about the experts All content is checked by medical journalists.Elevated liver values occur in a wide variety of diseases. Slightly elevated liver values are a common laboratory finding and are not always a sign of serious illness. Bad liver values are often a side effect of alcohol consumption or regular use of certain medications. However, greatly increased liver values urgently need to be clarified. Read here which diseases are common reasons for high liver values and the importance of liver value quotients.
Increased liver values: why is that?
The blood count and liver values ALT, AST and GLDH are increased when the liver cells are damaged, for example by fungal poisoning or acute viral hepatitis. The destruction of the liver cells releases the enzymes and enters the blood in high concentrations. At the same time, there is a reduction in those substances that are produced by the liver cells (albumin, coagulation factors).
On the other hand, g-glutamyltransferase, alkaline phosphatase (AP) and bilirubin are increased in a large number of diseases that cause biliary congestion. These include:
- Inflammation of the biliary tract (cholangitis), gallstones (cholelithiasis)
- Liver tumor
- hepatitis
- Cirrhosis of the liver
- Congested liver
- Cystic fibrosis (cystic fibrosis)
- congenital diseases such as Alagille syndrome (rare hereditary disease)
The alkaline phosphatase (AP) is not increased in liver and gallbladder diseases, but also in diseases with increased bone formation (such as osteosarcoma, bone metastases, myeloma). An AP increase also occurs in the last trimester of pregnancy and then has no disease value.
Bilirubin is also not only a liver function test, but also an important parameter for the breakdown of red blood cells. Such hemolysis occurs, for example, in certain anemias (such as sickle cell anemia) or when wrong blood transfusions are given. Other reasons for increased bilirubin are:
- Burns
- Death of skeletal muscle cells (rhabdomyolysis), for example in an epileptic fit or severe trauma
- Disturbed bilirubin metabolism in congenital diseases such as Meulengracht's disease
Elevated liver values: the importance of quotients
If the liver values are bad, the ratio of different measured values to one another (quotient) can provide an indication of the underlying disease.
The so-called Schmidt quotient is obtained by dividing the sum of AST and ALT by the measured value of glutamate dehydrogenase. Values below 20 occur mainly in biliary cirrhosis or liver metastases. If the Schmidt quotient is between 20 and 50, the reason is often an acute flare-up of chronic hepatitis; if it is over 50, acute viral hepatitis or alcohol hepatitis is probable.
The ratio of AST to ALT (de-ritis quotient) can help to assess the cause of hepatitis: values below 1 occur, for example, in acute viral hepatitis, values around 1 in liver cirrhosis. Values above 1, on the other hand, indicate chronic hepatitis and values above 2 indicate alcohol-related liver damage.
However, the calculation of such quotients does not make sense if the liver values are normal - only increased liver values and their relationship to one another are meaningful.
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