ALT (serum glutamic pyruvic transaminase, SGPT)

ALT is a liver enzyme that plays a role in protein metabolism, like AST (asparate aminotransferase).

Elevated alanine aminotransferase predicts new-onset type 2 diabetes .[1]

Liver damage from hepatitis B or C, or from drugs: slight elevated serum levels of ALT can be a sign of :

Toxic hepatitis: 30 to 50 times normal values of serum ALT Mycardial infarction: no or only minor elevations of serum ALT The AST/ALT ratio is occasionally used in the differential diagnosis of liver disease.

Clinical Implications:

Elevated along with AST:

Viral hepatitis

Infectious mononucleosis

Drug induced acute liver cell injury

Elevated to a Lesser Degree and Frequency than AST:

Acute alcoholic liver disease Active cirrhosis Liver passive congestion Long standing extra hepatic bile duct obstruction Metastatic tumor of the liver

Interfering Factors:

Hemolysis

Drugs that can cause lower levels: acetic acid (indomethacin), carbenicillin, clindamycin, digitalis, erythromycin, gentamicin, lincomycin, mithramycin, spectinomycin, tetracycline, meperdine, (demerol), morphine, codeine, methyldopa, granethidine, salicylates, rifampin,fluazepam (Dalmane), oral contraceptives, and propranolol (Inderal).

See herb therapy to lower AST and ALT

See Chinese herb therapy for hepatitis B.

[1] Diabetes. 2004 Nov;53(11):2855-60.