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Liver Blood Test

Medical Author: Siamak Nabili, MD, MPH
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

Doctor to Patient

Liver...The Largest Gland in the Body!

Medical Author: Leslie J. Schoenfield, M.D., Ph.D.
Medical Editor: Jay W. Marks, M.D.

The liver is the largest gland in the body, and medication affects liver functionThe liver is the largest solid organ in the body. I think a lot of people probably know that. But they may not know that it is also the largest gland in the body. You see, the liver is also considered a gland because, among its various functions, it makes and secretes bile. (Just for your reference, the stomach and intestine are large hollow organs. Glands are organs or parts of organs that make and secrete substances. And bile is a fluid that both aids in digestion and transports fats as well as waste products into the intestine.)

Actually, there are all sorts of glands in the body that make and secrete substances, including the pancreas (digestive enzymes), thyroid and other endocrine glands (hormones), gastric glands in the stomach (acid), and lymph glands or nodes (lymph). The liver is even larger, I think, than most mammary glands (milk).


Doctor to Patient

Introduction to liver blood test

An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured for any reason, these enzymes are spilled into the blood stream. Enzymes are proteins that are present throughout the body, each with a unique function. Enzymes help to speed up (catalyze) routine and necessary chemical reactions in the body.

Among the most sensitive and widely used of these liver enzymes are the aminotransferases. They include aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). These enzymes are normally contained within liver cells. If the liver is injured, the liver cells spill the enzymes into blood, raising the enzyme levels in the blood and signaling the liver damage.

What are the aminotransferases?

The aminotransferases catalyze chemical reactions in the cells in which an amino group (amino acids are building blocks of proteins) is transferred from a donor molecule to a recipient molecule. Hence, the names "aminotransferases."

Medical terms can sometimes be confusing, as is the case with these enzymes.

  • Another name for aminotransferase is transaminase.

  • The enzyme aspartate aminotransferase (AST) is also known as serum glutamic oxaloacetic transaminase (SGOT); and

  • alanine aminotransferase (ALT) is also known as serum glutamic pyruvic transaminase (SGPT).

To put matters briefly, AST = SGOT and ALT = SGPT.

Normally, where are the aminotransferases?

AST (SGOT) is normally found in a diversity of tissues including liver, heart, muscle, kidney, and brain. It is released into serum when any one of these tissues is damaged. For example, its level in serum rises with heart attacks and with muscle disorders. It is therefore, not a highly specific indicator of liver injury.

ALT (SGPT) is, by contrast, normally found largely in the liver. This is not to say that it is exclusively located in liver, but that is where it is most concentrated. It is released into the bloodstream as the result of liver injury. It therefore serves as a fairly specific indicator of liver status.



Next: What are normal levels of AST and ALT? »

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Liver Blood Tests

What is PBC?

Primary biliary cirrhosis (PBC) is a chronic (long duration) disease characterized by progressive inflammation and destruction of the small bile ducts within the liver. What are the bile ducts and what do they do? Lined with cells named biliary epithelial cells, the bile ducts are tubules that make up a plumbing system for the liver. The bile ducts along with the gallbladder are part of what is called the biliary tract.

The plumbing system begins in the liver with very small caliber ducts that connect to increasingly larger caliber ducts, like a tree in which twigs connect to small branches that connect to larger branches. In fact, this system is often referred to as the biliary tree. The large right and left bile ducts, still within the liver, connect to an even larger common bile duct that runs outside the liver to the small intestine just beyond the stomach. The common bile duct connects by the cystic duct to the gallbladder....

Read the Primary Biliary Cirrhosis article »











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