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SGPT (Serum Glutamic-Pyruvic Transaminase)

SGPT is an enzyme found primarily in the liver. Lesser amounts are found in the heart, skeletal muscle and kidney.

Types Of Liver Function Tests :-  

1) The first category of liver function tests measures detoxification and excretory functions. The serum bilirubin test is typical of this group.
Bilirubin is a substance in bile which is produced by the breakdown of red blood cells. Bilirubin is orange-colored. When bilirubin levels are above normal, a condition called jaundice results.

Excess bilirubin often results from the increased destruction of red blood cells, or hemolysis. A high bilirubin level might also occur because the liver can't remove bilirubin in a timely manner.

2) Another type of liver function test detects damage to the liver structure by measuring liver enzyme levels in the liver. Elevated liver enzymes tell your physician that there is an obstruction to bile flow, or there's damage to the liver cells.

3) A liver function test also includes tests that are based on bio-synthetic functions. These type of liver function test typically includes the serum globulin test and the serum albumin test.

Three types of globulins (globulins contain most of the antibodies of the blood) are measured by the serum globulin test. They are known as alpha, beta and gamma. The liver synthesizes the alpha and beta globulins, and the cells of the immune system synthesize the gamma globulin.
When the liver isn't functioning properly, the alpha and the beta globulins are decreased and the gamma globulin levels are increased.

Serum albumin is the main protein in blood plasma. A drop in the normal serum albumin level could be a clue of chronic liver disease. However, other conditions like kidney disorders and malnutrition could also be the result of a decrease in serum albumin.

4) The last category of the liver function test includes ultrasonography and biopsy. Ultrasonography helps in the diagnosis of obstructive jaundice. It is also used when gall stone disease might be present. Ultrasonography is also helpful in detecting lesions in the liver. It can furthermore be used with a Doppler test to assess the condition of the blood vessels.

A biopsy can also be helpful in determining problems with liver function. A biopsy, of course, is done through the skin in cases where the cause of liver disease is undetermined. Biopsy can also be extremely helpful in diagnosing enlarged liver, suspected cancers, and enlarged spleen.

A liver function test can be useful in evaluating a wide range of normal functions performed by the liver. But a reliable diagnosis also depends on a complete physical examination and a detailed medical history along with the tests themselves.

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What Do Elevated AST And ALT Mean ?

AST (SGOT) and ALT (SGPT) are sensitive indicators of liver damage from different types of disease. In rare cases, higher-than-normal levels of these liver enzymes may have causes other than liver problems. The interpretation of elevated AST and ALT levels depends upon the whole clinical picture. The precise levels of these enzymes do not correlate well with the extent of liver damage or the prognosis. Thus, the exact levels of AST (SGOT) and ALT (SGPT) cannot be used to determine the degree of liver disease or predict the future.  For example, patients with acute viral hepatitis may develop very high AST and ALT levels (sometimes in the thousands of units/liter range). But most patients with acute viral hepatitis A recover fully without residual liver disease.

What Liver Diseases Cause High Liver Enzyme Levels ?

The highest levels of AST and ALT are found with disorders that cause the death of numerous liver cells (extensive hepatic necrosis). This occurs in such conditions as acute viral hepatitis A or B, pronounced liver damage inflicted by toxins as from an overdose of acetaminophen (Tylenol), and prolonged collapse of the circulatory system when the liver is deprived of fresh blood bringing oxygen and nutrients. AST and ALT serum levels in these situations can range anywhere from ten times the upper limits of normal to thousands of units/liter.

The most common cause of mild to moderate elevations of these liver enzymes is fatty liver. In the United States, the most frequent cause of fatty liver is alcohol abuse. Other causes of fatty liver include diabetes mellitus and obesity. Chronic hepatitis C is also becoming an important cause of mild to moderate liver enzyme elevations.

What Medications Cause Abnormal Liver Enzyme Levels ?

A host of medications can cause abnormal liver enzymes levels. Examples include:

-- Pain relief medications such as aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), neproxen (Narosyn), diclofenac (Voltaren), and phenybutazone (Butazolidine)

-- Anti-seizure medications such as phenytoin (Dilantin), valproic acid, carbamazepine (Tegretol), and phenobarbital

-- Antibiotics such as the tetracyclines, sulfonamides, isoniazid (INH), sulfamethoxazole, trimethoprim, nitrofurantoin

-- Cholesterol lowering drugs such as the "statins" (Mevacor, Pravachol, Lipitor, etc.) and niacin

-- Cardiovascular drugs such as amiodarone (Cordarone), hydralazine, quinidine, etc.

-- Anti-depressant drugs of the tricyclic type
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What Are The Treatment Options For High Liver Enzymes ?

Evaluation of healthy patients with abnormal liver enzymes needs to be individualized. If alcohol or prescription drugs are responsible for the abnormal liver enzyme levels, stopping alcohol or the medication (under a doctor's supervision) should help. If obesity is suspected as the cause of fatty liver, weight reduction of 5% to 10% should also bring the liver enzyme levels to normal or near normal levels. If abnormal liver enzymes persist despite abstinence from alcohol, weight reduction and stopping certain suspected drugs, blood tests can be performed to help diagnose treatable liver diseases. The blood can be tested for the presence of hepatitis B and C virus and their related antibodies.

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