How To Check The Liver: What Tests To Take, What Do They Show, The Norm

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

How to check the liver: what tests to pass, their decoding, norm and deviations

The content of the article:

Who needs a liver test
What liver screening shows
Blood biochemistry
Diagnosis of liver fibrosis
Diagnosis of viral and autoimmune hepatitis

How to check the liver and what tests to take are far from idle questions.

The liver is the largest excretory gland in the human body. It is located in the upper right quadrant of the abdominal cavity, directly below the diaphragm, and performs many functions in humans:

neutralization of xenobiotics (toxic substances), in particular, poisons, toxins, allergens;
neutralization and removal from the body of excess vitamins, mediators, hormones, as well as a number of toxic metabolic products (ketone bodies and acetone, ethanol, phenol, ammonia);
providing the body's energy needs by converting various energy sources (lactic acid, glycerin, amino acids, free fatty acids) into glucose;
storing the body's energy reserves in the form of glycogen stores and regulating carbohydrate metabolism;
storage of some trace elements (cobalt, copper, iron) and vitamins (A, B ₁₂, D);
participation in the metabolism of a whole group of vitamins (A, group B, C, D, PP, K, E, folic acid);
participation in the process of hematopoiesis in the fetus;
regulation of lipid metabolism;
secretion and excretion of bile;
blood deposition.

Given the function of the liver, it is often called the biochemical laboratory of the body. Any violations in the activities of this body are fraught with a serious threat. Moreover, every year liver diseases are diagnosed more often. This is facilitated by malnutrition, alcohol abuse, and a sedentary lifestyle.

The liver plays an essential role in the body, it is called the biochemical laboratory of the body

Who needs a liver test

A feature of many liver diseases is that they are practically asymptomatic for a long time, and are diagnosed only when less than 15% of all cells of this organ remain functional in the patient. Examples of such diseases are chronic hepatitis, cirrhosis, liver cancer.

Doctors recommend that all people undergo a medical examination annually, which allows timely detection of liver dysfunctions. But there are some symptoms, upon the appearance of which the patient's examination should be carried out immediately. These include:

discomfort in the right hypochondrium;
an increase in the size of the liver, detected during ultrasound or palpation of the abdomen;
an unpleasant taste in the mouth;
frequent nausea;
unexplained weight loss;
increased irritability;
drowsiness;
jaundice;
sweetish (liver) odor from the mouth;
vomiting mixed with blood (internal bleeding from the dilated veins of the esophagus is a complication of liver cirrhosis).

The study of liver function should be carried out during pregnancy (it is best to do this even at the planning stage), before starting a course of treatment with potent drugs, as well as before any surgical intervention.

What liver screening shows

Screening, that is, checking the liver is carried out for the following purposes:

diagnostics of possible liver diseases (fatty hepatosis, autoimmune or viral hepatitis);
identification and assessment of the degree of histological disorders of the organ tissue structure (cirrhosis, fibrosis).

The patient, first of all, must consult a doctor who will collect an anamnesis, conduct an initial examination and give a referral for the necessary blood tests, and then make a decoding of the results obtained.

Blood biochemistry

Biochemical blood test is one of the most important methods of laboratory diagnostics, which allows assessing the functioning of almost all systems and organs based on information on the metabolism of carbohydrates, fats, proteins. Any pathological condition of the liver almost immediately manifests itself as a change in the biochemical parameters of the blood. Depending on the patient's condition, the doctor can prescribe him either a standard biochemical blood test, or an extended one, which includes more than 13 indicators. Most often, blood biochemistry when checking liver functions includes determining the following indicators:

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are liver enzymes that are directly involved in protein metabolism. The rate of their maintenance is 40 U / l for men, 30 U / l for women. An increase in liver enzymes indicates acute viral or toxic forms of hepatitis, obstructive jaundice, liver cancer, cirrhosis. A decrease in enzyme content indicates extensive liver necrosis or severe vitamin B ₆ deficiency.
Alkaline phosphatase. This is a whole group of enzymes that regulate the metabolism of phosphoric acid. The normal alkaline phosphatase content is between 40 and 150 U / L. An increase in concentration is observed in cholestatic syndrome, toxic hepatitis, cancer, cirrhosis and liver necrosis.
Bilirubin. It is a yellow pigment formed during the breakdown of hemoglobin. The rate of total bilirubin in the blood is 3.5–17.5 µmol / L. An increase occurs with hepatitis, gallstone disease, liver cancer.
Albumen. It is the main protein in human blood that is produced in the liver. Normally, its concentration in the blood is 35–55 g / l. A decrease in the indicator indicates either liver cirrhosis or massive death of hepatocytes.
Cholinesterase is a group of enzymes produced in the liver. Any hepatic pathology is accompanied by a decrease in the concentration of cholinesterase in the blood (the norm is 5,000-12,500 U / L).
Prothrombin index (PTI). It characterizes the blood coagulation ability. The norm is 75-142%. Since the synthesis of prothrombin is carried out in the liver, any of its diseases lead to a decrease in the level of PTI.
Thymol test. A kind of sedimentary (coagulation) sample. It is used to assess the protein-synthetic function of the liver. The normal value is between 0 and 4 units. An increase is observed in patients with hepatitis A (including anicteric form), toxic hepatitis and liver cirrhosis.

Diagnosis of liver fibrosis

Fibrosis of the liver is a pathological process in which hepatocytes are destroyed and replaced with coarse (fibrous) connective tissue. Preliminary diagnosis of this condition is carried out according to the data of ultrasound scanning. A liver biopsy was previously required to confirm the diagnosis. Currently, there are special test systems to assess the degree of liver fibrosis. Preparation for research and blood sampling are exactly the same as for biochemical analysis.

Elastography can also assess the degree of liver fibrosis. This study is carried out with a special ultrasonic device "FibroScan".

Elastography is a modern method of ultrasound diagnostics of the liver

These diagnostic methods allow diagnosing liver cancer in the early stages, as well as assessing the prognosis of this disease.

Diagnosis of viral and autoimmune hepatitis

The clinical picture of hepatitis of different types is almost the same. Patients develop symptoms of general intoxication (weakness, fatigue, sleep disturbances, nausea, headache, muscle and joint pain, loss of appetite), icteric staining of mucous membranes and skin, liver enlarged on palpation. It is possible to determine which form of hepatitis is observed in a particular patient using a number of blood tests.

If infectious hepatitis is suspected, a child or adult is prescribed an analysis to determine the serum level of immunoglobulins of class M and G to viral hepatitis A, B, C, D, G, E. In addition, it is necessary to make a quantitative and qualitative determination of the DNA and RNA of hepatitis viruses by the polymerase chain reaction (PCR).

To confirm or exclude the diagnosis of autoimmune hepatitis, it is necessary to conduct a blood test for the content of specific antibodies to liver tissue.

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