Liver function tests and liver injury - focusing on AST/ALT and PLT count

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  • 肝機能検査、肝障害について─健診における問題点

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Abstract

 Serum AST, ALT, γ-GTP and PLT count have been used for the screening of liver injury in health evaluation and promotion in Japan. The judgment of normal, mildly abnormal, necessity of follow-up or necessity of therapy in liver condition have been done based on the serum levels of these blood chemistries. However, the ranges of upper limit of serum ALT is distributed from less than 25IU/L to 48IU/L among 78 affiliated university hospitals in Japan. Recently it was reported that healthy ranges for serum ALT levels were less than 30IU/L in men and less than 19IU/L in women from Italy. In proportion to the progression of liver fibrosis, serum AST/ALT is getting increased and PLT count is getting decreased. These results indicate that the judgment of normal, mildly abnormal, necessity of follow-up or necessity of therapy in liver injury should be done based on not only serum levels of AST and ALT but also AST/ALT and PLT count. It is necessary to reconsider the upper limits of serum AST, ALT and PLT count in Japanese population.

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