AST (Aspartate Transaminase, SGOT)

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AST

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AST (aspartate aminotransferase) is an enzyme that is found mostly in the liver, but also in muscles. When your liver is damaged, it releases AST into your bloodstream. An AST blood test measures the amount of AST in your blood. The test can help your health care provider diagnose liver damage or disease.

About

Aspartate aminotransferase (AST) is found in high concentrations in liver, heart, skeletal muscle, and kidney. AST is present in both cytoplasm and mitochondria of cells. In cases involving mild tissue injury, the predominant form of AST is that from the cytoplasm. Severe tissue damage results in more of the mitochondrial enzyme being released. High levels of AST can be found in cases such as myocardial infarction, acute liver cell damage, viral hepatitis, and carbon tetrachloride poisoning. Slight to moderate elevation of AST is seen in muscular dystrophy, dermatomyositis, acute pancreatitis, and crushed muscle injuries.

Preparation

You don't need any special preparations for an AST blood test. If your health care provider has ordered other blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.

Indications

You may get an AST blood test as part of your routine checkup or if you have symptoms of liver damage. These may include:
  • Nausea and vomiting
  • Weight loss
  • Tiredness
  • Weakness
  • Jaundice, a condition that causes your skin and eyes to turn yellow
  • Swelling and/or pain in your abdomen
  • Swelling in your ankles and legs
  • Dark-coloured urine and/or light-coloured stool
  • Frequent itching
Even if you don't have symptoms, your health care provider may order an AST blood test if you are at a higher risk of liver disease. Risk factors for liver disease include:
  • A family history of liver disease
  • Heavy drinking
  • Obesity
  • Diabetes
  • Taking certain medicines that can cause liver damage

Interpretation

Very high concentrations of AST (more than 10 times the upper limit of normal (ULN)) are usually due to a rapidly developing liver disease called acute hepatitis, which is often caused by a virus or by toxins/drugs such as paracetamol overdose. In acute viral hepatitis, AST concentrations usually stay elevated for about 1–2 months but can take as long as 3–6 months to return to normal.


Moderately high levels, often less than 4 times the upper limit of normal (ULN) are seen in the slowly developing variety of liver disease, chronic hepatitis, as well as alcohol abuse, cholestasis and heart, kidney or skeletal muscle damage The AST level can also be increased following the breakdown of red blood cells (haemolysis). In chronic hepatitis, AST often varies between normal and slightly increased, so doctors might request the test regularly to determine the pattern of change.


In some diseases of the liver, especially when the bile ducts are partially blocked, fatty change in the liver or with cirrhosis and certain cancers of the liver, AST concentrations may be slightly high or close to normal.


In chronic viral hepatitis, chronic alcoholism or non-alcoholic fatty liver disease a high AST/ALT ratio may be used to predict long-term complications such as cirrhosis.

Disclaimer

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

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