Which of the following enzyme assay is useful to diagnose alcoholism
Answer is A (SCOT) All the enzymes given in the options are elevated in Alcoholic hepatitis. Although none of the options appear to be appropriate, the best options amongst these should be AST or SGOT. In alcoholic hepatitis, in contrast to other causes of fatty liver, the AST and ALT are usually elevated two to seven fold. In general AST and ALT levels rise parallel to each other. In alcoholic liver disease the AST rises out of propoion to ALT such that the ratio of AST and ALT may become greater than 2. AST (SGOT) is therefore the single best answer. AST/ALT > 2:1 is suggestive of alcoholic liver disease. AST/ALT > 3 : 1 is highly suggestive of alcoholic liver disease. Laboratory dignosis of alcoholic fatty liver and alcoholic hepatitis Test Comments AST * Increase two to seven fold, less than 400U/L, greater than ALT ALT * Increased two to seven fold, less than 400 U/L AST/ALT * Usually less than I GGTP * Not specific to alcohol, easily inducible, elevated in all forms of fatty liver. Bilirubin * May be markedly increased in alcoholic hepatitis despite modest elevation in alkaline phosphatase PMN * If > 5500/mL, predicts severe alcoholic hepatitis when discriminant function > 32 Alkaline phosphatase levels may increase but it is not specific to alcohol liver disease Macrocytosis may be seen. (Raised MCV) Alcoholism is also associated with: Hyperiglyceremia Hypercholesterolemia Hyperbilirubinemia increase in circulating polymorphonuclear leucocytes > 5500/ml.
SGOT
SGPT
Alkaline phosphatase
Glutamyl aminotransferase