Which enzymes are elevated in hepatocellular injury as opposed to cholestasis?

Which enzymes are elevated in hepatocellular injury as opposed to cholestasis?

• A. ALP and GGT
• B. Bilirubin and albumin
• C. Amylase and lipase
• D. AST and ALT

Answer: (D)

When liver cells are damaged, enzymes from the hepatocytes leak into the bloodstream. The two enzymes most characteristic of hepatocellular injury are AST and ALT. They reflect damage to the liver cells themselves, with ALT being more liver-specific and AST also present in other tissues. In contrast, cholestasis tends to elevate enzymes related to bile ducts, especially alkaline phosphatase and GGT, because the problem is in bile flow, not direct hepatocyte injury. Amylase and lipase point to pancreatic injury, not liver injury, and bilirubin/albumin are not the enzymes that indicate hepatocellular damage. So the elevated enzymes in hepatocellular injury are AST and ALT.

When liver cells are damaged, enzymes from the hepatocytes leak into the bloodstream. The two enzymes most characteristic of hepatocellular injury are AST and ALT. They reflect damage to the liver cells themselves, with ALT being more liver-specific and AST also present in other tissues.

In contrast, cholestasis tends to elevate enzymes related to bile ducts, especially alkaline phosphatase and GGT, because the problem is in bile flow, not direct hepatocyte injury. Amylase and lipase point to pancreatic injury, not liver injury, and bilirubin/albumin are not the enzymes that indicate hepatocellular damage.

So the elevated enzymes in hepatocellular injury are AST and ALT.