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ALT (serum glutamic pyruvic transaminase, SGPT)

Edited by: Joe Hing Kwok Chu

ALT is a liver enzyme that plays a role in protein metabolism, like AST (asparate aminotransferase).

Elevated alanine aminotransferase predicts new-onset type 2 diabetes .[1]

Liver damage from  hepatitis B or C,  or from drugs:  slight elevated serum levels of ALT can be a sign of :

Toxic hepatitis:  30 to 50 times normal values of serum ALT

Mycardial infarction: no or only minor elevations of serum ALT

The AST/ALT ratio is occasionally used in the differential diagnosis of liver disease.

Clinical Implications:


Elevated along with AST:

     Viral hepatitis

     Infectious mononucleosis

     Drug induced acute liver cell injury


Elevated to a Lesser Degree and Frequency than AST:

     Acute alcoholic liver disease

     Active cirrhosis

     Liver passive congestion

     Long standing extra hepatic bile duct obstruction

     Metastatic tumor of the liver



Interfering Factors:


     Drugs that can cause lower levels: acetic acid (indomethacin), carbenicillin, clindamycin, digitalis, erythromycin, gentamicin, lincomycin, mithramycin, spectinomycin, tetracycline, meperdine, (demerol), morphine, codeine, methyldopa, granethidine, salicylates, rifampin,fluazepam (Dalmane), oral contraceptives, and propranolol (Inderal).


See herb therapy to lower AST and ALT


See Chinese herb therapy for hepatitis B.


[1]  2004 Nov;53(11):2855-60.

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