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Alanine aminotransferase (ALAT; also known as alanine transaminase) is an enzyme, or protein, that is associated with the metabolism of amino acids, and operates within liver cells. Therefore, ALAT concentration can measure damage or inflammation in liver cells. The ALAT enzyme occurs the most in liver cells, and in small concentrations in the lungs, heart, kidneys, and muscles, for instance. From the cells of the liver, the enzyme is released into the blood stream, which makes it possible to measure the concentration of the ALAT enzyme with a blood test.

When should ALAT be measured?

An ALAT test is recommended in the following situations, for example:

  • Suspected liver failure or hepatitis (inflammation of the liver)
  • Upper stomach pain
  • Abdominal obesity, which can involve fatty liver disease
  • High alcohol consumption
  • Long-term use of medications
  • Yellowness of the skin or eyes
What does the ALAT test measure?

The ALAT value primarily indicates possible damage to the cells of the liver. The most common causes of damage to the cells of the liver in Finland are alcohol and obesity. Short-term high alcohol consumption does not increase the ALAT value.

Normally, the result is:

Reference values: Women: <35 U/l Men: <50 U/L

The result indicates whether there are elevated ALAT enzymes in the bloodstream. However, the test does not give the reason for a result falling outside the reference range. Typically, further examinations after an abnormal ALAT test result include: 

  • Alkaline phosphatase (S-AFOS), an examination concerning the functioning of the gall bladder
  • Carbohydrate-deficient transferrin (S-CDT), alcohol-induced liver damage
  • Gamma-glutamyl transferase (S-GT), alcohol-induced liver damage
  • Mean corpuscular volume (MCV), detrimental alcohol consumption

If abnormal values are observed in the tests, you should consult a physician. (All tests can be completed before visiting the doctor’s office so that the results are available for the diagnosis.)

Read more about defining reference values.

The most typical cause of an elevated ALAT value is liver failure, but there are also other factors that elevate alanine aminotransferase:

  • Obesity can cause fatty liver disease.
  • Liver cirrhosis can be caused by chronic fatty liver disease. In liver cirrhosis, part of the liver tissue changes into connective tissue. In chronic liver cirrhosis, ALAT indicates the activity of the disease.
  • Long-term alcohol use
  • Some pharmaceuticals and natural health products (such as contraceptive pills, psychoactive drugs)
  • Anabolic steroids and narcotics
  • The ALAT value occasionally increases up to 40-fold in connection with inflammation of the liver, or acute hepatitis, caused by viruses and medications. - Other, less common causes of elevated ALAT enzyme include sepsis, pulmonary infarction, and liver or heart failure.

ALAT is often elevated even before the patient exhibits any symptoms. The concentration normalises within a few weeks or months after the disease.

  • Alkaline phosphatase is elevated in liver and bone diseases (1046 S-AFOS)
  • Bilirubin is formed by the breakdown of red blood cells and is a test for liver and bile duct diseases (1185 S-Bil)
  • Gamma-glutamyl transferase is a sensitive indicator of liver diseases (1489, S-GT)
  • Aspartate aminotransferase reacts quickly to liver, cardiac muscle, and musculoskeletal cell damage (1128 S-ASAT)
  • Calcium is critical for all cells of the body (2013 S-Ca, 6032 S-Ca-Albk)
  • Phosphate is an important building block of bones, cells, and DNA (1432 fS-Pi)
  • Alkaline phosphatase is elevated in liver and bone diseases (1046 S-AFOS)
  • Carbohydrate-deficient transferrin CDT (4101 S-CDT)

SYNLAB test list: Alaniiniaminotransferaasi (1026 S-ALAT)  https://www2.synlab.fi/laboratoriokasikirja/tutkimuskuvaukset/alaniiniaminoalat/

Terveyskirjasto health library: Alaniiniaminotransferaasi https://www.terveyskirjasto.fi/terveyskirjasto/tk.koti?p_artikkeli=snk03071&p_hakusana=alat

Potilaan Lääkärilehti https://www.potilaanlaakarilehti.fi/uutiset/alat-kertoo-maksasi-voinnista/

Tunturi S. Alaniiniaminotransferaasi (P-ALAT). Duodecim Terveyskirjasto 5 January 2021. https://www.terveyskirjasto.fi/snk03071/alaniiniaminotransferaasi-p-alat


Fasting is not required

This examination does not require fasting