LFT & lipid profile 2025

Classification :
 Serum total protein

Synthetic function  Serum Albumin
of liver
 Prothrombin time
Excretory  Serum bilirubin (total and direct)

function of liver
 AST (SGOT)
 ALT (SGPT)
Liver enzymes
 alkaline phosphatase (ALP)
 γ glutamyl transferase (GGT)
Significance:
1) Non-invasive methods for screening of liver disease as hepatitis.
2) Assess severity and allow prediction of outcome.
3) Disease and treatment follow-up.
4) Monitoring possible side effects of medications.
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 Three types of bilirubin could be measured or calculated in lab:
1- Total bilirubin
2- Direct bilirubin
3- Indirect bilirubin
❑ Normal total bilirubin up to 1 mg/dl :

a) If bilirubin level >1.2 mg/dl → Hyperbilirubinemia.
b) If bilirubin level >2.5 mg/dl → Jaundice.
Heme Catabolism:
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NB
 Bilirubin has limited aqueous solubility, so it binds to albumin to increases its
solubility in plasma.
 Liver has the ability to remove unconjugated bilirubin.
 The liver conjugates the bilirubin with glucuronic acid, so it is now called
“conjugated/ direct bilirubin”.
Types:
Hemolytic jaundice Hepatocellular Obstructive jaundice
jaundice
↑ Unconjugated (indirect) ↑ Unconjugated & ↑ Conjugated (direct)
bilirubin conjugated bilirubin bilirubin
↑ hemolysis of RBCs Liver cell failure Bile duct obstruction
e.g. Hemolytic anemia e.g. Liver cirrhosis e.g. Stone
1) Alanine transaminase (ALT)

= Serum Glutamic Pyruvate Transaminase (SGPT)
2) Aspartate transaminase (AST)
= Serum Glutamic Oxaloacetic Transaminase (SGOT)
3) Alkaline phosphatase (ALP)
4) Gamma glutamyl transferase (GGT)
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Alanine transaminase Aspartate transaminase Alkaline phosphatase Gamma glutamyl transferase
 Hepatocytes (Liver).  Hepatocytes (Liver).  Biliary duct of the liver.  Hepatocytes (Liver).
 Also in red cells, and cardiac  Also in bone & placental tissue.
Site
and skeletal muscle.
 More liver -specific than AST.  Not specific to the liver.  Not specific to the liver.  More specific to liver and
sensitive marker for cholestatic
Specificity
damage than ALP.
 Primary liver diseases  Liver diseases  Large bile duct obstruction,  With even minor, sub-clinical
 such as cirrhosis, carcinoma,  Myocardial infarction intrahepatic cholestasis levels of liver dysfunction
Elevate in : viral hepatitis and obstructive  Muscle disease  Infiltrative diseases of the liver.
jaundice.
Normal range  up to 45 IU/L  up to to 35 IU/L.  45 to 145 IU/L  up to 55 IU/L

 Albumin is the most abundant plasma protein in human.
 It accounts for about 60% of the total serum protein.
 It is produced only in the liver.
 Long half-life: 20 days
 Prothrombin: synthesized by liver, marker of liver function.
 Half-life: 6 hrs. (indicates the present function of the liver).
 Vitamin K deficiency also causes prolonged PT.
 Intake of vitamin K does not affect PT in liver disease.
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Principle :
 The quantitative measurement of colorless materials is based on the principle
that they will be converted to colored substances in certain chemical or
biological reactions.
 The intensity of the color produced is directly proportional to substance
concentration in the sample.
 This colored solutions can absorb light at certain wave lengths.
 Then by measuring the absorbance of the colored products, the substance

concentration can be calculated.
 In colorimeter: it is necessary to prepare 3 tubes:
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Principle :
Bromocresol green (BCG) colorimetric method
❑ Albumin at pH 4.3 is sufficiently cationic to bind the anionic indicator dye
bromocresol green (BCG) to form a blue-green colored complex.
❑ The intensity of the blue-green color is directly proportional to albumin

concentration in the sample.
Procedure
❑ Sample: Serum, plasma
❑ Method: Pipette into test tubes
Blank Standard Sample

Working reagent 1ml 1ml 1ml
Standard --- 10 μl ---
Sample --- --- 10 μl
Distilled water 10 μl --- ---
Mix & incubate for 5 min at (20-25C)
Reading:
❑ Measure the absorbance of sample and standard against blank at wave
length 578 nm.
Calculation:
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Comment:
❑ Normal Serum albumin levels = 3.5 to 5 g/dl.
❑ Lower than normal levels of albumin is strongly suggestive of chronic liver
disease.
Causes of hypoalbuminemia
 Mal-nutrition (Starvation)
 Mal-absorption (Crohn’ s disease)
 Chronic liver disease
 Chronic infection
 Tissue damage (severe burns)
 Prolonged fever/ inflammation
 Nephrotic syndrome
The low plasma osmotic pressure allows water to move out of the blood
capillaries into the tissues (edema, ascites).
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Definition ❑ Blood tests that measure amount of lipids in your blood
Test Normal range

Total cholesterol Up to 200 mg/dl
Include Triglycerides Less than 150 mg/dl
HDL-C 45-65 mg/dl
LDL-C Less than 100 mg/dl
1. To assess the lipid status of an individual.
2. To diagnose dyslipidemia.
3. To evaluate risk of atherosclerosis & coronary artery disease.
Significance
4. To monitor the efficacy of:
 Lipid lowering therapy like statins.
 Lifestyle changes like diet or exercise on the lipid levels.
NB
❑ Total cholesterol = HDL-C+ LDL-C+ VLDL-C
❑ LDL-C is either :
1. Measured directly
2. Calculated by this formula :
 LDL-C = Total cholesterol – (HDL-c + TG/5)

[TG/5 represents VLDL-C]
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Precautions for sampling
1. Blood sample should be collected after 12-hour fasting
(no food or drink, except water)
2. 12-hour Fasting is essential :
a) To minimize variation, since eating affect triglycerides levels for many
hours.
b) To produce a better calculation of LDL-cholesterol, which is often
calculated from an equation using fasting triglycerides value.
3. Blood is collected in red dry tube for serum.
Principle:
❑ Cholesterol esters are hydrolyzed by cholesterol esterase to cholesterol
which is oxidized by cholesterol oxidase into cholest-4-en-3-one + H2O2
❑ H2O2 is detected by colorimetric probe by peroxidase.
❑ The intensity of color is proportional to cholesterol concentration.
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Procedure
❑ Sample: Serum, plasma
❑ Method: Pipette into test tubes
Blank Standard Sample

Working reagent 1ml 1ml 1ml
Standard --- 10 μl ---
Sample --- --- 10 μl
Distilled water 10 μl --- ---
Mix & incubate for 10 min at room temperature
Reading
❑ Measure the absorbance of sample and standard against blank at wave
length 505 nm using the spectrophotometer.
Calculation:
Causes of hypercholesterolemia:
1. Normal cholesterol values: less than 200 mg/dl
2. Causes of hypercholesterolemia:
 Familial Hypercholesterolemia
 Hypothyroidism
 Nephrotic syndrome
 Obesity
 D.M
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LFT & lipid profile 2025

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Classification :

 Serum total protein

Excretory  Serum bilirubin (total and direct)

❑ Normal total bilirubin up to 1 mg/dl :

1) Alanine transaminase (ALT)

Normal range  up to 45 IU/L  up to to 35 IU/L.  45 to 145 IU/L  up to 55 IU/L

 Then by measuring the absorbance of the colored products, the substance

❑ The intensity of the blue-green color is directly proportional to albumin

Blank Standard Sample

Test Normal range

 LDL-C = Total cholesterol – (HDL-c + TG/5)

Blank Standard Sample

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