Enzymes of Clinical Significance Clinical Chemistry Review 99
ENZYME TISSUE(S) CLINICAL SIGNIFICANCE OTHER
Acid phosphatase (ACP)
Alkaline phosphatase
(ALP)
Aspartate aminotrans-
ferase (AST)
Alanine aminotrans-
ferase (ALT)
Gamma glutamyl
transferase (GGT)
Prostate
Almost all
Many. Highest in
liver, heart, skeletal
muscle.
Liver, RBCs
Liver, kidneys,
pancreas
↑in prostate cancer
↑liver & bone disease. Levels
higher in biliary tract obstruc-
tion than in hepatocellular
disorders (hepatitis, cirrhosis)
↑with liver disease (marked
↑with viral hepatitis), acute
myocardial infarction (AMI),
muscular dystrophy
↑with liver disease
↑in all hepatobiliary disor-
ders, chronic alcoholism
Limited value today. PSA is more specific.
↑in children, adolescents, pregnant women,
& with healing bone fractures. Optimum
pH = 9–10.
Avoid hemolysis.
More specific for liver disease than AST. Marked
↑with viral hepatitis.
Most sensitive enzyme for all types of liver dis-
ease. Highest levels with obstructive disorders.
Treatment centers use to monitor abstention
from alcohol.
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