Quick Review Cards for Medical Laboratory Science

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.

continued...