同: ALT

WordNet

a crystalline amino acid that occurs in many proteins

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/10/06 04:56:34」(JST)

wiki en

Alanine transaminase or ALT is a transaminase enzyme (EC 2.6.1.2). It is also called serum glutamic pyruvic transaminase (SGPT) or alanine aminotransferase (ALAT).

ALT is found in serum and in various bodily tissues, but is most commonly associated with the liver. It catalyzes the two parts of the alanine cycle.

Function

It catalyzes the transfer of an amino group from alanine to α-ketoglutarate, the products of this reversible transamination reaction being pyruvate and glutamate.

glutamate + pyruvate ⇌ α-ketoglutarate + alanine

Alanine transaminase

Clinical significance

It is commonly measured clinically as a part of a diagnostic evaluation of hepatocellular injury, to determine liver health. When used in diagnostics, it is almost always measured in international units/liter (U/L).^[1]^[2] While sources vary on specific normal range values for patients, 10-40 U/L is the standard normal range for experimental studies.^[1] Alanine transaminase shows a marked diurnal variation.

Elevated levels

Patient type	Reference ranges^[3]
Female	5–38 IU/L
Male	10–50 IU/L

Significantly elevated levels of ALT(SGPT) often suggest the existence of other medical problems such as viral hepatitis, diabetes, congestive heart failure, liver damage, bile duct problems, infectious mononucleosis, or myopathy. For this reason, ALT is commonly used as a way of screening for liver problems. Elevated ALT may also be caused by dietary choline deficiency. However, elevated levels of ALT do not automatically mean that medical problems exist. Fluctuation of ALT levels is normal over the course of the day, and ALT levels can also increase in response to strenuous physical exercise.^[4]

When elevated ALT levels are found in the blood, the possible underlying causes can be further narrowed down by measuring other enzymes. For example, elevated ALT levels due to liver-cell damage can be distinguished from biliary duct problems by measuring alkaline phosphatase. Also, myopathy-related ALT levels can be ruled out by measuring creatine kinase enzymes. Many drugs may elevate ALT levels, including Zileuton, omega-3-acid ethyl esters (Lovaza)^[5], anti-inflammatory drugs, antibiotics, cholesterol medications, some antipscyhotics such as Risperidone, and anti-convulsants.^{[citation needed]}

For years, the American Red Cross used ALT testing as part of the battery of tests to ensure the safety of its blood supply by deferring donors with elevated ALT levels. The intent was to identify donors potentially infected with Hepatitis C because there was no specific test for that disease at the time. Prior to July 1992, widespread blood donation testing in the USA for Hepatitis C was not carried out by major blood banks. With the introduction of second-generation ELISA antibody tests for Hepatitis C, the Red Cross changed the ALT policy. As of July 2003^[update], donors previously disqualified for elevated ALT levels and no other reason may be reinstated as donors by contacting the donor counseling department of their regional Red Cross organization.^[6]

References

^ ^a ^b Wang, CS; Chang, Ting-Tsung; Yao, Wei-Jen; Wang, Shan-Tair; Chou, Pesus (2012). "Impact of increasing alanine aminotransferase levels within normal range on incident diabetes". J Formos Med Assoc 111 (4): 201–8. doi:10.1016/j.jfma.2011.04.004. PMID 22526208.
^ Ghouri, N; Preiss, David; Sattar, Naveed (2010). "Liver enzymes, nonalcoholic fatty liver disease, and incident cardiovascular disease: a narrative review and clinical perspective of prospective data". Hepatology 52 (3): 1156–61. doi:10.1002/hep.23789. PMID 20658466.
^ GPnotebook > reference range (ALT) Retrieved on April 5, 2012
^ Paul T. Giboney M.D., Mildly Elevated Liver Transaminase Levels in the Asymptomatic Patient, American Family Physician.
^ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683599/?tool=pmcentrez Omega-3-acid Ethyl Esters (Lovaza) For Severe Hypertriglyceridemia, Pharmacy and Pherapeutics.
^ Red Cross Donor Requirements

External links

Alanine+transaminase at the US National Library of Medicine Medical Subject Headings (MeSH)
ALT: MedlinePlus Medical Encyclopedia

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 肝酵素および肝機能検査値の異常が認められた患者に対するアプローチ approach to the patient with abnormal liver biochemical and function tests
2. 肝細胞障害を検出するための肝臓生化学検査 liver biochemical tests that detect injury to hepatocytes
3. 嚢胞性線維症：肝胆道系疾患 cystic fibrosis hepatobiliary disease
4. 肝線維症の非侵襲的評価：血清学的検査および画像診断 noninvasive assessment of hepatic fibrosis overview of serologic and radiographic tests
5. 小児における腹部の鈍的外傷の概要 overview of blunt abdominal trauma in children

English Journal

Survival effects of physical activity on mortality among persons with liver disease.

Loprinzi PD1, VanWagner LB2.
Preventive medicine reports.Prev Med Rep.2015 Dec 29;3:132-4. doi: 10.1016/j.pmedr.2015.12.011. eCollection 2016.
Physical activity is protective of premature mortality and those with liver disease are at an increased risk of early mortality. It is thus plausible to suggest that physical activity may have survival benefits among those with liver disease, but this has yet to be investigated. In a national sample
PMID 26844199

Efficacy and Safety of Bortezomib in Multiple Myeloma Patients with Hepatitis B: A Multicenter Retrospective Study.

Lu J, Chen WM, Geng CY, Durie BG, Huang XJ1.
Chinese medical journal.Chin Med J (Engl).2016 5th Feb;129(3):274-278. doi: 10.4103/0366-6999.174508.
BACKGROUND: The efficacy and safety evidence of bortezomib in multiple myeloma (MM) patients with hepatitis B is vacant. This study aimed to investigate the efficacy and safety of bortezomib in MM patients with hepatitis B in China.METHODS: From 2006 to 2011, 739 newly diagnosed MM patients were scr
PMID 26831227

Epidemiological, clinical, virological features of hepatitis B newly diagnosed in 2011 in Marseille University hospitals, southeastern France.

Moussa S1, Brah S1,2, Parola P1,2, Gerolami R3, Gamerre M3, Boubli L4, Ruiz JM5, Ravaux I1, Mokhtari S2, Mancini J6, Romera MH7, Motte A7, Tamalet C2,7, Colson P2,7.
Journal of medical virology.J Med Virol.2016 May;88(5):828-36. doi: 10.1002/jmv.24398. Epub 2015 Oct 15.
Hepatitis B virus (HBV) infection is a public health problem. In France, 0.68% of adults are chronically infected. We aimed to describe the epidemiological, virological and clinical characteristics of HBV infections newly diagnosed in 2011 in University hospitals of Marseille, the second largest Fre
PMID 26439319

Japanese Journal

「肝臓の病態」を読む検査 : AST(aspartate aminotransferase、アスパラギン酸アミノトランスフェラーゼ) ALT(alanine aminotransferase、アラニンアミノトランスフェラーゼ) (特集ズバッと読み取る! 検査値アセスメント検査値の"ここ見て!"9項目)

Expert nurse 31(12), 41-44, 2015-10
NAID 40020596972

ビタミンB_6酵素の構造,機能,進化に関する研究

ビタミン 89(7), 327-340, 2015-07-25
NAID 110009969987

Aberrant Expression of Keratin 7 in Hepatocytes as a Predictive Marker of Rapid Progression to Hepatic Failure in Asymptomatic Primary Biliary Cirrhosis

Acta Medica Okayama 69(3), 137-144, 2015-06
NAID 120005621907

Related Pictures

★リンクテーブル★

リンク元	「アラニンアミノトランスフェラーゼ」「アミノ転移」「ALT」「アラニンアミノ基転移酵素」「alanine transaminase」
拡張検索	「L-alanine aminotransferase」
関連記事	「alanine」「aminotransferase」

「アラニンアミノトランスフェラーゼ」

Alanine transaminase
Identifiers
EC number	2.6.1.2
CAS number	9000-86-6
Databases
IntEnz	IntEnz view
BRENDA	BRENDA entry
ExPASy	NiceZyme view
KEGG	KEGG entry
MetaCyc	metabolic pathway
PRIAM	profile
PDB structures	RCSB PDB PDBe PDBsum
Gene Ontology	AmiGO / EGO
Search
PMC	articles
PubMed	articles
NCBI Protein	search

glutamic-pyruvate transaminase
Identifiers
Symbol	GPT
Entrez	2875
HUGO	4552
OMIM	138200
RefSeq	NM_005309
UniProt	P24298
Other data
EC number	2.6.1.2
Locus	Chr. 8 q24.2-qter

　　[★]

英: alanine aminotransferase, L-alanine aminotransferase, ALT
同: グルタミン酸ピルビン酸トランスアミナーゼ glutamic-pyruvic transaminase, GPT; グルタミン酸アラニントランスアミナーゼ glutamic-alanine transaminase、L-アラニン:2-オキソグルタル酸アミノトランスフェラーゼ L-alanine:2-oxoglutarateaminotransferase
関: アスパラギン酸アミノ基転移酵素 AST、マクロALT。アミノ転移

臨床検査医学 090113

概念

肝細胞からの逸脱酵素。肝以外での含有量は少ない。
旧来のGPTおなじ
肝細胞障害の指標　→　炎症が沈静化していれば(慢性肝炎や肝硬変の末期)、正常範囲を示しうる。

酵素

http://www.uniprot.org/uniprot/P24298

EC 2.6.1.2。
分子量：54,637Da

機能

可逆的アミノ基転移反応を触媒する
L-アラニン（L-alanine）＋2-オキソグルタル酸（2-oxoglutarate）＝ピルビン酸（pyruvate）＋L-グルタミン酸（L-glutamate
補酵素：ピリドキサールリン酸（VB6）補酵素
組織の炎症や挫滅により血中に逸脱
消化管から由来する大量のアラニンを肝臓でピルビン酸へと変換し，糖新生の基質として供給
全身に存在するが、特に肝臓に多い。

臨床検査

基準値：4-43U/L。7-41 U/L(HIM A-3)

1,000U/L以上

急性ウイルス肝炎

判別

高度上昇　：急性肝炎、劇症肝炎、ショック
中程度上昇：急性肝炎ｍ慢性活動性肝炎、閉塞性黄疸
軽度上昇　：脂肪肝、肝硬変、アルコール性肝障害、胆石発作、肝癌、心筋梗塞(うっ血肝により肝細胞障害を来し、軽度上昇)

ALTは慢性期な疾患でASTより優位となる。(アルコール性の肝疾患や肝硬変、肝癌は異なる)
急性ウイルス性肝炎(極期)、慢性肝炎、過栄養性脂肪肝

	AST	ALT
含有量	3	1
局在	心筋、肝臓、骨格筋、腎臓赤血球	肝臓、腎臓、心臓、骨格筋
逸脱しやすさ	逸脱しにくい	逸脱しやすい
血中半減期	2日	6日
肝小葉内の分泌	中心静脈	辺縁