SGOT and SGPT in Liver Function Test report: what do they indicate?

Posted On January 22, 2023January 22, 2023

Introduction

You must have seen SGOT and SGPT in liver function test (LFT) report. Do you know the SGOT/SGPT means in LFT?

Generally, your liver makes a lot of enzymes that release into the blood. The SGOT and SGPT are key enzyme markers of your liver and tell the information about your liver health status.

Whenever your liver gets injured; it might be due to inflammation or necrosis (by infection or sepsis). In that case, these enzymes get more vulnerable.

In liver injury, liver cells become more permeable. Due to this, SGOT/SGPT enzymes leak out into the bloodstream.

Here, SGPT (ALT) is more specific for liver injury. While, SGOT (AST) is non-specific for the liver that indicates other body parts injuries like heart muscles, skeletal muscles, red blood cells, kidneys, brain, etc.

A liver function test is a routine biochemical blood test that is used in clinical practice. This test helps your doctor in diagnosing liver problems.

Although, the liver function test includes many parameters such as ALP, SGOT, SGPT, albumin, GGT, prothrombin time, conjugated bilirubin, and unconjugated bilirubin. 

But today, we will discuss only SGOT/SGPT in liver function tests and understand the significance of SGOT/SGPT in clinical practice.

Let’s start the topic –

What is SGPT in liver function test reports?

The SGPT is a liver enzyme that gives information about your liver. It is more specific to the liver.

It is a strong parameter of the liver function test when your liver gets dysfunctional.

The SGPT full form is “Serum Glutamate Pyruvate Transaminase”. It is also called ALT (Alanine transaminase).

ALT is a type of aminotransferase. It particularly involves the amino acid metabolism and gluconeogenesis process.

The production of ALT in hepatocytes (liver cells) is 3000 times more than ALT present in your blood.

This means ALT is highly present in your liver cells. When your liver cells get injured, this ALT enzyme leaks out from your liver cells and raises the ALT level in your bloodstream.

What happens if SGPT is high? And, why does the SGPT level increase? 

Suppose you observe a high SGPT value in your LFT report; it indicates that you have some liver dysfunction or inflammation.

SGPT (or ALT) is a strong indicator of liver injury. Whenever your liver cells get damaged, the ALT level rises in your blood. 

You can see the high SGPT level in certain liver diseases like –

1. Chronic Viral Hepatitis

Some viruses damage your liver cells. Viral hepatitis is one of the common causes of liver damage.

In viral hepatitis, your liver cells get damaged by some viruses such as hepatitis A, B, C, D, and E viruses.

Generally, it is seen that acute viral hepatitis is caused by hepatitis A and E, while chronic viral hepatitis may arise from hepatitis B, C, and D.

This chronic (long-term) viral hepatitis may lead to liver cirrhosis or liver cancer. In this condition, you can see the high SGPT level in your blood. 

2. Autoimmune hepatitis

Your liver can also damage by autoimmune disease.

Sometimes the immune cells mistakenly damage your own liver cells during a fight against viruses, this is called Autoimmune Hepatitis. In this condition, your immune system does not differentiate healthy body cells and viruses.

Due to this, it damages liver cells which leads to elevating SGPT levels.

It rarely happens and is mostly seen in HIV, Cytomegalovirus (CMV), measles, herpes simplex or Epstein-Barr virus.

To make laboratory confirmation, you need to check your autoantibodies test such as ANA (antinuclear antibodies) and ASMA (anti-smooth muscle antibodies).

If you have positive ANA or ASMA with a higher ALT level, this indicates autoimmune hepatitis.

3. Liver cancer

When your abnormal hepatocytes (or liver cells) start uncontrolled growth, this is called Hepatocellular Carcinoma (or liver cancer).

In liver cancer, the SGPT level rises more than 1000 IU/L in your blood.

The major cause of liver cancer is long-term viral hepatitis B/C, cigarette smoking, alcohol, uncontrolled diabetes, obesity, or NAFLD (non-alcoholic fatty liver disease).

4. Genetic liver diseases

The SGPT level also gets more vulnerable in genetic liver conditions such as Wilson disease, Celiac disease, Hemochromatosis, etc.

What level of SGPT indicates liver damage?

Normally, SGPT can be detected in small concentrations in our blood. You can see the normal range of SGPT is 7 to 56 units per litre (IU/L) but it varies from lab to lab.

The high level of SGPT (more than 56 IU/L) liver enzyme indicates liver damage or diseases.

Suppose your SGPT/ALT level is 2860 and your SGOT/AST level is 1660 IU/L.

SGPT>>SGOT → Liver injury

These values highly indicate liver injury because the SGPT value is almost double, which could be hepatitis.

What is SGOT in liver function test reports?

Like SGPT, SGOT is also an enzyme that synthesizes in our liver. The SGOT full form is “Serum Glutamic-Oxaloacetic Transaminase”. It is also called AST (Aspartate Transaminase).

The AST is also a type of aminotransferase that particularly involves in the amino acid metabolism and gluconeogenesis process.

Your AST enzyme secretes from the liver during a liver injury but it also releases when your other body parts get damaged including heart muscles, skeletal muscles, kidneys, blood cells, pancreas, lungs and brain.

Therefore, the SGOT is non-specific to liver injury.

AST enzyme gives information about your liver, heart muscles, skeletal muscles, kidneys, blood cells and brain.

What is the reason for increasing SGOT?

The SGOT normal range is between 8 and 45 IU/L in your blood plasma (varies from lab to lab).

Suppose someone has a very high AST (SGOT) level. It indicates that it could be a liver injury. But it could also indicate a non-hepatic injury; which means other body parts are damaged.

The AST level may get increase 5 times more than ALT in the following conditions –

1. Haemolysis

Haemolysis means the destruction of red blood cells. Some amounts of AST are present in our red blood cells. Normally, haemolysis occurs in the spleen after the complete lifespan of RBCs.

But sometimes your red blood cells (RBCs) break down very fast than usual speed and it releases haemoglobin content in plasma that causes infection. This condition is called “Haemolysis“.

This haemolysis may spill out AST/SGOT levels in your blood plasma.

The cause of haemolysis may be due sickle cell anaemia, toxins, or genetic problem.

You can see a high AST/SGOT level than ALT/SGPT in your liver function test report.

2. Rhabdomyolysis

The skeletal muscles also contain a certain amount of AST. If someone gets any type of destruction in muscles, this condition is called “Rhabdomyolysis“.

In rhabdomyolysis, AST is released from your skeletal muscle cells and gets an increase in your blood.

3. Myocardial infarction

AST enzyme is chiefly present in your heart muscles (myocardium).

When your heart muscles get injured or complete blockage of a coronary artery. This condition is called “Myocardial Infarction“.

In myocardial infarction, AST enzyme starts to leak out from your heart muscles and gets an increase in your bloodstream.

AST is also considered a cardiac marker.

4. Alcohol Liver Damage

Alcohol-induced liver damage is a crucial cause of AST elevation.

If you take an excessive amount of alcohol in your daily life. Then, the high concentration of alcohol is the potential to damage your liver cells. This condition is called “Alcohol Liver Damage“, “Alcoholic fatty liver disease (AFLD)” or “Alcoholic Liver Cirrhosis“.

In this condition, the AST level gets double than ALT (AST/ ALT ratio is 2:1).

What if SGOT is higher than SGPT? What happens when SGOT is high?

Generally, it is difficult to determine the condition of the liver from SGOT (or AST).

A high SGOT does not indicate the severity of liver damage. It could be a cause of liver damage but it is not a specific marker for your liver.

You need to check the SGPT level to determine the direct cause of liver injury.

Suppose you find a high SGOT level and a normal SGPT level in your LFT report. In this condition, it indicates that SGOT is coming from a different part of your body.

It could be an indication of heart muscle damage, skeletal muscle injury, or blood cell destruction.

If you get other body parts injuries except for the liver. In that case, your SGOT/AST levels become too much high while your SGPT/ALT level little bit high.

What is the danger level of SGOT and SGPT in liver function tests?

Suppose you see a very high level of SGOT and SGPT level (more than 1000 to 10000 IU/L) in your liver function test report, it could indicate certain conditions –

1. Acute Viral hepatitis

Your SGOT and SGPT levels also get very high in acute viral hepatitis.

Acute viral hepatitis is caused by hepatitis A and E viruses. In this condition, the SGPT and SGOT level get more than 1000 IU/L.

These enzymes may also get increased in dengue hepatitis. In dengue infection, if you have a severe form of dengue fever with bleeding, it is called “Dengue Hemorrhagic Fever (DHF).

This DHF may damage your liver and cause dengue hepatitis.

2. Ischemic hepatitis

You might have seen some people have a severe heart attack; this is called cardiogenic shock.

Normally, your heart provides oxygenated blood to your liver by the hepatic artery.

But when you have a cardiogenic shock. In this condition, your heart does not pump properly. Due to this, the liver does not get enough blood which leads to “Ischemic Hepatitis” or “Shock liver“.

In ischemic hepatitis, your liver cells start to damage and increase the release of SGOT and SGPT levels in your blood.

You may have a severe decrease in blood pressure (or hypotension) in liver shock.

Also read → Emergency drug for cardiogenic shock 

3. Medicine induced hepatitis

There are a lot of medicines that potential to damage your liver cells during metabolism.

But the most common is paracetamol (or acetaminophen).

You may have a dangerous level of SGOT and SGPT in your blood if you have taken an excessive amount of paracetamol dose. This is called “Acetaminophen Poisoning” which leads to hepatotoxicity.

In paracetamol poisoning, your SGOT and SGPT levels go up more than 1000 IU/L. In some cases, it can exceed more than 10000 IU/L.

You might have seen a caution warning on the strips of paracetamol “Taking more than daily dose acetaminophen (paracetamol) may cause serious liver damage.”

I have made a list of some important medicine that may cause liver injury –

If you are taking these medicines for a long time, it may cause permanent liver damage such as liver fibrosis and cirrhosis, chronic hepatocellular and/or cholestatic liver damage.

Conclusion

Liver function test is an important tool in current clinical practice.

We have seen how SGOT and SGPT in liver function tests help your doctor in diagnosing liver and other organ dysfunction.

In liver function tests, SGPT (ALT) is more precise for liver diseases such as long-term viral hepatitis, autoimmune hepatitis, liver cancer, liver genetic disease, etc.

On the contrary, SGOT (AST) is less specific for the liver but it is more specific for other organ dysfunction such as red blood cell destruction, skeletal muscle damage, heart disease, taking an excessive amount of alcohol, etc.

In some cases, both SGOT and SGPT levels get increased if more than 1000 IU/L such as acute (sudden or short-term) viral hepatitis, ischemic hepatitis and medicine-induced hepatitis.

It is only an informative post.

Whenever you get an imbalance of SGOT and SGPT in liver function test report, you must consult your doctor. Depending on the results, your doctor may diagnose your condition or prescribe treatment.

Please share it, if you found this post informative.

FAQ

Q 1 Which is more sensitive SGOT or SGPT?

The SGPT (ALT) is more sensitive or specific for liver injury. While, SGOT (AST) is more sensitive or specific for other body part injuries such as heart, brain, skeletal muscles etc.

Q 2. Does SGPT mean fatty liver?

You can see a mild elevation of SGPT (ALT) level in the LFT report if someone has a non-alcoholic fatty liver disease (NAFLD). While SGOT (AST) is more concerned with Alcoholic fatty liver disease (AFLD).

Q 3. What is the critical level of SGPT?

It is normal to have SGPT levels between 55 and 60 IU/L. When the SGPT level gets doubles or triples from normal value then it indicates mildly elevated SGPT. But, if the SGPT level crosses 9000 IU/L, we will consider it a dangerous level of SGPT. It usually happens in chronic liver disease or liver cirrhosis. 

Q 4. What are the symptoms of a high level of SGPT?

You may have the following symptoms if you found a high level of SGPT in liver function test report –

• Having jaundice
• Excessive Bleeding
• Breathing problems.
• Dark urination
• Stomach pain
• Loss of appetite
• Light coloured stool
• An increase in swelling in the legs.
• Feeling fatigued.
• Nausea and vomiting

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