Ast blood test decoding is normal. Increased levels of ast in the blood. Reasons for changes in indicator levels

What does the AST indicator mean in a biochemical blood test? Aspartate aminotransferase or AST is necessary for the body to maintain homeostasis. Various methods can be used to examine a patient. But a blood test for biochemistry is used quite often. With its help, you can identify how the composition of the blood has changed, and on this basis make a diagnosis. To confirm the diagnosis, a comprehensive examination is performed.

Specifics of the analysis

With a biochemical blood test, it is possible to determine the patient’s AST level. There are indicators that are considered to be the norm. If deviations from the norm are noticed, the reasons for what is happening are determined. What is AsAt (AST)? What is the significance of AST in a blood test?

Biochemical blood test is an in-depth study physiological fluid. It is given to the patient when their health deteriorates or a complex illness is suspected.

Early development characteristic symptoms may not appear, while blood tests reveal any abnormalities.

A blood biochemistry test shows the development of:

liver diseases;
heart pathologies.

Treatment for initial stage increases the chances of a full recovery.

AST enzymes are found in the heart muscles, kidneys, muscles and liver tissues. If the amount increases, there is a possibility of developing heart and muscle diseases. In case of a heart attack, the doctor can make a prognosis of the patient’s condition based on AST indicators.

Norms for AST levels in the blood:

For men - 31 units per liter.
For women - 40 units per liter.

To exclude false results, blood is drawn in the morning on an empty stomach. Before this, you should not drink alcohol or drugs.

The results should be reviewed by a doctor and, if necessary, further examination should be prescribed. There may be slight deviations from the norm, which are considered normal. But if the difference is significant, you need to consult a specialist.

Deviations from the norm

Discrepancies with the norm in the content of an enzyme such as aspartate aminotransferase can occur quite often.

This happens for several reasons:

Incorrect preparation for analysis.
Failure to follow the doctor's recommendations before taking blood.
When any disease develops.

To correctly decipher the analysis, you need to know the parameters of the AST and ALT indicators. If ALT is 150% higher than normal, and AST is more than 450%, damage to the heart muscle can be assumed due to a disruption in its blood supply. Then urgent hospitalization and hospital treatment may be necessary.

Abnormalities in AST and ALT may indicate liver dysfunction. Biochemistry analysis will help identify pathology at the very beginning of development, when no external symptoms are observed.

But changes in indicators may be affected by:

alcohol;
fatty foods;
stressful situation;
overwork;
great physical activity;
eating food less than 10 hours before taking biomaterial;
use medicines. Especially if they are used on an ongoing basis;
period of bearing a child;
the patient is overweight.

It is necessary to tell specialists about the impact of external factors so that additional points are taken into account when deciphering the data obtained.

Possible diseases

By establishing real AST levels in the blood, the presence of various diseases can be detected.

These include:

The initial stage of development of cirrhosis.
Liver oncology at stages 1 and 2.
Hepatitis is viral or toxic.
Toxic liver damage from drugs.
Inflammation of the pancreas.
Inflammation of the gallbladder.
Abnormal heart function or heart attack.
State of shock.

If the values of AST and ALT deviate from the norm, it is necessary to conduct an examination of the heart and liver.

Experts use the de Ritis index for diagnosis. It is detected by dividing AST values by ALT. In this case, their ratio will be known.

Index values:

a healthy person should have a value of 1.3 Units;
deviations can be no more than 0.42 more or less;
if it is exceeded by 1.3, but less than 2, hepatitis is suggested;
if the index is 2, we can talk about the development of cirrhosis or heart attack;
when the index value is less than 1.3, liver dystrophy develops.

Additionally, a urine test and ultrasound examination are performed, and only after this a final diagnosis is made. But there may be a case when AST levels are normal, and other tests indicate the course of the disease. This can occur when liver cells are destroyed if the disease has already progressed.

This usually happens in the following situations:

late stage of cirrhosis;
liver failure.

The complete absence of healthy cells prevents the body from producing enzymes. In this case, it is necessary to conduct a comprehensive examination to eliminate the cause of the disease. It is recommended to do a blood test if the condition worsens. general condition health without delaying a visit to the doctor. Preventive examinations are carried out at least once a year.

Decoding biochemistry data

A biochemical blood test is a special study.

The results can be interpreted correctly if the following points are observed:

Interpretation of the notation system used. For AsAt there are several of them (U/l and mole). A specialist can bring them to generally known indicators.
Refusal to independently attempt to decipher the results obtained.
Compliance with all recommendations before collecting material for research.
Be sure to take into account the patient’s height, weight, age and the relationship between these values.

If the AST level is below the permissible norm, the patient may experience a lack of vitamin B. In women, this may be associated with bearing a child, as well as in representatives of both sexes with surgical intervention or severe fatigue and exhaustion of the body. With the help of special therapy, the situation can be corrected. The patient should rest and recuperate. But there are situations when this indicates the progression of the disease in the body. Then the patient will need an appointment special drugs, relieving pain. In this case, it is no longer possible to stop the progression of the disease.

To maintain AST parameters within normal limits, it is recommended:

adhere to the right lifestyle;
undergo regular preventive examinations;
follow any doctor's recommendations;
exercise and eat right;
do not consume alcohol, nicotine and drugs.

Only a doctor can evaluate the results as a whole. It is better for this to be a specialist who sees the patient constantly. It is necessary to know everything about chronic diseases, the treatment being taken, and the use of medications. Correct decoding of AST is an important link in diagnosis.

Aspartate amine transferase, AST, ACaT, or AST in a blood test means the same term in medicine, meaning the content of an enzyme in the human body that is involved in protein metabolism and the breakdown of amino acids. This enzyme is part of many cell membranes and is found mainly in the spleen, heart, brain, liver, pancreas, and also in skeletal muscles. But ast may not show its activity in all organs. Moreover, if asthma is elevated, you can think about a rather limited circle possible pathologies. As long as the structure and functions of the cells are not impaired, and the organs that predominantly contain ast are functioning fully in a normal mode, the level of the enzyme in question in the blood stream will be minimal and not beyond the normal range. Excessive release of ast enzyme into the bloodstream is usually provoked by a violation of the integrity of the cells of a particular organ, as well as pathological conditions developing in it.

In what situations and under what suspicions is it prescribed? biochemical analysis blood on AST, what does this mean, aspatate aminotransferase is increased, and what pathological conditions provoke excessive release of enzymes into the blood, we will consider all this in the article.

Normal ast in the blood

In order to assess the results obtained and the intensity of the enzyme in the blood plasma, you need to know how much it should normally be in the blood plasma. healthy person.

Reference values (normal) for aspartate aminotransferase levels differ slightly in men, women and children. Here are the established limits of the indicator, measured in units per liter (U/l):

from birth to one year - up to 58 U/l;

1-4 years - up to 50 U/l;

4-7 years - up to 48 U/l;

7-13 years - up to 44 U/l;

14-18 years - up to 39 U/l

Adults:

men - no more than 41 U/l;

women - no more than 31 U/l.

It should be noted that minor deviations from the level are allowed in children at the time of active maturation, in pregnant women in the first trimesters of pregnancy, as well as in patients who are treated with medications and intramuscular injections that affect liver function and provoke an increase in AST activity.

In other cases, if aspartate aminotransferase is elevated, the doctor may suspect the development of extremely serious diseases and pathological conditions.

Causes of increased asthma in the blood

Ideally, in a healthy person, the activity of the enzyme in the blood should be low. If in a blood test the ast is elevated, 5-10 times relative to certain norms, usually this situation is caused by the development viral infections. Usually, the patient is asked to donate blood several times for biochemical testing to exclude the possibility of a false or temporary deviation. After all, there are often cases when aspartate aminotransferase, ast, is increased as a result of certain conditions, for example:

after an injury or bruise to skeletal muscles received the day before;
after receiving a burn;
after suffering heatstroke;
after poisoning with poisonous mushrooms.

If the increase in the enzyme is repeated and is not associated with the above pathological conditions, it may signal that serious diseases have occurred. Increased blood pressure causes:

Hepatitis (acute, chronic, viral);
Heart injuries (closed or open type);
Myocardial infarction or acute heart failure;
Severe angina attack;
Cirrhosis, cancer, liver carcinoma;
Liver damage from toxic or hepatotoxic poisons, e.g. ethanol or carbon tetrachloride;
Endogenous intoxications within the body resulting from infectious or purulent lesions of soft tissues and internal organs;
Acute pancreatitis;
Cholestasis (stagnation of bile), as well as primary cancer of the bile ducts;
Destruction or necrosis of muscle tissue, myodystrophy, myositis, gangrene, etc.;
Advanced alcoholism, resulting in the death of liver cells.

If the AST blood test is elevated, what this means for a particular person must be decided by the doctor, based on several diagnostic methods and a thorough examination.

As a rule, in order to determine in which organ the disorder or lesion occurred, the level of alanine aminotransferase (ALT or Alat) is determined together with aspartate aminotransferase (ast or asat). If alt and ast are elevated in a blood test, the reasons most likely lie in the pathological processes occurring in the tissues in which they are present. The ratio of these two enzymes is medically called the de Ritis coefficient. If this parameter is more than 1, then we are often talking about heart disease, in other cases we are talking about liver disorders. Normally, this coefficient should be in the range from 0.9 to 1.8; in case of a heart attack, it can increase 5 times; in case of hepatitis, on the contrary, it drops to 0.5-0.6.

Also during diagnosis, together with intracellular enzymes, an indicator such as conjugated bilirubin can be examined, an increase in which occurs with viral and induced lesions, with cirrhosis, biliary tract obstruction, as well as chemical or alcohol poisoning. Increased alt and ast with normal bilirubin, maybe with hidden forms cirrhosis or liver failure, it all depends on how elevated the enzyme levels are. If the level of alate and asate in the blood is increased by less than 2 times compared to the maximum standard value, it is not identified as a dangerous pathological process, in this case the patient is only recommended to undergo regular monitoring and analysis.

It is necessary to clearly understand that an increase in alt and ast is not an independent disease, but only its consequence. Therefore, in order to lower enzymes, it is necessary to eliminate the causes of increased asat (ast) in the blood.

Take care of your health!

AST blood test is a biochemical blood test that determines the amount of intracellular enzyme aspartate aminotransferase.

This analysis method is used to diagnose diseases of the myocardium, liver and muscle disorders, and is usually prescribed simultaneously with ALT blood tests, as well as a bilirubin test.

This analysis allows you to determine the amount of cellular enzyme AST in the tissues of the liver, kidneys, heart, skeletal muscles, nervous system and other organs. If, during a blood test, the AST transcript shows a high amount of aspartate aminotransferase in the tissues of the body, this allows us to draw conclusions about the presence of disorders in a particular organ.

Norm

Normal AST content in the blood depends on the patient's gender:

in women the figure is within 31 U/l;
for men, the normal value is up to 41 U/l;
in newborns, the norm is considered to be from 25 to 75 U/l;
in children aged from one year to eighteen years – 15 to 60 U/l.

As you can see, the activity of aspartate aminotransferase in a woman’s body is slightly lower than in a man’s body, and in children it is higher than in adults.

Indications for the purpose of analysis

An AST blood test is necessary to accurately determine the intracellular enzyme aspartate aminotransferase, which is detected as a result of biochemical analysis.

It is prescribed in the following cases:

All liver pathologies.
All types of jaundice and bilirubin metabolism disorders.
Autoimmune diseases.
Endocrine diseases.
Infections.
Intoxication.
Malignant tumors.
Allergic skin diseases.
Long-term treatment with antibiotics, chemotherapy and various toxic drugs.
Diseases of the circulatory system.
Chronic and acute heart diseases.
Kidney failure.
Injuries to the abdomen and chest.
Preparation for a complex surgical operation.
Purulent-septic pathologies.
Encephalopathy of unknown etiology.
Bile outflow disorders, cholelithiasis.
Chronic pancreatitis.
Evaluation of treatment of liver and cardiac pathologies

It is important to note that 7-15 days before donating blood for AST, you should completely avoid taking medications. However, if this cannot be done, the doctor should be informed of the amount of drugs and their daily dosage before drawing blood.

Causes of elevated AST

Why is the AST reading elevated and what does it mean? In adults, AST levels increase in diseases accompanied by the breakdown of tissues rich in these enzymes. An excess of AST by 2–5 times is considered moderate, 6–10 times is considered average, higher levels are considered a significant increase.

More often AST above normal is diagnosed when:

or ;
alcohol intoxication;
development of obstructive jaundice;
destruction of liver cells;
dermatomyositis;
mesenteric infarction;
progressive muscular dystrophy;
fatty liver;
local radiation damage;
acute;
necrosis of cardiomyocytes (heart muscle cells);
necrosis or injury of skeletal muscle cells;
poisoning with chloroform, toadstool, carbon tetrachloride;
therapy with hepatotoxic drugs and drugs that cause cholestasis.

Determination of AST levels is often carried out in combination with ALT. The presence of data on the level of these two enzymes allows us to assume the localization of the pathological process, its severity and make a prognosis. There is the so-called Ritis coefficient - the AST/ALT ratio. Normally, this indicator is 1.33. In case of heart disease it increases, and in case of liver pathology it decreases (with the exception of alcohol damage).

What to do

It is necessary to clearly understand that an increase in AST is not the cause of the disease. This is its consequence. Therefore, only the elimination of the causative disease can interrupt the cause-and-effect relationship, which will be reflected in the normalization of AST activity and will become a criterion for victory over this disease.

Any cases of increased aspartate aminotransferase are a reason to seek specialized medical help. This harmless and asymptomatic sign often hides serious chronic diseases that will only manifest themselves after some time.

Since this sign signals the destruction of cells containing this enzyme (heart, liver, muscles), it is necessary to diagnose and treat diseases of these organs.

During a preventive examination, monitoring chronic patients or diagnosing the causes of certain disorders, patients are often prescribed a blood biochemistry test. The content of ALT and AST, the norm of which indicates the absence of severe pathologies of internal organs, is a valuable diagnostic criterion.

What it is

Alanine and aspartate aminotransferase are enzymes that are present in the cells of visceral organs and blood plasma. They accept Active participation in the metabolism of individual amino acids (alanine and aspartic acid). An increase or decrease in ALT and AST in the blood indicates the destruction of functional cells due to a necrotic, cancer or inflammatory process.

Alanine transferase is found primarily in hepatocytes (liver cells) and myocardiocytes (heart cells), but is also present in the kidneys, skeletal muscles, pancreas. Its main function is the transfer of the amino group of alanine acid to ketoglutaric acid with the further formation of pyruvic and glutamic acids, which play an important role in the biochemical reactions of the body.

Aspartic transferase is found in hepatocytes, cardiomyocytes, muscle and kidney tissues, etc. Its function is the formation of aspartate and ketoglutarate by transferring an amino acid group. The metabolism of these acids is necessary for the implementation of the urea cycle and endogenous glucose formation.

Aspartic transferase is present in the same tissues as the first enzyme, but due to a different functional purpose, it is found in them in different concentrations. This means that not only the nature of deviations from the norm, but also the relationship between AST and ALT helps to make a correct diagnosis for disorders in biochemistry.

Analysis for AST and ALT is mandatory when checking liver function (liver tests), studying the causes of dyspepsia, diagnosing the condition of the myocardium, muscle fibers and other internal organs.

Norms and deviations

The levels of ALT and AST in the blood differ depending on gender and age. A change in the normal concentration of enzymes is observed with heavy sports loads and pregnancy.

Due to large quantity influencing factors, a slight deviation upward or downward from the norm is not a pathology.

In adults

In patients over 18 years of age, AST and ALT are normally:

Alanine aminotransferase: up to 31 U/l in adult women outside the period of pregnancy, up to 32 U/l in pregnant women, up to 45 U/l in men.
Aspartate aminotransferase: up to 31 U/L in non-pregnant women, up to 30 U/L in expectant mothers, up to 47 U/L in men.

Reference values depend on the sensitivity of laboratory equipment. Normal level AST and ALT in the blood are given in the analysis form next to the patient’s results column.

A valuable diagnostic indicator is the ratio of ALT to AST: normally it is 0.77. More common is the Ritis coefficient, which is the inverse ratio (AST to ALT): its value ranges from 0.88 to 1.72 (1.3 with possible deviations of no more than 0.42).
In other words, it is ideal if AST is 1.5 times higher than ALT.

In children

The norm of ALT and AST in the blood of children is determined primarily by their age, and not by gender.

In adolescents over 15 years of age, the aminotransferase level gradually comes into line with adult levels.

Causes and symptoms of increase

The cause of abnormal concentrations of alanine and asparagine aminotransferases is pathological processes during internal organs, occurring with massive decay of functional cells. The size of the excess enzyme content indicates the nature of the disease and the location of the lesion.

Minor deviations in the blood test for ALT and AST are allowed only if other blood parameters are normal: urea (2.8-7.2), bilirubin (3.4-17.1), alkaline phosphatase (up to 38 in women, up to 55 in men) and albumin (32-52). They are measured in mmol/l, µmol/l, units/l and g/l respectively.

Only AST is elevated

An isolated increase in AST blood test is observed in the following conditions:

acute myocardial infarction (increase in enzyme concentration);
myocarditis;
high severity angina pectoris;
acute heart failure;
rehabilitation after cardiac surgery;
recent angiocardiography;
pulmonary artery thrombosis;
acute rheumatic carditis;
cardiomyopathy of various etiologies.

A change in the biochemical indicator may be accompanied by shortness of breath, chest pain, cyanosis of the lips and other symptoms characteristic of heart pathologies.

In addition, an increase in AST with normal ALT levels may indicate destruction muscle mass. The reason for this may be the problem of protein absorption, difficulty obtaining energy. As a result, muscles are destroyed as a source of energy.

Only ALT is elevated

A pathological blood test for ALT is observed in diseases such as:

acute and chronic viral hepatitis;
alcoholic and toxic damage to hepatocytes, incl. medications (sulfonamides, antibiotics, NSAIDs, psychotropic drugs, cytostatics, etc.);
oncological processes in the liver;
fatty hepatosis;
pancreatitis;
infectious mononucleosis complicated by damage to the spleen and liver;
burns;
shock, etc.

An isolated increase in alanine aminotransferase concentration is observed in rare cases. Most often, with lesions of the liver and other areas with high concentrations of the enzyme, an increase in the content of both transferases is observed with a sharp decrease in the Ritis coefficient.

An increase in ALT may be accompanied by pain in the right and left hypochondrium, a feeling of heaviness in the abdomen, yellowing of the skin and whites of the eyes, darkening of the urine, loss of strength, weakness and dyspeptic symptoms (diarrhea, flatulence, appetite disturbances). On early stages hepatitis occurring without jaundice, a change in the concentration of alanine enzyme may be the only sign of the disease.

Joint promotion

A simultaneous increase in ALT and AST levels is typical for the following conditions:

gestosis in pregnant women;
extensive injuries and inflammatory processes in muscle tissue;
active participation in heavy sports;
diseases of the kidneys, liver and heart.

An increase in transaminase concentrations can be observed in children and adolescents during periods of active growth.

How to prepare and donate blood

The concentration of liver enzymes can be affected by physical activity, food intake, taking medications and other toxic substances (ethanol, nicotine, etc.). To obtain the most reliable result, you should follow the preparation rules that exclude the influence of these factors.

You need to know how to correctly take blood tests for AST and ALT:

for 8 hours before collecting biomaterial (blood from a vein), use only still water and exclude food;
2-3 days before the examination, reduce the intensity of sports activities, eliminate strength exercises and avoid stress;
3 days before taking blood, avoid fatty foods, smoked meats, industrially processed meat, fast food and other unhealthy foods;
refrain from smoking and drinking alcoholic beverages during the week before the test;
8-9 days in advance, stop taking dietary supplements and medications(antibiotics, NSAIDs, etc.), if therapy involves the possibility of a break.

Before collecting biomaterial, you should inform your doctor about medications taken for a long course.

To prevent hidden diseases, a biochemical blood test must be taken annually during a preventive examination.

How to reduce indicators

Depending on the reasons for the increase in ALT and AST in blood tests, the patient may be recommended a diet, correction of the daily routine (excluding severe physical activity and bad habits), drug treatment and folk remedies.

A diet with increased concentrations of liver enzymes suggests:

refusal of alcoholic and carbonated drinks, fatty meats, sausages, smoked meats, spicy and fried foods, marinades;
limiting salt intake;
active consumption of plant foods, lean meats and fish, and dairy products.

In the treatment of pathologies that cause an increase in the content of enzymes in the blood, the following drugs are used:

antispasmodics (Drotaverine, No-shpa, Spazmalgon);
hepatoprotectors (Heptral, Phosphogliv, Karsil);
enzymatic agents (Creon, Pancreatin, Mezim);
glucocorticosteroids (Prednisolone, Dexamethasone, Hydrocortisone);
antivirals (Entecavir, Telaprevir, Sofosbuvir);
interferons (Viferon, Pegasis);
anticoagulants (sodium heparin);
antianginal and antihypertensive drugs (Amlodipine, Timolol, Nitroglycerin);
vitamin complexes (vitamins B, C and E).

For liver pathologies, decoctions of burdock, immortelle and St. John's wort roots, as well as milk thistle seeds, are used. If the cause of the increase in transferases is heart disease, the patient is recommended to take an infusion of adonis.

In contact with

In order to correctly prescribe treatment, it is necessary to accurately diagnose the disease itself. For this purpose, a general and biochemical blood test is most often prescribed. The latter includes studies of AST and ALT (Alat and Asat). What is it, how much is the norm and why can their level increase?

ALT and AST in a blood test: what is it?

AST (aspartate aminotransferase, AST, AST) is a special enzyme that takes part in the transfer of the amino acid aspartate from one biomolecule to another. In this case, B6 acts as a coenzyme. The greatest activity of this enzyme occurs in the heart, muscle tissue, liver and kidneys.

There is also another, no less important component of biochemical research. This is ALT (ALT, alanine aminotransferase, AlAT) - a special enzyme that transfers the amino acid alanine from one biomolecule to another. As in the first case, vitamin B6 acts as a coenzyme. It is also worth noting that in addition to maximum activity in the heart, liver, kidneys and muscle tissue, it is found in the pancreas.

A blood test for AST, as well as for ALT, is included in the biochemical blood test. Accordingly, they have their own specific content standards. There may be differences not only in the results of men and women, but also in different age categories. So, in men ALT is no more than 40 U/liter, and in women no more than 32 U/liter.

ALT can be significantly elevated in physically healthy people due to an active lifestyle and taking various medications. It is also most often observed to be elevated in adolescents, as their body is in the stage of active growth. A biochemical blood test reveals such indicators quite well, especially since there is a general decoding for the indices.

As for the norm of the AST indicator, it is also different for men and women. For men, the norm is considered to range from 15 to 31 U/liter, and for women it can reach from 20 to 40 U/liter. Also, as in the previous case, a completely insignificant increase can be observed in a healthy person after taking various medications.

AST also increases after drinking alcohol, which does not exclude the result after taking certain alcohol-based medications. These medications include valerian, almost all antibiotics, paracetamol and vitamin A.

Table of norms for performing a biochemical blood test

Reasons for increased indicators

IN medical practice There are many different cases where an increase in the transaminases in question is possible. This way you can accurately identify the most common causes of false results. A biochemical blood test for AST and ALT will be elevated during myocardial infarction. The highest ALT value can be observed in the acute form of the disease. These figures may deviate from the norm by 130–150%.

Fluctuations in AST levels can reach from 450 to 500% of normal. In this case, the decoding will be more thorough, since it is necessary to calculate all existing parameters to obtain an accurate result for the patient. Also, the ALT level may increase in acute gastritis, regardless of its form.

An increase in numbers can be observed 15 days before the examination and the onset of significant symptoms. The presence of hepatitis A and B is no exception. If treatment is carried out correctly and on time, then all indicators return to normal in about a month and a half. The main thing is that the results of AST and ALT must be interpreted correctly, otherwise the patient will have to undergo a re-examination.

Indicators may increase in severe form viral hepatitis, while the coefficient of serum transferase activity can reach values from 0.55 to 0.65.

Indicators may not increase in acute form of liver cirrhosis. There are quite a few cases where an increase is still observed and reaches 77% of the norm. Particular attention should be paid to bilirubin values when analyzing transaminase data.

More often it happens that aminotransferase dissociation manifests itself in hyperbilirubinemia and at the same time aminotransferase activity decreases. Such actions when detecting transaminases may indicate the presence of liver failure, which occurs in an acute form, as well as the presence of hepatic jaundice. It is characterized by persistent biliary hypertension.

Video: AST and ALT blood test

Survey

In order to take a biochemical blood test for AST and ALT, you do not need any special preparation. It is freely available. The main thing is to take it in the morning on an empty stomach and warn about taking certain medications, if any. It is also necessary to completely limit the intake of alcohol and tobacco. This can significantly affect the result, thereby producing false research results.

It is important to prescribe this analysis to the patient on time and carry it out correctly, especially if it concerns these indicators. Most often, examinations for AST and ALT should be contained in the medical record, which guarantees the health of each person when applying for a job.