Chemical reactions are responsible for numerous functions of the human body, where enzymes play a crucial role.

An example is the splitting of sugar (glucose) recorded about the food. Only through several chemical reactions the energy contained in the sugar molecule could expose the cells of the body.

Certain proteins, enzymes are essential for these chemical reactions. This small “catalysts” speed up chemical reactions in the body. Without enzymes, biochemical reactions would not or only very slowly expire.

For the metabolism, but also for many other bodily functions are enzymes of central importance. Therefore, each cell of the body produces enzymes. Depending on the cell comes (such as liver, muscle or nerve cell) from which institution and what is their function, different enzymes are produced.

Certain enzymes in the blood are elevated or humble, can be one of the institutions reveals the function or the State. But at the same time, many enzymes are formed by cells of various organs. A deviation from the normal value is therefore not always clearly to interpret. In this case the doctor consults further investigation.

The amount of enzymes in the blood is subject to fluctuations, for example due to genetic or dietary causes for the part. The enzyme activity is determined depending on the laboratory under different conditions (for example, at a different temperature). Therefore, the normal range may differ from the values mentioned here. Usually the laboratory-specific standard section is printed out with on the analysis result list.


Called concentration changes of GOT (glutamate Oxaloacetate transaminase), also ASAT (aspartate amino transferase), and GPT (glutamate pyruvate transaminase), also ALAT (alanine amino transferase) called in the blood is an indication of damage to the liver. Both enzymes are present in all cells of the body although, their concentration is however much higher than in other organs in the liver. Usually together for a blood test, the doctor determines these two enzymes. For certain diseases, it can be diagnostically valuable to put the concentration of two enzymes in relation to each other. So, the values of the GOT are stronger than the GPT increases, while the inactive chronic liver inflammation opposed the relationship such as particularly serious liver damage. Since also the heart and muscles produce the GOT relatively highly, also damage these organs can lead to an increase in the value of the laboratory. Moderately elevated enzyme levels occur very frequently and are often caused by alcohol or medication.

  • GOT and GPT are for example raised at:
    • Acute viral hepatitis (acute hepatitis, acute viral hepatitis)
    • Chronic inflammation of the liver
    • Cirrhosis of the liver
    • Paris
    • Heart attack
    • Muscle diseases
  • GOT and GPT reduces:
    • Typically no value of diseases


The enzyme gamma-GT is found in various organs such as the liver, pancreas, kidneys, or brain. Increases of gamma-glutamyl transferase (gamma-GT) – value are however usually a reference to a disease of the biliary tract. Especially in bile congestion (cholestasis), the levels of this enzyme in the blood rise sharply. Elevated levels of gamma-GT are also characteristic of long-term alcohol abuse and can be used to control of an alcohol withdrawal.

But also diseases of the pancreas, kidney or the heart can lead to elevated gamma-GT values what difficult to interpret of this laboratory value in some cases.

  • Gamma-GT is for example increased when:
    • Bile congestion (cholestasis)
    • Acute liver inflammation from viruses (hepatitis)
    • Chronic inflammation of the liver (mainly alcoholic hepatitis)
    • Alcohol abuse
    • Taking certain drugs
    • Acute pancreatitis (acute pancreatitis)
    • Pancreatic cancer (Carcinoma of the pancreas)
    • Kidney disease
    • Heart attack
    • Burns
    • Diabetes mellitus
    • High blood pressure (hypertension)
    • Certain changes of the brain
  • Gamma-GT reduces:
    • Typically no value of diseases

Alkaline phosphatase (AP)

The alkaline phosphatase is found in higher concentrations in the bone, in the liver into the bile ducts and during pregnancy the placenta. Pathological changes of these institutions, the concentration of alkaline phosphatase in the blood can be elevated. Usually, the doctor determines the alkaline phosphatase in combination with calcium and phosphate to uncover the cause of bone diseases. Special bone cells, the osteoblasts produce the alkaline phosphatase. Osteoblasts are cells that build bone, in contrast to osteoclasts, that are responsible for bone resorption. In many pathological conversion processes of bone are both involved osteoblasts as osteoclasts, resulting in an increase of alkaline phosphatase in the blood. Also liver disease can increase the concentration of alkaline phosphatase in the blood stream.

  • Alkaline phosphatase is among other things raised at:
    • Bone disease:
      • Knochenmarkentzündung (Paget’s disease)
      • Bone cancer (osteosarcoma)
      • Rickets (vitamin D deficiency)
      • Osteomalacia
    • Bile congestion (cholestasis)
    • Leberzellschäden (acute viral hepatitis, chronic hepatitis)
    • Certain drugs (AEDs)
  • Alkaline phosphatase is for example reduced when:
    • Congenital hypophosphatasia

Lactate dehydrogenase (LDH)

The lactate dehydrogenase (LDH) comes in contrast to other enzymes, in many institutions in high concentrations. Particularly high lactate dehydrogenase is found in liver, muscle, red blood cells (erythrocytes) and kidneys. Many diseases can have an increase of LDH resulted. Vice versa, elevated LDH levels in the serum allows alone for any conclusions about the cause of the disorder. The LDH is therefore mostly as control parameters used for the course of diseases that go hand in hand with an increased concentration of this enzyme in the blood. This way, it can on the basis of the LDH check for example the history of heart attack or the regression of a tumor. Particularly high levels of LDH occur for example in the context of an anaemia.

  • Lactate dehydrogenase can be increased by:
    • Vitamin B12 deficiency (pernicious anemia)
    • Anaemia due to folic acid deficiency (folic acid anemia)
    • Anaemia due to destruction of red blood cells (hemolytic anemia)
    • Heart damage (e.g. heart attack, heart failure, etc.)
    • Liver damage (acute hepatitis, toxic Leberzellnekrosen, liver metastases)
    • Pulmonary embolism, ALA
    • Sarcoidosis
    • Tumors (especially advanced solid tumors)
    • Musculoskeletal diseases (such as Duchenne muscular dystrophy, major surgical procedures etc.)
    • Kidney damage (nephrotic syndrome)
  • Lactate dehydrogenase reduces:
    • Typically no value of diseases

Troponin T and creatine kinase MB (CK-MB)

The injury of the heart, for example by a heart attack or a Herzentzündung (myocarditis), leads to damage to the heart muscle cells. Because the so-called cardiac enzymes creatine kinase MB and troponin T in the body in the heart muscle cells, own them themselves well to damage to the heart muscle cells to demonstrate. In the case of illness they are found in the blood stream and can be detected using a blood sample. Besides the enzymes of Troponin T and CK-MB, there are still non-specific heart enzymes, which means they are increased in a number of other diseases and thus allow no clear evidence of heart muscle damage.

Damage to the heart muscle leads only with a delay of several hours to an increase of cardiac enzymes. The timing of the increase will vary depending on the cardiac enzyme. Troponin T goes up after three, CK-MB after about four to eight hours after the heart muscle damage, for example a heart attack.

The doctor assessed troponin T and the creatine kinase MB always in connection with the Gesamtkreatinkinase. A proportion of more than five percent of CK-MB in the entire creatine speaks of heart muscle damage.

  • Elevated troponin T comes in above:
    • Heart attack
    • Heart muscle damage after injury (trauma), and after operations
    • Angina pectoris
  • Decreased troponin T:
    • Typically no value of diseases
  • Highly elevated levels of CK-MB may occur when:
    • Strong violations
    • Muscle necrosis
    • Muscle inflammation (Myositis)
    • Epileptic seizure
  • Causes of elevated CK-MB values can be:
    • Heavy physical exertion
    • Heart attack
    • Inflammatory heart disease
    • Muscular Dystrophies
    • UnderActive of thyroid (hypothyroidism)
    • Malignant tumours
    • Extended, not muscular tissue doomsday
  • CK-MB low values:
    • Typically no value of diseases

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