• AST
• Aspartate aminotranspeptidase
• GOT
• Serum glutamic oxaloacetic transaminase
• SGOT
• Transaminases

Red, tiger, or green top tube

Venous blood

Reject specimen if there is:

• Hemolysis
• Turbidity

When monitoring serial levels of AST collect specimen at the same time each day as some variation may occur based upon time of day.

• Aspartate aminotransferase (AST), formerly known as serum glutamic oxaloacetic transaminase (SGOT), is an intracellular enzyme involved in amino acid metabolism.
• Present in cells of the liver, heart, skeletal muscles, kidneys, pancreas and red blood cells
• Released into serum when there is cellular damage
• Used primarily to evaluate acute liver disease or injury

Testing of AST is useful to:

• Help in the detection and differential diagnosis of acute liver diseases and injuries, as part of the panel of liver function tests.
• In the past used in diagnosis of myocardial infarction in correlation with creatine kinase and LDH levels (now troponin, myoglobin and creatine kinase used)
• Monitor course of the disease and effectiveness of therapy in hepatic disorders
• Monitor treatment with drugs which are potentially hepatotoxic or nephrotoxic
• In alcoholic hepatitis, the AST is usually more elevated than the ALT (the reverse is typical in viral hepatitis)

Additional information:

• AST levels are high at birth and decrease with age
• Generally, AST is more sensitive but less specific than alanine aminotransferase (ALT) in detecting liver disease
• In patients with hepatitis C, an AST/ALT ratio > 1 suggests cirrhosis

Consult your laboratory for their normal ranges as these may vary somewhat from the ones listed below.

An increased AST level is seen in the following conditions:

Acute elevation of AST:

• Liver Diseases
• Hepatitis (autoimmune, infectious, traumatic)
• Cholestasis
• Intrahepatic
• Extrahepatic
• Alcoholism
• Hepatic necrosis
• Hepatotoxicity
• Ingestion of poisonous mushrooms
• Carbon tetrachloride poisoning
• High doses of vitamin A
• Drugs (see section below)
• Infectious mononucleosis
• Liver abscess
• Metastatic carcinoma
• Primary liver carcinoma
• Shock liver (injury to the liver)
• Heart Disorders
• Acute myocardial infarction
• Acute myocarditis
• Cardiac arrhythmias
• Congestive heart failure
• Pericarditis
• Recent cardiac catheterization or angioplasty
• Skeletal Muscle related conditions
• Exercise (Strenuous)
• Intramuscular injections (rarely)
• Surgery (Extensive)
• Skeletal muscle diseases such as Duchenne's muscular dystrophy
• Trauma
• Red Blood cells related conditions
• Anemia; Hemolytic
• Anemia; Megaloblastic
• Other
• Acute pancreatitis
• Acute pulmonary infarction
• Acute renal failure
• Burns (2^nd/3^rd degree)
• Cerebrovascular accident
• Delirium tremens
• Dermatomyositis
• Eclampsia
• Heat exhaustion/Heat stroke
• Heparin therapy
• Hypothyroidism
• Seizures
• Shock
• Tissue necrosis

Chronically elevated AST:

• Hepatic
• Alcohol abuse
• -1 antitrypsin deficiency
• Autoimmune hepatitis
• Drugs (see section below)
• Fatty liver
• Hemochromatosis
• Hepatitis; Autoimmune
• Hepatitis; B or C (Chronic)
• Nonalcoholic steatohepatitis
• Steatosis
• Wilson's disease ( 40 years)
• Nonhepatic (AST increases more than ALT)
• Acquired muscle diseases
• Celiac sprue
• Inherited disorders of muscle metabolism
• Strenuous exercise

Drugs known to increase result:

• Those causing cholestasis:
• Amitriptyline
• Anabolic-androgenic steroids
• Benzodiazepines
• Chlorothiazide
• Chlorpropamide
• Dapsone
• Erythromycin
• Estrogens
• Ethionamide
• Gold salts
• Imipramine
• Mercaptopurine
• Nitrofurans
• Oral contraceptives
• Penicillins
• Phenobarbital
• Phenothiazines
• Progesterone
• Tricyclic antidepressants
• Those causing hepatocellular damage:
• Acetaminophen
• Acetylsalicylic acid (aspirin)
• Allopurinol
• Amiodarone
• Anabolic steroids
• Anticonvulsants
• Asparginase
• Azithromycin
• Bromocriptine
• Captopril
• Carbamazepine
• Cephalosporins
• Chloramphenicol
• Clindamycin
• Clofibrate
• Danazol
• Diclofenac
• Enflurane
• Ethambutol
• Ethionamide
• Fenofibrate
• Fluconazole
• Fluoroquinolones
• Foscarnet
• Gentamicin
• Hydralazine
• Ibuprofen
• Indomethacin
• Interferon
• Interleukin-2
• Isoniazid (INH)
• Levamisole
• Levodopa
• Lincomycin
• Low-molecular weight heparin
• Methyldopa
• Monoamine oxidase inhibitors
• Naproxen
• Niacin
• Nifedipine
• Nitrofurans
• Opiates
• Oral contraceptives
• Probenecid
• Phenybutazone
• Phenytoin
• Procainamide
• Quinine
• Ranitidine
• Retinol
• Ritodrine
• Salicylates (in children)
• Statins (Mevacor, Pravachol, Lipitor, Crestor, etc)
• Sulfonylureas
• Sulfamethoxazole
• Tetracycline
• Tobramycin
• Trimethoprim
• Valproic acid
• Verapamil

A low result is usually of no clinical significance.

Decreased levels of AST are seen in the following conditions:

• Long-term kidney dialysis
• Pregnancy
• Uremia
• Vitamin B₆ deficiency

Drugs known to decrease result:

• metronidazole
• trifluperazine
• some herbs/naturals such as Chinese fructus schizandrae sinensis

• Canadian Association of Gastroenterology Practice Guidelines. Evaluation of abnormal liver enzyme tests. The Canadian Journal of Gastroenterology 1998;12(6): 417-421.
• Lab tests online. AST [Homepage on internet] ©2001-2006 [updated 2006 Mar 17;cited 2006 Jul 7] Available from http://labtestsonline.org/understanding/analytes/ast/test.html
• http://hepatitis-central.com/hcv/labs/liverenzymes.htm
• Laboratory Corporation of America. Aspartate Aminotransferase [Homepage on internet] c2003 [updated 2003 May 14;cited 2006 Jul 7] Available from http://www.labcorp.com/datasets/labcorp/html/chapter/mono/pr007900.htm
• MedlinePlus: Medical Encyclopedia. AST [Homepage on internet] c2005 [updated 2005 Feb 14;cited 2006 Jul 7] Available from http://www.nlm.nih.gov/medlineplus/ency/article/003472.htm
• Nissl J. BC HealthGuide. Aspartate Aminotransferase (AST) [Homepage on internet] c1995-2006 [updated 2004 Apr 12;cited 2006 Jul 7] Available from http://www.bchealthguide.org/kbase/topic/medtest/hw20331/descrip.htm
• Stransky J, Ryzlova M, Stritesky J, et al. [Aspartate aminotransferase (AST) more than alanine aminotransferase (ALT) levels predict the progression of liver fibrosis in chronic HCV infection.][Article in Czech] Vnitr Lek 2002 Oct;48(10):924-8.