High SGPT Levels with Normal SGOT: Liver Health Concerns

The SGPT level is elevated, while the SGOT level is normal?

Hello Dr.
Liang, I recently participated in a company health check-up, and the results for my liver, gallbladder, kidney function, and blood lipids are all normal.
However, my SGPT level is two and a half times the maximum reference value (result: 74, hospital reference value: 5-30 IU/L), while my SGOT is normal (result: 27, hospital reference value: 5-35 IU/L).
Below are my health check data.
I have researched related information online and roughly understand that my liver's metabolic detoxification and synthesis functions are normal, but there is inflammation present.

In the past two years during my student days, I usually went to bed after 4:00 AM but typically got 7-8 hours of sleep.
However, in the last three months since starting work, my late-night habits have not changed, but due to work reasons, my sleep duration has significantly decreased to an average of about 5.5 hours (going to bed at 4:00 AM and waking up at 9:30 AM), and I often feel sleep-deprived upon waking.

I would like to ask the doctor if, aside from conditions like hepatitis or fatty liver, it is possible that my excessive fatigue and long-term late nights have caused my SGPT levels to rise to this extent? Is this value excessively dangerous? Thank you in advance for your response.

(P.S.
I do not smoke, do not drink alcohol, have no kidney disease or diabetes, my blood pressure is slightly high at 140/90, and my height is 174 cm with a weight of 74 kg.)

SGOT: 27 (5-35 IU/L)
SGPT: 74 (5-30 IU/L)
Alkaline Phosphatase (ALK-P): 63 (40-110 IU/L)
Gamma-Glutamyl Transferase (r-GT): 32.5 (8-50 IU/L)
Total Protein (T-P): 7.4 (6-8.2 g/dL)
Albumin (ALB): 4.2 (3.5-5 g/dL)
Globulin (GLOB): 3.2 (2.5-3.8 g/dL)
Albumin/Globulin Ratio (A/G): 1.31 (1-2)

Total Bilirubin (T-Bil): 1.3 (0.2-1.3 mg%)
Direct Bilirubin (D-Bil): 0.29 (0-0.4 mg%)

Cholesterol (Cho): 178 (130-200 mg/dL)
Triglycerides (T-G): 88 (50-200 mg/dL)
High-Density Lipoprotein (HDL): 63.7 (30-85 mg/dL)
Low-Density Lipoprotein (LDL): 96.7 (0-130 mg/dL)
Blood Glucose: 112.4 (70-120 mg/dL)

Alpha-Fetoprotein (AFP): 2.5 (0-10.9 ng/ml)
Prostate-Specific Antigen (PSA): 1.08 (0-4.5 µg/ml)
C-Reactive Protein (CRP): Negative
Risk Factor Test (AI): 2.79 (0-5.5 mIU/ml)

guest, 20~29 year old female. Ask Date: 2003/12/18

Dr. Liang Jiade reply Gastroenterology and Hepatology

Hello, excessive fatigue, prolonged staying up late, medication use, and fatty liver can potentially lead to elevated liver function indices, but other various causes must also be considered.
Furthermore, it is necessary to monitor changes in liver function values over time.
If there is a persistent increase in liver function, additional serum tests should be conducted.
If you have any questions, please consult a hospital for examination.

Reply Date: 2003/12/18

More Info

High levels of SGPT (ALT) with normal SGOT (AST) can indeed raise concerns regarding liver health, but it's essential to interpret these results in the context of your overall health and lifestyle. Your SGPT level of 74 IU/L, which is significantly above the normal range (5-30 IU/L), suggests that there may be some liver inflammation or damage, while your SGOT level of 27 IU/L falls within the normal range.
The liver enzymes SGOT and SGPT are commonly used to assess liver function. SGPT is more specific to the liver, while SGOT can be elevated in other conditions, such as heart disease or muscle injury. When SGPT is elevated and SGOT is normal, it may indicate liver-related issues, but it does not necessarily mean there is severe liver damage.

Several factors can contribute to elevated SGPT levels, including:
1. Fatty Liver Disease: Non-alcoholic fatty liver disease (NAFLD) is a common condition that can lead to elevated liver enzymes. It is often associated with obesity, diabetes, and high cholesterol levels.

2. Viral Hepatitis: While you mentioned that you are not aware of any hepatitis infections, it is still a possibility that should be ruled out through appropriate testing.

3. Medications and Toxins: Certain medications, supplements, or exposure to toxins can lead to liver enzyme elevation. It is crucial to review any medications or supplements you are taking with your healthcare provider.

4. Alcohol Consumption: Although you stated that you do not drink alcohol, it's worth noting that even moderate alcohol consumption can affect liver enzymes.

5. Chronic Stress and Fatigue: Your lifestyle, particularly the lack of sleep and increased stress from work, can also impact liver health. Chronic fatigue and sleep deprivation can lead to metabolic disturbances that may affect liver function.

Given your situation, it is plausible that your elevated SGPT levels could be related to your lifestyle factors, including sleep deprivation and stress. Chronic lack of sleep can lead to increased cortisol levels, which may affect liver metabolism and contribute to inflammation.

While your SGPT level is concerning, it is not necessarily indicative of a severe condition. However, it is essential to monitor your liver health closely. Here are some recommendations:
1. Follow-Up Testing: It would be prudent to have follow-up liver function tests to monitor your SGPT levels over time. This will help determine if the elevation is persistent or if it resolves with lifestyle changes.

2. Lifestyle Modifications: Improving your sleep hygiene is crucial. Aim for 7-9 hours of quality sleep per night. Establish a regular sleep schedule, create a relaxing bedtime routine, and minimize screen time before bed.

3. Diet and Exercise: Adopt a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Regular physical activity can help maintain a healthy weight and improve liver health.

4. Hydration: Ensure you are well-hydrated, as proper hydration supports overall metabolic processes, including liver function.

5. Consult a Specialist: If your SGPT levels remain elevated or if you experience any symptoms such as fatigue, jaundice, or abdominal pain, consider consulting a hepatologist or a gastroenterologist for further evaluation.

In summary, while your elevated SGPT levels warrant attention, they do not necessarily indicate a severe liver condition. By addressing lifestyle factors and following up with your healthcare provider, you can take proactive steps to support your liver health.

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