Exploration biochimique du foie en 2017

Biochemistry of the liver is particularly relevant because liver exerts many important functions such as synthesis, stocking, elimination and transformation of biomolecules. The biochemical exploration of bile secretion needs the determination in serum of various bilirubin forms, bile acids, and enzymes such as PAL, GGT and 5'-Nuc, all of them being useful for the diagnosis of cholestasis and to the classification of icterus. The functions of the liver are explored by the dosage of both albumin and hemostasis factors reflecting the level of liver failure. The liver exerts also important purification functions which can be explored by the determination of ammonium, and the realization of BSP or ICG tests. Liver cytolysis is classically studied by transaminases (SGOT and SGPT), LDH and its iso-enzymes, GLDH and even α-GST. Inflammation is studied with the measure of the sedimentation rate and the electrophoresis analysis of serum proteins. Liver fibrosis has now the benefit of the dosages of proteins from the extracellular matrix, often gathered in fibrosis scores. The detection of alcoholism is easier with the development of CDT test (« Carbohydrate Deficiency Transferrin »), more specific than the elevated « Mean Corpuscular Volume » (MCV) and the « Gamma-Glutamyl-Transpeptidase » (GGT) activity.