AST Assay
AST Assay
Reagent | Aspartate Aminotransferase (AST)
A Marker of Hepatocellular Injury
Benefits of the Randox Aspartate Aminotransferase (AST) assay
Excellent precision
The Randox AST assay displayed a within run precision of < 4.96%.
Excellent stability
The Randox AST assay is stable to expiry when stored at +2oC to +8oC.
Liquid ready-to-use
The Randox AST assay is available in a liquid ready-to-use format for convenience and ease-of-use.
Calibrator and controls available
Calibrator and controls available offering a complete testing package.
Applications available
Applications available detailing instrument-specific settings for the convenient use of the Randox AST assay on a variety of clinical chemistry analysers.
Ordering Information
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
Cat No | Size | ||||
---|---|---|---|---|---|
AS3804 | R1 6 x 51ml (L) R2 6 x 14ml | Enquire | Kit Insert Request | MSDS | Buy Online |
AS101 | R1 1 x 100ml (L) R2 1 x 100ml (Colorimetric, manual only) | Enquire | Kit Insert Request | MSDS | Buy Online |
AS8005 | R1 6 x 56ml (L) R2 6 x 20ml | Enquire | Kit Insert Request | MSDS | Buy Online |
AS8306 | R1 4 x 20ml (L) R2 4 x 7ml | Enquire | Kit Insert Request | MSDS | Buy Online |
(L) Indicates liquid option |
Clinical Significance
Enzymes are organic molecules responsible for the acceleration of biochemical reactions, however, emerge unchanged following the reaction. Aminotransferases are a family of enzymes that catalyse the conversion of amino acids to 2-oxo-acids by the transfer of amino acids 1. AST is present in mitochondrial and cytosolic enzymes (80% and 20% of activity respectively), found in brain, cardiac muscle, kidneys, leucocytes, liver, lungs, red blood cells and skeletal muscle 2.
AST is a marker of hepatocellular injury, predominantly alcohol-related liver injury (chronic hepatitis C) and cirrhosis (chronic hepatitis B). In alcoholic liver disease, P-5-P becomes deficient, which is greater on ALT activity compared to AST activity. Consequently, ALT activity is reduced, whereas AST activity is increased 2. The hallmark finding for alcohol liver disease is the AST to ALT ratio of at least 2:1 3. The marked laboratory findings for ischaemic hepatitis is an elevated bilirubin level, however, AST levels are > 10 times the upper reference range limit 2. Acute viral hepatitis, drug or toxin induced liver disease and ischaemic liver injury are characterised by extremely elevated aminotransferase levels 3.
Muscular dystrophy, including Duchenne muscular dystrophy is characterised by hypertransaminasemia. Elevations in both ALT and AST are most striking in the early stages of muscular disease, prior to the onset or only when subtle symptoms are present. Consequently, during these initial stages, ALT/AST testing can enable the early identification of disease and so the early intervention of treatment plans 4.
The diagnosis of liver disease in COVID-19 patients can be challenging for the clinician. There is often uncertainty as to whether there was a pre-existing undiagnosed liver disease. Also, many medications utilised to treat moderate and severe disease have their own profiles of liver toxicity. Elevations of aminotransferase is the most common abnormality in patients presenting with COVID-19. It was identified that AST is more frequently elevated in comparison to ALT 5. AST showed statistically significant elevations in severe COVID-19 in comparison to mild cases 6.
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Albumin Assay
Reagent | Albumin
A Marker of Hepatic Dysfunction
Benefits of the Randox Albumin Assay
Excellent precision
The Randox albumin assay displayed a within run precision of < 1.97%.
Calibrator and controls available
Calibrator and controls available for a complete testing package.
Working Stability
Working reagent stable up to 3 months when stored at +15oC to +25oC.
Flexibility
Liquid and Lyophilised Reagents available for greater customer choice.
Applications available
Applications available detailing instrument-specific settings for the convenient use of the Randox albumin assay on a variety of clinical chemistry analysers.
Ordering information
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
Cat No | Size | ||||
---|---|---|---|---|---|
AB3800 | 9 x 51ml (L) | Enquire | Kit Insert Request | MSDS | Buy Online |
AB8301 | 4 x 20ml (L) | Enquire | Kit Insert Request | MSDS | Buy Online |
(L) Indicates liquid reagent |
Clinical Significance
Albumin is the most abundant circulating protein found in plasma, representing approximately half of the total protein content in health human plasma. Synthesised by liver hepatocytes, it is rapidly excreted into the bloodstream, approximately 10gm – 15gm per day, with little remaining in the liver 1. It is responsible for the maintenance of colloidal osmotic pressure, provision of the majority of plasma antioxidant activity, and the binding of a variety of compounds 2.
A correlation between serum albumin concentrations and ill-health has been identified, with an astonishingly strong inverse correlation between serum albumin and mortality risk 2. The association of it with other confounding variables increase mortality (fig 1). The concentration is related to the rates of synthesis and catabolism, but also influenced by state of hydration, lymphatic return, external losses (burns), and rates of transcapillary escape. In starvation, both the synthesis and catabolism fall, whereas in nephrotic syndrome, synthesis rises and catabolism falls 3.
Fig. 1. Potential associations between serum albumin and mortality 3
A direct, casual relationship between serum albumin and mortality is represented by arrow a or the sequence b, a. A non-casual, confounding relationship is represented by arrows b and c. A co-causal relationship is represented by arrows a and c.
Low circulating albumin is associated with an adverse metabolic profile characterised by increased adipose tissue inflammation, glucose concentrations, and adiposity. It inversely correlates with type 2 diabetes mellitus (T2DM) risk 4. Moreover, serum albumin concentrations are inversely correlated with the risk of ketosis in hospitalised patients with T2DM and may require the early initiation of insulin therapy to prevent complications. It is a promising prognostic marker in hospitalised diabetic patients with acute hyperglycaemia 5.
Low levels of serum albumin is common in cirrhosis and is associated with a reduced survival rate. In this setting, the native isoform can be severely reduced as a result of several post-transcriptional changes that impair the non-oncotic properties of the molecule 6.
Hypoalbuminemia status has been associated with the critically ill and mortality across several clinical settings. Hypoalbuminemia can potentially lead to the early recognition of severe disease associated with COVID-19 and can assist clinicians in making informed decisions for their patients 7.
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References