Liver Function Panel

IFCOR's Liver Function Panel measures nine markers — total protein, albumin, bilirubin (total and conjugated), AST, ALT, GGT, ALP, and cholinesterase — to assess hepatocellular integrity, biliary flow, and the liver's synthetic capacity. Cholinesterase is a marker of hepatic protein synthesis rarely included in standard liver panels; it falls in liver failure, chronic hepatitis, and malnutrition, providing an early synthetic function warning. At 250 Kč total with phlebotomy, this targeted panel is economical enough for repeat monitoring before and after dietary changes, alcohol reduction programmes, or medication adjustments.

The liver performs over 500 distinct metabolic functions, and liver disease — including non-alcoholic fatty liver disease (NAFLD/MASLD), alcoholic hepatitis, viral hepatitis, and drug-induced hepatotoxicity — can progress to cirrhosis or hepatocellular carcinoma while remaining asymptomatic for years. IFCOR's nine-marker Liver Function Panel captures both hepatocellular damage and synthetic function through a complementary set of biomarkers. ALT (alanine aminotransferase) is located predominantly in hepatocytes and is the most specific marker of liver cell damage — elevated ALT is the earliest and most sensitive indicator of hepatocellular injury from alcohol, medications, viral infection, or metabolic liver disease. AST (aspartate aminotransferase) is found in liver, heart, muscle, and red blood cells; an AST:ALT ratio above 2 is a strong indicator of alcoholic hepatitis. GGT (gamma-glutamyl transferase) is the most sensitive marker of biliary disease and chronic alcohol intake, and is also elevated by obesity, diabetes, and enzyme-inducing medications. ALP (alkaline phosphatase) rises primarily in cholestatic (biliary obstruction) conditions — elevated ALP with normal ALT/AST suggests biliary rather than hepatocellular disease. Bilirubin (total and conjugated/direct) quantifies bile pigment accumulation; elevated conjugated bilirubin indicates intrahepatic or extrahepatic cholestasis, while unconjugated elevation suggests haemolysis or Gilbert's syndrome. Total protein and albumin reflect hepatic synthetic capacity — albumin falls progressively in chronic liver disease as the capacity to synthesise proteins declines, providing a marker of disease severity and nutritional status. Cholinesterase (also called butyrylcholinesterase or pseudocholinesterase) is synthesised exclusively by the liver and falls in proportion to functional hepatic parenchyma loss, making it a sensitive synthetic function marker that complements albumin. Together, these nine markers provide a comprehensive, layered assessment of hepatic health in a single fasting blood draw.