Aspartate Aminotransferase (AST)(SGOT)

Aspartate aminotransferase (AST) is an enzyme found primarily in the liver, heart, kidneys, and muscles. While slight changes in AST may be normal due to the body’s increased metabolic demands, significantly high levels can indicate liver stress or potential liver conditions, such as preeclampsia or HELLP syndrome. In this article, we’ll cover the importance of AST testing in pregnancy and optimal ranges.

AST Testing

​Aspartate aminotransferase (AST)(SGOT) measures total AST in a blood sample and is an analyte found on the comprehensive metabolic panel (CMP).

AST is an enzyme found in the body's cells, particularly in the heart, liver, and kidneys but also in the muscles, RBCs, and brain. AST testing provides a total AST count from all sources.

There are two isoenzymes of AST found in humans.

• Cytoplasmic AST (cAST or GOT1): This isoenzyme is primarily found in the cytoplasm of various cells, including liver cells. 
  
• Mitochondrial AST (mAST or GOT2): This isoenzyme is in the mitochondria of cells, including heart and skeletal muscle cells. 

Both isoenzymes play a role in amino acid metabolism and are released into the bloodstream when cells are damaged. 

AST in Pregnancy

The effects of pregnancy on serum ALT and AST activity levels are somewhat controversial. A slight increase in ALT and/or AST activity has been found in a few studies during the third trimester. Most studies, however, show that serum ALT and AST activity levels do not change during pregnancy or remain within the normal limits established in nonpregnant women. 

​AST levels can increase during childbirth and increase 88% within the first five days of postpartum. This is increased further in cesarean delivery and anesthesia use during labor.

High AST in Pregnancy

​Higher ALT/AST in early pregnancy, even within the normal range, is an independent risk factor of GDM.

Most Common Causes of High AST in Pregnancy

• Cardiovascular Damage/Inflammation
• Kidney Damage/Inflammation
• Liver Damage/Inflammation
• Hemolysis
• Hypothyroidism
• Hyperemesis Gravidarum
• Preexisting Insulin Resistance
• Oxidative Stress
• Autoimmune Disease
• Excess Intense Physical Activity (Overexercising)
• Certain Medications (Acetaminophen)
• Blood Clots/Trauma
• Wilson's Disease/Excess Copper
• Environmental Chemical Exposure

Low AST in Pregnancy

​There is limited data on the consequences of low AST in pregnancy,

Most Common Causes of Low AST in Pregnancy

• Vitamin B6 (Pyridoxine) Deficiency
• Low Protein Diet
• Hypothyroidism
• Genetics

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Medical Disclaimer:
This content is for educational purposes only and is intended for licensed medical professionals. It is based on current research, subject to change, and not intended to diagnose, treat, or prevent any medical condition. This information does not replace consultation with a qualified healthcare provider. Seek professional medical evaluation and treatment from a licensed provider. Use of this information is at your own risk.​

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