Which two enzymes help distinguish bone from liver disease when ALP is increased?

Which two enzymes help distinguish bone from liver disease when ALP is increased?

• A. 5-NT and GGT
• B. ALT and AST
• C. CK and LDH
• D. ALP and TP

Answer: (A)

When ALP is elevated, it can come from bone or liver. To tell the source, use enzymes that are specific to the liver. Gamma-glutamyl transferase (GGT) rises with hepatobiliary disease and is not elevated by bone disease. 5'-nucleotidase (5'-NT) behaves similarly, increasing with liver pathology. So, measuring both helps pinpoint the origin: if both GGT and 5'-NT are elevated alongside ALP, the ALP is likely from the liver; if they stay normal, the ALP is more likely from bone. The other enzyme pairs don’t provide this specific distinction as effectively.

When ALP is elevated, it can come from bone or liver. To tell the source, use enzymes that are specific to the liver. Gamma-glutamyl transferase (GGT) rises with hepatobiliary disease and is not elevated by bone disease. 5'-nucleotidase (5'-NT) behaves similarly, increasing with liver pathology. So, measuring both helps pinpoint the origin: if both GGT and 5'-NT are elevated alongside ALP, the ALP is likely from the liver; if they stay normal, the ALP is more likely from bone. The other enzyme pairs don’t provide this specific distinction as effectively.