ABSTRACT
This chapter looks at the chemical pathology of liver and gall bladder disorders. These are common in clinical practice, and liver function tests constitute one of the most frequently requested clinical biochemistry laboratory profiles. The liver has essential synthetic and excretory functions and can be thought of as a large ‘metabolic factory’. Fatty acids reaching the liver from fat stores may be metabolized in the tricarboxylic acid cycle, converted to ketones or incorporated into triglycerides. The liver has a very large functional reserve. Deficiencies in synthetic function can be detected only if liver disease is extensive. Bilirubin is normally transported to the liver bound to albumin. Several biochemical tests constitute what are called the ‘liver function tests’. Strictly speaking, changes in plasma enzyme activity generally indicate liver cell membrane damage rather than hepatic function capacity. Alkaline phosphatase is derived from a number of different tissues, including the liver, the osteoblasts in bone and the placenta.
