Which transaminase is far more specific for liver disease than the other?

The transaminase that is far more specific for liver disease is alanine aminotransferase (ALT). This enzyme is primarily found in the liver, and its elevation in serum often indicates liver cell injury or inflammation. While aspartate aminotransferase (AST) can also indicate liver damage, it is not as specific because AST is found in other tissues, including the heart, muscles, and kidneys. Therefore, an increase in AST levels could result from conditions affecting these other tissues, diluting the specificity for hepatic disease.

Alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) are also not as specific to liver disease as ALT. ALP is associated with bile duct obstruction and bone disease, while GGT can be elevated in liver conditions but also in disorders of the pancreas and kidneys. The specificity of ALT for liver pathology makes it a more reliable marker for assessing liver health compared to the other enzymes mentioned.