Which enzyme is most associated with cholestasis when elevated?

Which enzyme is most associated with cholestasis when elevated?

• A. ALP
• B. ALT
• C. AST
• D. Bilirubin

Answer: (A)

Cholestasis impairs bile flow, which causes a rise in enzymes released from the biliary tract. Alkaline phosphatase is abundant in bile duct epithelium, so its level increases when bile flow is obstructed or when cholestasis is present. Transaminases like ALT and AST reflect hepatocellular injury rather than bile flow problems, so they don’t specifically indicate cholestasis. Bilirubin is a pigment, not an enzyme, though it can accumulate with impaired excretion. So the enzyme most associated with cholestasis when elevated is alkaline phosphatase.

Cholestasis impairs bile flow, which causes a rise in enzymes released from the biliary tract. Alkaline phosphatase is abundant in bile duct epithelium, so its level increases when bile flow is obstructed or when cholestasis is present. Transaminases like ALT and AST reflect hepatocellular injury rather than bile flow problems, so they don’t specifically indicate cholestasis. Bilirubin is a pigment, not an enzyme, though it can accumulate with impaired excretion. So the enzyme most associated with cholestasis when elevated is alkaline phosphatase.