- AST/ALT ratio
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AST/ALT ratio Diagnostics LOINC 16325-3, 1916-6 The aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio is sometimes useful in differentiating between causes of liver damage (hepatotoxicity).[1][2][3]
Contents
Interpretation
- When greater than 2.0, it is more likely to be associated with alcoholic hepatitis[4] or hepatocellular carcinoma
- When less than 1.0, it is more likely to be associated with viral hepatitis
The ratio is less useful in scenarios where the liver enzymes are not elevated, or where multiple conditions co-exist.
History
Pathophysiology sample values BMP/ELECTROLYTES: Na+=140 Cl−=100 BUN=20 / Glu=150 K+=4 CO2=22 PCr=1.0 \ ARTERIAL BLOOD GAS: HCO3-=24 paCO2=40 paO2=95 pH=7.40 ALVEOLAR GAS: pACO2=36 pAO2=105 A-a g=10 OTHER: Ca=9.5 Mg2+=2.0 PO4=1 CK=55 BE=−0.36 AG=16 SERUM OSMOLARITY/RENAL: PMO = 300 PCO=295 POG=5 BUN:Cr=20 URINALYSIS: UNa+=80 UCl−=100 UAG=5 FENa=0.95 UK+=25 USG=1.01 UCr=60 UO=800 PROTEIN/GI/LIVER FUNCTION TESTS: LDH=100 TP=7.6 AST=25 TBIL=0.7 ALP=71 Alb=4.0 ALT=40 BC=0.5 AST/ALT=0.6 BU=0.2 AF alb=3.0 SAAG=1.0 SOG=60 CSF: CSF alb=30 CSF glu=60 CSF/S alb=7.5 CSF/S glu=0.4 It is also known as the "De Ritis Ratio",[5][6] named after De Ritis, who performed early analysis on transaminases.[6]
References
- ^ Nyblom H, Berggren U, Balldin J, Olsson R (2004). "High AST/ALT ratio may indicate advanced alcoholic liver disease rather than heavy drinking". Alcohol Alcohol. 39 (4): 336–9. doi:10.1093/alcalc/agh074. PMID 15208167. http://alcalc.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=15208167.
- ^ Nyblom H, Björnsson E, Simrén M, Aldenborg F, Almer S, Olsson R (September 2006). "The AST/ALT ratio as an indicator of cirrhosis in patients with PBC". Liver Int. 26 (7): 840–5. doi:10.1111/j.1478-3231.2006.01304.x. PMID 16911467. http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1478-3223&date=2006&volume=26&issue=7&spage=840.
- ^ Gopal DV, Rosen HR (February 2000). "Abnormal findings on liver function tests. Interpreting results to narrow the diagnosis and establish a prognosis". Postgrad Med 107 (2): 100–2, 105–9, 113–4. PMID 10689411. http://www.postgradmed.com/index.php?art=pgm_02_2000?article=869.
- ^ Sorbi D, Boynton J, Lindor KD (April 1999). "The ratio of aspartate aminotransferase to alanine aminotransferase: potential value in differentiating nonalcoholic steatohepatitis from alcoholic liver disease". Am. J. Gastroenterol. 94 (4): 1018–22. doi:10.1111/j.1572-0241.1999.01006.x. PMID 10201476.
- ^ Kenneth D. McClatchey (2002). Clinical laboratory medicine. Lippincott Williams & Wilkins. pp. 288–. ISBN 9780683307511. http://books.google.com/?id=3PJVLH1NmQAC&pg=PA288. Retrieved 21 May 2010.
- ^ a b De Ritis F, Coltorti M, Giusti G (July 2006). "An enzymic test for the diagnosis of viral hepatitis: the transaminase serum activities. 1957". Clin. Chim. Acta 369 (2): 148–52. doi:10.1016/j.cca.2006.05.001. PMID 16781697. http://linkinghub.elsevier.com/retrieve/pii/S0009-8981(06)00250-6.
See also
Medical test: Serology, reference range: Clinical biochemistry blood tests (including BMP, CMP) (CPT 82000-84999) Fluid/electrolytes electrolytes (Na+/K+, Cl-/HCO3-) · renal function, BUN-to-creatinine ratio (BUN/Creatinine) · Ca
derived values: Plasma osmolality · Serum osmolal gapAcid-base Nutrition Iron tests: Transferrin saturation = Serum iron / Total iron-binding capacity; Ferritin · Transferrin · Transferrin receptorEndocrine ACTH stimulation test · Thyroid function tests (TSH)
Blood sugar: Glucose test · C-peptide · Fructosamine · Glycated hemoglobinMetabolic Cardiovascular Digestive Liver function tests: protein tests (Human serum albumin, Serum total protein) · ALP · transaminases (ALT, AST, AST/ALT ratio) · Bilirubin (Unconjugated, Conjugated)
Amylase · Lipase (Pancreatic lipase)
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