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AST/ALT ratio. LOINC. 16325-3, 1916-6. The AST/ALT ratio or De Ritis ratio is the ratio between the concentrations of two enzymes, aspartate transaminase (AST) and alanine transaminase, aka alanine aminotransferase (ALT), in the blood of a human or animal. It is used as one of several liver function tests, and measured with a blood test.
The AST/ALT ratio increases in liver functional impairment. In alcoholic liver disease, the mean ratio is 1.45, and mean ratio is 1.33 in post necrotic liver cirrhosis. Ratio is greater than 1.17 in viral cirrhosis, greater than 2.0 in alcoholic hepatitis, and 0.9 in non-alcoholic hepatitis.
ALT is commonly measured clinically as part of liver function tests and is a component of the AST/ALT ratio. [6] When used in diagnostics, it is almost always measured in international units/liter (IU/L) [7] or μkat. While sources vary on specific reference range values for patients, 0-40 IU/L is the standard reference range for experimental ...
In medicine, the presence of elevated transaminases, commonly the transaminases alanine transaminase (ALT) and aspartate transaminase (AST), may be an indicator of liver dysfunction. [ 1][ 2] Other terms include transaminasemia, [ 3] and elevated liver enzymes (though they are not the only enzymes in the liver).
Serum AST level, serum ALT (alanine transaminase) level, and their ratio (AST/ALT ratio) are commonly measured clinically as biomarkers for liver health. The tests are part of blood panels. The half-life of total AST in the circulation approximates 17 hours and, on average, 87 hours for mitochondrial AST. [4]
AST and ALT blood levels are both elevated, but at less than 300 IU/liter, with an AST:ALT ratio > 2.0, a value rarely seen in other liver diseases. [50] In the United States, 40% of cirrhosis-related deaths are due to alcohol. [32] In non-alcoholic fatty liver disease (NAFLD), fat builds up in the liver and eventually causes scar tissue. [51]
The ratio of aspartate aminotransferase to alanine aminotransferase is usually 2 or more. [13] In most cases, the liver enzymes do not exceed 500. A liver biopsy is not required for the diagnosis, however it can help confirm alcoholic hepatitis as the cause of the hepatitis if the diagnosis is unclear. [3] [14]
AST and ALT levels are almost always less than 500. The elevated AST to ALT ratio is due to deficiency of pyridoxal phosphate , which is required in the ALT enzyme synthetic pathway. Furthermore, alcohol metabolite–induced injury of hepatic mitochondria results in AST isoenzyme release.
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