Progressive liver functional impairment is associated with an increase in AST/ALT ratio.
The ratio of serum aspartate aminotransferase to alanine aminotransferase (AST/ALT ratio) has been proposed as a noninvasive method of assessing liver fibrosis and cirrhosis. Our aims were to confirm the usefulness of the AST/ALT ratio in diagnosing cirrhosis noninvasively as well as to verify the existence of a relationship between the ratio and liver functional impairment. In all, 348 patients (177 with chronic hepatitis, 171 with cirrhosis) were retrospectively evaluated and the AST/ALT ratio was related to monoethyl glycine xylidide (MEGX) formation. Moreover, in a subgroup of 54 patients we analyzed the relationships among the AST/ALT ratio and indocyanine green clearance and half-life. The AST/ALT ratio was able to separate patients with mild fibrosis from those with severe fibrosis and cirrhosis. The AST/ALT ratio, MEGX, prothrombin activity, and platelet count were selected by multivariate analysis as variables associated with cirrhosis. The AST/ALT ratio showed significant correlations both with MEGX formation and with indocyanine green clearance and half-life. The alterations of indocyanine green kinetics, which depend upon liver blood flow and uptake, were likely due to progressive fibrosis. These findings might partially explain the increase in the AST/ALT ratio as disease progresses.
Giannini
E
E
Gastroenterology Unit, Department of Internal Medicine (D.I.M.I), University of Genova, Italy.
Botta
F
F
Fasoli
A
A
Ceppa
P
P
Risso
D
D
Lantieri
P B
PB
Celle
G
G
Testa
R
R
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D002908:Chronic Disease; D004796:Clinical Enzyme Tests / Q000379:methods / Q000706:statistics & numerical data; D018450:Disease Progression; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood / Q000145:classification / Q000175:diagnosis; D019698:Hepatitis C, Chronic / Q000097:blood / Q000145:classification / Q000175:diagnosis; D006801:Humans; D008012:Lidocaine / Q000031:analogs & derivatives / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood / Q000145:classification / Q000175:diagnosis; D008111:Liver Function Tests / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D008012:Lidocaine; C001173:monoethylglycinexylidide; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase