[The importance of AST / ALT rate in nonalcoholic steatohepatitis diagnosis].
OBJECTIVE
There is a histologic similarity between nonalcoholic steatohepatitis and alcoholic liver disease and in some cases differential diagnosis may be difficult, since some patients do not report abusive alcohol consumption.


OBJECTIVE
Evaluating the usefulness of setting the rate AST/ALT for the differential diagnosis of nonalcoholic steatohepatitis and alcoholic liver disease.


METHODS
Twenty nine obese patients with nonalcoholic steatohepatitis were compared with 28 patients with alcoholic liver disease. The diagnosis of nonalcoholic steatohepatitis was made after exclusion of other causes of liver disease and by histologic findings of, at least, macrovesicular steatosis and hepatocellular necrosis.


RESULTS
In patients with nonalcoholic steatohepatitis the medium AST value was 52.3 +/- 21.2 U/L and ALT of 90.1 +/- 37.9 U/L, being the AST/ALT rate lower than 1 in all patients. In patients with alcoholic liver disease the medium AST value was 140 +/- 82.5 U/L and ALT was 50.6 +/- 40.3 U/L. The rate was higher than 1 in all cases and higher than 2 in 24 (85.7%), being statistically significant when compared with patients with nonalcoholic steatohepatitis.


CONCLUSIONS
The AST/ALT rate seems to be useful in the differential diagnosis of liver diseases, while lower than 1 is highly suggestive of nonalcoholic steatohepatitis.
Faculdade Federal de Ciências Médicas de Porto Alegre (FFFCMPA) e Irmandade Santa Casa de Misericórdia de Porto Alegre. izamin@zaz.com.br
Júnior Idilio
JI
Zamin
Angelo Alves
AA
de Mattos
Christiano
C
Perin
Gabriel Zatti
GZ
Ramos
D000328:Adult; D000410:Alanine Transaminase / Q000032:analysis*; D001219:Aspartate Aminotransferases / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D004796:Clinical Enzyme Tests; D005234:Fatty Liver / Q000175:diagnosis*; D005260:Female; D006505:Hepatitis / Q000175:diagnosis*; D006519:Hepatitis, Alcoholic / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase