title: Elevation of the AST to ALT ratio in association with the severity of esophageal varices in patients with HCV-related compensated liver cirrhosis.
abstract: OBJECTIVE
  The development of esophageal varices depends on the progression of liver fibrosis. However, it has not yet been sufficiently clarified whether biomarkers of liver fibrosis can be used to predict the incidence of varices in cirrhotic patients with a well-maintained liver function (Child-Pugh class A).
  
  
  METHODS
  Three established markers of liver fibrosis, including AST-to-ALT ratios (AAR), FIB-4 and AST-to-platelet ratio indices (APRI), were analyzed in HCV-positive cirrhotic patients with Child-Pugh class A status, and the relationships between these markers and the risk of variceal bleeding were investigated.
  
  
  RESULTS
  The values of AAR and FIB-4 in the patient with varices with a high risk of hemorrhage were significantly higher than those in the patients without high-risk varices, whereas the value of APRI was not found to be related to the risk of variceal bleeding. Of all the parameters examined, the values of AAR were the most significantly different between the two (with or without high-risk varices) groups. In addition, the values of AAR increased in line with variceal severity.
  
  
  CONCLUSIONS
  The value of AAR is related to the severity and risk of variceal bleeding in patients with HCV-related compensated cirrhosis.
authors.affiliation: Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Iwata
authors.forename: Hirayuki
authors.initials: H
authors.lastname: Enomoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Sakai
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Aizawa
authors.forename: Hironori
authors.initials: H
authors.lastname: Tanaka
authors.forename: Naoto
authors.initials: N
authors.lastname: Ikeda
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takashima
authors.forename: Akio
authors.initials: A
authors.lastname: Ishii
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Yukihisa
authors.initials: Y
authors.lastname: Yuri
authors.forename: Kazunari
authors.initials: K
authors.lastname: Iwata
authors.forename: Masaki
authors.initials: M
authors.lastname: Saito
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Imanishi
authors.forename: Hiroko
authors.initials: H
authors.lastname: lijima
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases; D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human