ASAT/ALAT ratio provides prognostic information independently of Child-Pugh class, gender and age in non-alcoholic cirrhosis

Haukeland, John Willy; Schreiner, Linn Therese; Lorgen, Inger; Frigstad, Svein-Oskar; Bang, Christina; Raknerud, N; Konopski, Zbigniew

doi:10.1080/00365520802158614

Cited by 28 publications

(18 citation statements)

References 28 publications

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“…(17,19) For the AAR, a cutoff value 1 has been predictive of cirrhosis in chronic viral hepatitis and nonalcoholic steatohepatitis. (20)(21)(22) VCTE, measured by FibroScan, was evaluated in patients after 2007, with informed consent. (23) Individuals specifically trained in the technique performed the elastography.…”

Section: Evaluation Of Existing and New Diagnostic Criteria For Adultmentioning

confidence: 99%

Adult‐onset cystic fibrosis liver disease: Diagnosis and characterization of an underappreciated entity

et al. 2017

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Background & Aims Cystic fibrosis liver disease (CFLD), a leading cause of death in cystic fibrosis (CF), is mostly described in pediatric populations. Adult-onset CFLD lacks sufficient characterization and diagnostic tools. Methods A cohort of CF patients without CFLD during childhood were followed for up to 38 years with serologic testing, imaging, and noninvasive fibrosis markers. Historical CFLD diagnostic criteria were compared with a newly proposed CFLD criteria. Results 36 CF patients were followed for a median of 24.5 years(IQR=15.6, 32.9). By the last follow-up, 11(31%) had died. With conventional criteria, 8(22%) patients had CFLD, and by new criterion, 17 (47%) had CFLD at a median age of 36.6 years(IQR=26.5, 43.2). By new criterion, those with CFLD had higher median ALT(42 vs 27, p=0.005), AST(26 vs 21, p=0.01), direct bilirubin(0.13 vs 0.1, p=0.01), PT(14.4 vs 12.4, p=0.002), and APRI(0.31 vs 0.23, p=0.003) over the last two years of follow-up. Subjects with a Fibroscan® >6.8kPa had higher ALT(42 vs 28U/L, p=0.02), AST(35 vs 25U/L, p=0.02), APRI(0.77 vs 0.25, p=0.0004), FIB-4(2.14 vs 0.74, p=0.0003) and lower platelet counts(205 vs 293, p=0.02). One CFLD patient had nodular regenerative hyperplasia. Longitudinally, mean platelet counts significantly declined in the CFLD group(310 to 230U/L, p=0.0005). Deceased CFLD patients had lower platelet counts than those alive with CFLD(143 vs 258 U/L, p=0.004) or those deceased with no CFLD(143 vs 327U/L, p=0.006). Conclusion Adult-onset CFLD may be more prevalent than previously described which suggests a later wave of CFLD that impacts morbidity. Routine liver tests, radiologic imaging, noninvasive fibrosis markers and fibroscan® can be utilized algorithmically to identify adult CFLD. Further evaluation in other CF cohorts should be performed for validation.

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Section: Evaluation Of Existing and New Diagnostic Criteria For Adultmentioning

confidence: 99%

Adult‐onset cystic fibrosis liver disease: Diagnosis and characterization of an underappreciated entity

et al. 2017

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“…The predictive value of the AST/ALT ratio has been validated in non-alcoholic liver disease, chronic viral hepatitis, primary sclerosing cholangitis, and primary biliary cirrhosis [74]. In many forms of acute and chronic liver injury or steatosis (fatty infiltration of the liver), this ratio is less than or equal to 1, while in alcoholic hepatitis, an AST/ALT ratio is often greater than 2.…”

Section: Diagnostics Of Acquired Liver Fibrosismentioning

confidence: 99%

Non-Invasive markers for hepatic fibrosis

et al. 2011

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With great advancements in the therapeutic modalities used for the treatment of chronic liver diseases, the accurate assessment of liver fibrosis is a vital need for successful individualized management of disease activity in patients. The lack of accurate, reproducible and easily applied methods for fibrosis assessment has been the major limitation in both the clinical management and for research in liver diseases. However, the problem of the development of biomarkers capable of non-invasive staging of fibrosis in the liver is difficult due to the fact that the process of fibrogenesis is a component of the normal healing response to injury, invasion by pathogens, and many other etiologic factors. Current non-invasive methods range from serum biomarker assays to advanced imaging techniques such as transient elastography and magnetic resonance imaging (MRI). Among non-invasive methods that gain strongest clinical foothold are FibroScan elastometry and serum-based APRI and FibroTest. There are many other tests that are not yet widely validated, but are none the less, promising. The rate of adoption of non-invasive diagnostic tests for liver fibrosis differs from country to country, but remains limited. At the present time, use of non-invasive procedures could be recommended as pre-screening that may allow physicians to narrow down the patients' population before definitive testing of liver fibrosis by biopsy of the liver. This review provides a systematic overview of these techniques, as well as both direct and indirect biomarkers based approaches used to stage fibrosis and covers recent developments in this rapidly advancing area.

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“…The predictive value of the AST/ALT ratio has been validated in nonalcoholic liver disease, chronic viral hepatitis, primary sclerosing cholangitis, and primary biliary cirrhosis. 24 In some forms of acute and chronic hepatitis and/or steatosis this ratio is ≤ 1, whereas in alcoholic hepatitis an AST/ALT ratio is often > 2. While these proportions are only suggestive of certain hepatic etiologies, there is a superposition between the groups that exclusively depend on the AST/ALT ratio, for example when diagnosing patients with hepatitis C with alcohol abuse.…”

Section: Aspartate Aminotransferase and Alanine Aminotransferasementioning

confidence: 99%

Biomarkers for liver fibrosis: Advances, advantages and disadvantages

Cequera

Méndez

2014

Revista de Gastroenterología de México (English Edition)

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ASAT/ALAT ratio provides prognostic information independently of Child-Pugh class, gender and age in non-alcoholic cirrhosis

Abstract: A high ASAT/ALAT ratio is associated with increased mortality in cirrhosis. In non-alcoholic patients the ratio may provide prognostic information independently of classical risk factors.

Cited by 28 publications

References 28 publications

Adult‐onset cystic fibrosis liver disease: Diagnosis and characterization of an underappreciated entity

Adult‐onset cystic fibrosis liver disease: Diagnosis and characterization of an underappreciated entity

Non-Invasive markers for hepatic fibrosis

Biomarkers for liver fibrosis: Advances, advantages and disadvantages

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