Mitochondrial aspartate aminotransferase in nonalcoholic cirrhosis

High Ast/Alt Ratio May Indicate Advanced Alcoholic Liver Disease Rather Than Heavy Drinking

“…However, the AST/ALT ratio in eight PBC patients who had developed cirrhosis did not differ from that in 34 PBC patients without cirrhosis [1.13 ± 0.35 (SD) vs 0.97 ± 0.35] arguing against the development of cirrhosis as the sole determinant for a high AST/ALT ratio. Furthermore, in contrast to the high ratio observed in our alcohol cirrhotic patients, the magnitude of the reported mean AST/ALT ratio in the patients with chronic viral hepatitis and cirrhosis is generally only slightly above 1 (Williams and Hoofnagle, 1988;Cadiot et al, 1989;Sheth et al, 1998;Park et al, 2000;Anderson et al, 2000;Assy and Minuk, 2000;Giannini et al, 2001;Pohl et al, 2001). The mean and maximum ratio in our PBC patients was 1.0 and 2.0, respectively.…”

“…An increased AST/ALT ratio in patients with increased serum aminotransferase activity has also been associated with the development of cirrhosis in Nonalcoholic Steatohepatitis (Sorbi et al, 1999), even though a still higher AST/ALT ratio was observed in a group of non-biopsied patients with alcoholic liver disease. Furthermore, a high AST/ALT ratio in patients with increased serum aminotransferases has been reported in chronic viral hepatitis (Williams and Hoofnagle, 1988;Cadiot et al, 1989;Reedy et al, 1998;Sheth et al, 1998;Anderson et al, 2000;Assy and Minuk, 2000;Park et al, 2000;Giannini et al, 2001Giannini et al, , 2003Pohl et al, 2001) even though reports on relatively low positive predictive values have been published (Imperial et al, 2000).…”