AST/ALT ratio

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AST/ALT ratio
Diagnostics
LOINC16325-3, 1916-6
 
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AST/ALT ratio
Diagnostics
LOINC16325-3, 1916-6

The AST/ALT ratio (aspartate transaminase–alanine transaminase ratio or aspartate aminotransferase–alanine aminotransferase ratio) is the ratio between the concentrations of aspartate transaminase (AST) (aspartate aminotransferase) and alanine transaminase (ALT) (alanine aminotransferase) in the blood of a human or animal. It is measured with a blood test and is sometimes useful in medical diagnosis to differentiate between causes of liver damage, or hepatotoxicity.[1][2][3]

The reverse of AST/ALT, the ALT/AST ratio, is also sometimes reported in clinical practice.

Interpretation[edit]

In healthy people AST > ALT; when ALT > AST, pathosis is likely.[citation needed] Thus:


However, the AST/ALT ratio is less useful in scenarios where the liver enzymes are not elevated, or where multiple conditions co-exist.

History[edit]

Pathophysiology sample values
BMP/ELECTROLYTES:
Na+ = 140Cl = 100BUN = 20/
Glu = 150
K+ = 4CO2 = 22PCr = 1.0\
ARTERIAL BLOOD GAS:
HCO3- = 24paCO2 = 40paO2 = 95pH = 7.40
ALVEOLAR GAS:
pACO2 = 36pAO2 = 105A-a g = 10
OTHER:
Ca = 9.5Mg2+ = 2.0PO4 = 1
CK = 55BE = −0.36AG = 16
SERUM OSMOLARITY/RENAL:
PMO = 300PCO = 295POG = 5BUN:Cr = 20
URINALYSIS:
UNa+ = 80UCl = 100UAG = 5FENa = 0.95
UK+ = 25USG = 1.01UCr = 60UO = 800
PROTEIN/GI/LIVER FUNCTION TESTS:
LDH = 100TP = 7.6AST = 25TBIL = 0.7
ALP = 71Alb = 4.0ALT = 40BC = 0.5
AST/ALT = 0.6BU = 0.2
AF alb = 3.0SAAG = 1.0SOG = 60
CSF:
CSF alb = 30CSF glu = 60CSF/S alb = 7.5CSF/S glu = 0.4

It is also known as the "De Ritis Ratio",[5][6] named after De Ritis, who performed early analysis on transaminases.[6]

References[edit]

  1. ^ Nyblom H, Berggren U, Balldin J, Olsson R (2004). "High AST/ALT ratio may indicate advanced alcoholic liver disease rather than heavy drinking". Alcohol Alcohol. 39 (4): 336–9. doi:10.1093/alcalc/agh074. PMID 15208167. 
  2. ^ Nyblom H, Björnsson E, Simrén M, Aldenborg F, Almer S, Olsson R (September 2006). "The AST/ALT ratio as an indicator of cirrhosis in patients with PBC". Liver Int. 26 (7): 840–5. doi:10.1111/j.1478-3231.2006.01304.x. PMID 16911467. 
  3. ^ Gopal DV, Rosen HR (February 2000). "Abnormal findings on liver function tests. Interpreting results to narrow the diagnosis and establish a prognosis". Postgrad Med 107 (2): 100–2, 105–9, 113–4. doi:10.3810/pgm.2000.02.869. PMID 10689411. 
  4. ^ Sorbi D, Boynton J, Lindor KD (April 1999). "The ratio of aspartate aminotransferase to alanine aminotransferase: potential value in differentiating nonalcoholic steatohepatitis from alcoholic liver disease". Am. J. Gastroenterol. 94 (4): 1018–22. doi:10.1111/j.1572-0241.1999.01006.x. PMID 10201476. 
  5. ^ Kenneth D. McClatchey (2002). Clinical laboratory medicine. Lippincott Williams & Wilkins. pp. 288–. ISBN 978-0-683-30751-1. Retrieved 21 May 2010. 
  6. ^ a b De Ritis F, Coltorti M, Giusti G (July 2006). "An enzymic test for the diagnosis of viral hepatitis: the transaminase serum activities. 1957". Clin. Chim. Acta 369 (2): 148–52. doi:10.1016/j.cca.2006.05.001. PMID 16781697. 

See also[edit]