The AST/ALT Ratio as an Indicator of Cirrhosis in Patients With PBC

Liver Int. 2006 Sep;26(7):840-5. doi: 10.1111/j.1478-3231.2006.01304.x.

Abstract

Objectives: A non-invasive, simple and non-expensive test to predict cirrhosis would be highly desirable. The aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio has been proven to be such an indicator of cirrhosis in alcoholic liver disease, hepatitis C.

Aim: To test whether the AST/ALT ratio is a marker of cirrhosis also in patients with primary biliary cirrhosis (PBC).

Methods: The study consisted of 160 patients. In 126 patients, we had clinical and laboratory data at the time of diagnosis and follow-up with outcome: liver-related death, liver transplantation and survival. In 121 patients, we had laboratory data and liver histology.

Results: We found that the AST/ALT ratio was significantly higher in cirrhotic patients than in non-cirrhotic patients. A high AST/ALT ratio was significantly associated with esophageal varices and ascites. In a multivariate analysis, bilirubin and ALP were predictors of poor prognosis.

Conclusion: The AST/ALT ratio seems to be of clinical value as a hint to the diagnosis of cirrhosis in patients with PBC but not as a prognostic factor.

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood*
  • Aspartate Aminotransferases / blood*
  • Biomarkers
  • Case-Control Studies
  • Disease Progression
  • Female
  • Humans
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / physiopathology
  • Liver Cirrhosis, Biliary / blood*
  • Liver Cirrhosis, Biliary / physiopathology
  • Liver Function Tests
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Sensitivity and Specificity

Substances

  • Biomarkers
  • Aspartate Aminotransferases
  • Alanine Transaminase