The absolute level of liver enzyme elevation does not correlate well with the severity of ALD, however, the pattern of elevation in transaminases is helpful in making a diagnosis of liver injury due to alcohol as AST is typically two to three times greater than ALT in alcoholic liver injury[28].
Conclusions: Most patients with high alcohol consumption but without severe liver disease do not have an AST/ALT ratio above 1. High AST/ALT ratio suggests advanced alcoholic liver disease.
Most causes of liver cell injury are associated with a greater increase in ALT than AST, but an AST/ALT ratio of 2:1 or greater is suggestive of alcoholic liver disease, particularly in the setting of an elevated gamma-glutamyl transferase.
Aminotransferase abnormalities are common in alcoholic liver disease. A disproportionate increase of serum aspartate aminotransferase, AST (SGOT) compared to alanine aminotransferase, ALT (SGPT) is highly suggestive of alcoholic liver injury— especially if the ratio of AST:ALT is greater than 2.0.
An elevated level of the liver enzyme GGT is another gauge of heavy alcohol use and liver injury.
The most common causes of elevated ALT levels in subjects undergoing health screening exams are alcohol intake, viral hepatitis, and NAFLD [18].
A normal AST:ALT ratio should be <1. In patients with alcoholic liver disease, the AST:ALT ratio is >1 in 92% of patients, and >2 in 70%. AST:ALT scores >2 are, therefore, strongly suggestive of alcoholic liver disease and scores <1 more suggestive of NAFLD/NASH.
An elevated serum AST in relation to serum ALT (alanine aminotransferase) has been proposed as an indicator that alcohol has induced organ damage. Thus, when AST/ALT ratio is >1.5, this is considered as highly suggestive that alcohol is the cause of the patient's liver injury (Correia et al., 1981; Salaspuro, 1987).
An AST/ALT ratio higher than one (where the AST is higher than ALT) means you may have cirrhosis. An AST/ALT ratio higher than 2:1 (where the AST is more than twice as high as the ALT) is a sign of alcoholic liver disease.
If you stop drinking alcohol for 2 weeks, your liver should return to normal.
Alcohol: Alcohol can affect blood sugar and fat levels, giving inaccurate results to blood tests that require fasting. If a person is being asked to fast before a blood test, they should also refrain from drinking alcohol. Smoking: Smoking can also affect blood test results.
An ALT test result of >100 IU/l is a clear indicator of serious liver disease, but a mildly elevated ALT result (30–100 IU/l) is often ascribed to the use of medication (for example statins) or alcohol, obesity, or, for lower ALT levels (<50 IU/l), considered as part of the normal distribution of test results.
Increased ALT activity is more specific for liver damage than increased aspartate aminotransferase (AST) activity.
However, patients with nonalcoholic fatty liver disease may have normal transaminase levels. The ratio of AST/ALT usually is less than 1 (in alcoholic liver disease, this ratio typically will be greater than 2) but may increase as the severity of the liver damage increases.
ALT is found predominately in the liver, with lesser quantities found in the kidneys, heart, and skeletal muscle. As a result, the ALT is a more specific indicator of liver inflammation than the AST, as the AST may also be elevated in diseases affecting other organs, such as the heart or muscles.
AST levels can fluctuate between 5 and 10% from one day to the next in the same individual. Moderate exercise increases AST levels for as long as 24 hours, usually less than 3 times the upper limit of normal.
The researchers also found that even a single episode of binge drinking elevated the levels of the liver enzyme CYP2E1, which metabolizes alcohol into toxic by-products that can cause oxidative damage and other forms of tissue injury.
Discussion. In present study, we assessed the extent of elevated liver enzymes; AST and ALT, in severely dehydrated children with AGE. Most of the patients (60, 43.5%) showed temporary isolated AST elevation along with normal ALT level. Concurrent elevated AST/ALT was observed in 22 (15.9%) children.
Performance of each diagnostic test regarding alcohol consumption. The prevalence of abnormal ALT and AST levels increased significantly from zero to greater than two drinks per day, as did MCV, GGT, and apolipoprotein A1 levels.
A high AST level often means there is some liver damage, but it is not necessarily caused by hepatitis C. A high AST with a normal ALT may mean that the AST is coming from a different part of the body. It is important to realize that the AST level in most patients with hepatitis C goes up and down.
The MSV test is part of a full blood count (FBC) and is used to identify recently ingested alcohol. The test works by looking at the average volume of red blood cells in a specimen.
Generally, symptoms of alcoholic liver disease include abdominal pain and tenderness, dry mouth and increased thirst, fatigue, jaundice (which is yellowing of the skin), loss of appetite, and nausea. Your skin may look abnormally dark or light. Your feet or hands may look red.
Usually, the upper limit of ALT is 35 - 40 U/L. Moderate increase in ALT (such as 70 U/L) is seen in chronic hepatitis, chronic obstruction of bile ducts, heart damage, alcohol abuse, liver tumor, skeletal muscle damage. In any acute liver conditions, ALT is much more elevated.