The biochemical markers for chronic alcohol consumption that have been most commonly studied are serum GGT, AST, ALT, mean corpuscular volume (MCV) and carbohydrate-deficient transferrin (CDT)[82-84]. An AST to ALT ratio over 2 is highly suggestive of ALD[85,86].
Laboratory findings consistent with the diagnosis of alcoholic liver disease include: Elevated liver enzymes: Aspartate aminotransferase (AST) level will be greater than that of Alanine aminotransferase (ALT) AST and ALT levels both will be below 300 IU/ml.
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.
Blood tests used to assess the liver are known as liver function tests. But liver function tests can be normal at many stages of liver disease. Blood tests can also detect if you have low levels of certain substances, such as a protein called serum albumin, which is made by the liver.
Liver disease is the most likely diagnosis if the AST level is more than twice that of ALT (9), a ratio some studies have found in more than 80 percent of alcoholic liver disease patients. An elevated level of the liver enzyme GGT is another gauge of heavy alcohol use and liver injury.
An elevated gamma glutamyl transferase (GGT) level may indicate high alcohol consumption. The GGT test is 30 to 50 percent sensitive for detecting consumption of four or more drinks per day (Rosman, 1992; Sharpe, 2001).
The predominance of AST over ALT in alcohol-related liver disease was first reported by Harinasuta et al. in 1967. Many authors have since described AST/ALT ratios greater than 1.5 or greater than 2.0 as being highly suggestive of alcoholic hepatitis.
Patients with alcoholic hepatitis will typically have moderately elevated aminotransferases (less than 500 IU/mL), an AST:ALT ratio of two or greater and elevated serum bilirubin (greater than 5 mg/dL)[114,115].
Your doctor may perform a liver biopsy to see how much scarring in is your liver. A liver biopsy can diagnose cirrhosis when the results of other tests are uncertain. The biopsy may show the cause of cirrhosis.
Laboratory findings suggestive of cirrhosis:
Albumin < 3.8 mg/dL. AST > ALT (in non-alcoholic etiologies) INR > 1.2. Bilirubin > 1.5 mg/dL (very non-specific)
The most common causes of elevated ALT levels in subjects undergoing health screening exams are alcohol intake, viral hepatitis, and NAFLD [18].
γ-Glutamyl transpeptidase (GGT) is another marker of liver injury, and this enzyme is also elevated in people who consume alcohol. Of all liver enzymes, GGT is considered to be the most sensitive biomarker of alcohol consumption.
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.
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.
GGT is implicated in alcohol use by keeping intracellular glutathione, the body's most abundant anti-oxidant, at adequate levels to protect cells from oxidative stress resulting during metabolism (e.g. that of alcohol) (Whitfield 2001).
The liver damage associated with mild alcoholic hepatitis is usually reversible if you stop drinking permanently. Severe alcoholic hepatitis, however, is a serious and life-threatening illness.
Hyponatremia is the most common electrolyte disorder seen in people consuming excessive amounts of alcohol. Hyponatremia is diagnosed when the sodium plasma concentration is below 135 mM/L. Sodium is responsible for maintaining basic vital functions.
There is a persistent desire or unsuccessful efforts to cut down or control alcohol use. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. Craving, or a strong desire or urge to use alcohol.
The initial test to identify alcohols is to take the neutral liquid, free of water and add solid phosphorus(V) chloride. A a burst of acidic steamy hydrogen chloride fumes indicate the presence of an alcohol. Subsequent tests are needed to distinguish between alcohol classifications.
In general, high levels of ALT may be a sign of liver damage from hepatitis, infection, cirrhosis, liver cancer, or other liver diseases. The damage may also be from a lack of blood flow to the liver or certain medicines or poisons.
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.
The alanine aminotransferase (ALT) is a specific marker for liver inflammation and is typically elevated in individuals with a fatty liver. If your ALT test results are elevated, your doctor may order additional blood tests to check for other conditions including viral hepatitis.
The most common of these pathways involves two enzymes—alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). These enzymes help break apart the alcohol molecule, making it possible to eliminate it from the body. First, ADH metabolizes alcohol to acetaldehyde, a highly toxic substance and known carcinogen (1).