The AST/ALT ratio as an indicator of cirrhosis in patients with PBC

  1. Helena Nyblom1,
  2. Einar Björnsson1,
  3. Magnus Simrén1,
  4. Frank Aldenborg2,
  5. Sven Almer3,
  6. Rolf Olsson1

Article first published online: 3 AUG 2006

DOI: 10.1111/j.1478-3231.2006.01304.x

Issue

Liver International

Liver International

Volume 26, Issue 7, pages 840–845, September 2006

Additional Information

How to Cite

Nyblom, H., Björnsson, E., Simrén, M., Aldenborg, F., Almer, S. and Olsson, R. (2006), The AST/ALT ratio as an indicator of cirrhosis in patients with PBC. Liver International, 26: 840–845. doi: 10.1111/j.1478-3231.2006.01304.x

Author Information

  1. 1

    Department of Internal Medicine, Sahlgrenska University Hospital, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden,

  2. 2

    Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden and

  3. 3

    Department of Gastroenterology and Hepatology/IMK, University Hospital, Linköping, Sweden.

*Rolf Olsson, Department of Internal Medicine, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden. Tel: +46 31 342 1830 Fax: +46 31 822152 e-mail: rolf.olsson@medicine.gu.se

Publication History

  1. Issue published online: 3 AUG 2006
  2. Article first published online: 3 AUG 2006
  3. Received 1 February 2006,accepted 8 May 2006

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Keywords:

  • alanine aminotransferase;
  • aspartate aminotransferase;
  • liver cirrhosis;
  • primary biliary cirrhosis;
  • ratio;
  • sensitivity;
  • specificity

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.

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