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Dr. Andrew Rynne

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Is Alcohol Intake Causing AST To ALT Ratio 0.5?

Hi I am 54 male and my ALT is 118 Units/L and my AST 64 Units/L. I am a moderate red wine drinker; 2-3 glasses maybe 2 or 3 days per week. My AST to ALT ration is 0.5. do you think alcohol is causing this? Albumin level 4.6 gm/dL, Bilirubin Total 1.0 mg/dL
Mon, 8 Sep 2014
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Internal Medicine Specialist,  's  Response
Hi,

Thank you for your query. I can understand your concerns.





In alcoholic liver disease, the AST(SGOT) :ALT (SGPT) ratio usually exceeds 2. This is partially explained by the depletion in alcoholics of pyridoxal 5-phosphate, the biologically active form of vitamin B6 which is necessary for the activity of both enzymes and is depleted in alcoholics.
In alcoholic hepatitis and in contrast to other causes of fatty liver, the AST and ALT are usually elevated two- to sevenfold. They are rarely >400 IU, and the AST/ALT ratio >1
AST(SGOT), which is derived from alcoholic damage to mitochondria or smooth muscle, is more increased than the ALT (SGPT) which is confined to the liver.
In your case ALT level is elevated and more than AST,which is also elevated.
I will suggest you to undergo serum g-GT (gamma-glutamyl transpeptidase)- a widely used screening test for alcohol abuse. If g-GT is also elevated,the liver enyme elevations are alocohol induced.
Regards

Dr. T.K. Biswas M.D.
Mumbai
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Is Alcohol Intake Causing AST To ALT Ratio 0.5?

Hi, Thank you for your query. I can understand your concerns. In alcoholic liver disease, the AST(SGOT) :ALT (SGPT) ratio usually exceeds 2. This is partially explained by the depletion in alcoholics of pyridoxal 5-phosphate, the biologically active form of vitamin B6 which is necessary for the activity of both enzymes and is depleted in alcoholics. In alcoholic hepatitis and in contrast to other causes of fatty liver, the AST and ALT are usually elevated two- to sevenfold. They are rarely 400 IU, and the AST/ALT ratio 1 AST(SGOT), which is derived from alcoholic damage to mitochondria or smooth muscle, is more increased than the ALT (SGPT) which is confined to the liver. In your case ALT level is elevated and more than AST,which is also elevated. I will suggest you to undergo serum g-GT (gamma-glutamyl transpeptidase)- a widely used screening test for alcohol abuse. If g-GT is also elevated,the liver enyme elevations are alocohol induced. Regards Dr. T.K. Biswas M.D. Mumbai