Anjum Rashid Butt, Shahbaz Ahmad, Nayab Haider, Allah Ditta, M Asim Saeed Khokhar, Muhammad Saeed Khokhar, Mohd Tayyab.
Evaluation of AST / ALT ratio in patients with liver disease.
Pak J Med Sci Jan ;17(4):225-8.

Objective: To assess AST/ALT ratio in patients with liver disease, i.e. hepatitis and cirrhosis and to evaluate its significance as predictor of cirrhosis in our population. Place and Duration of Study: The study was carried out in the Department of Medicine and Gastroentero logy Medical Unit-I Post Graduate Medical Institute/Services Hospital, Lahore & Department of Pathology PGMI Lahore Pakistan. The period of study was from July 1999 to July 2000. Subject and Methods: This study comprised 75 patients suffering from liver disease. All the patients were thoroughly examined clinically and ultrasound was performed. They were divided into two groups; Group I: It included 50 (35 male, 15 female) patients with cirrhosis of the liver confirmed clinically and by ultrasonography. Group II: It comprised of 25 (18 male, 7 female) patients with acute hepatitis confirmed by serology. The blood sample were sent to department of pathology Postgraduate Medical Institutes Lahore. HBs Ag and anti-HCV were performed using the commercially available kits based on ELISA techniques. AST and ALT were determined using the kits based on photometric methods in which the Oxo-acids are assayed by coupling with 2-4 dinitrophenyl hydrazine. Results: The mean AST and ALT concentrations of the patients with hepatitis (Group II) were elevated significantly (P<0.001) as compared to those of the cirrhotic patients (Group I). In contrast, the mean AST/ALT ratios of the cirrhotic patients (Group I) were elevated significantly (P<0.001) than the patients with hepatitis. Conclusions: The present study shows that the mean AST/ALT ratios of the cirrhotic patients were significantly higher (P < 0.001) as compared to those with hepatitis. Hence, the AST/ALT ratio can be considered as a dependable marker of fibrosis in patients with chronic liver disease in Pakistan, even though liver biopsy remains the most definitive diagnostic measure for cirrhosis.

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