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

Journal article
Authors Helena Nyblom
Einar Björnsson
Magnus Simrén
Frank Aldenborg
Sven Almer
Rolf Olsson
Published in Liver international : official journal of the International Association for the Study of the Liver
Volume 26
Issue 7
Pages 840-5
ISSN 1478-3223
Publication year 2006
Published at Institute of Biomedicine, Department of Pathology
Institute of Medicine, Department of Internal Medicine
Pages 840-5
Language en
Keywords Adult, Aged, Alanine Transaminase, blood, Aspartate Aminotransferases, blood, Biological Markers, Case-Control Studies, Disease Progression, Female, Humans, Liver Cirrhosis, blood, etiology, physiopathology, Liver Cirrhosis, Biliary, blood, physiopathology, Liver Function Tests, Male, Middle Aged, Predictive Value of Tests, Prognosis, Sensitivity and Specificity
Subject categories Gastroenterology and Hepatology


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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