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Researchers find ALT/AST ratio linked to fatty liver in HCV

Researchers in Taiwan found that the alanine aminotransferase/aspartate aminotransferase ratio correlated with hepatosteatosis among patients with hepatitis C nongenotype 3 virus infection, according to published findings.

“This is the first study to reveal a strong relationship between the [ALT/AST] ratio and hepatosteatosis in patients with non-genotype 3 hepatitis C virus,” the researchers wrote. “This test could be easy to perform during regular health examinations, and a higher ratio may be strongly associated with significant steatosis.”

In a cross-sectional observational study, researchers analyzed data of 1,354 adults aged 20 years or older enrolled in a community-based annual check-up program located in Yunlin County, Taiwan, an area where HCV is prevalent, between December 2012 and September 2013.

Of the patients, 433 had NAFLD. Laboratory results indicated that patients with NAFLD had a higher prevalence of metabolic syndrome (MetS; 37%) compared with the non-NAFLD group (25.8%; P < .001), as well as a higher log-transformed fasting glucose level (4.7 ± 0.25 vs. 4.65 ± 0.23; P < .001), log-transformed lower high-density lipoprotein cholesterol level (mean 49.1 ± 12.2 vs. 51.8 ± 13.9 mg/dL; P = .001) and higher log-transformed triglyceride (TG; 4.72 ± 0.49 vs. 4.54 ± 0.46; P < .001).

Also, the ALT/AST ratio was higher in the patients with NAFLD (1.2 ± 0.4) compared to those without NAFLD (1.1 ± 0.4; P < .001).

Among the patients with a high degree of NAFLD, they had a higher incidence of MetS (45.8%) compared with the non-NAFLD group (26.9%; P < .001), as well as higher levels of log-transformed fasting glucose (4.73 ± 0.25 vs. 4.66 ± 0.23; P < .001), log-transformed uric acid (6.5 ± 1.7 vs. 6 ± 1.6 mg/dL; P < .001), log-transformed TG (4.84 ± 0.51 vs. 4.56 ± 0.46; P < .001) and a lower HDL level (47 ± 11.3 vs. 51.5 ± 13.6 mg/dL; P < .001) than those with a low degree of NAFLD. The incidence of NAFLD (40.2% vs. 28.6%) or high-degree NAFLD (20.6% vs. 10.1%) was higher in the participants with MetS. In addition, higher scores of MetS were also significant in high-degree NAFLD (P < .001 for all).

The patients with a higher ALT/AST ratio had a 1.9-fold higher risk of NAFLD (95% CI, 1.37-2.65) and a 2.44-fold higher risk of a high degree of NAFLD (95% CI, 1.58-3.77).

Analysis showed that after adjustments, ALT/AST ratio was independently associated with NAFLD (OR = 1.77; 95% CI, 1.27-2.48) and high-degree NAFLD (OR = 1.95; 95% CI, 1.25-3.04). The ALT/AST ratio remained associated with both NAFLD and high-degree NAFLD in hierarchical multivariate regression analysis.

The researchers concluded: “The ability to identify individuals with hepatosteatosis may help health care professionals to implement lifestyle interventions.” – by Melinda Stevens

Disclosures: The researchers report no relevant financial disclosures.