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High aspartate to alanine aminotransferase ratio is an indicator of cirrhosis and poor outcome in patients with primary sclerosing cholangitis
Author(s) -
Nyblom Helena,
Nordlinder Hans,
Olsson Rolf
Publication year - 2007
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2007.01471.x
Subject(s) - gastroenterology , primary sclerosing cholangitis , medicine , cirrhosis , primary biliary cirrhosis , liver transplantation , liver biopsy , alanine aminotransferase , alcoholic liver disease , cohort , biopsy , transplantation , disease
Objectives: A liver biopsy is performed mainly to stage primary sclerosing cholangitis (PSC). In viral hepatitis, alcoholic liver disease and in primary biliary cirrhosis, the ratio of aspartate to alanine aminotransferase (AST/ALT) has been proven to be an indicator of liver cirrhosis. We wanted to test whether or not an AST/ALT ratio ≥1 is an indicator of cirrhosis also in patients with PSC. Methods: A cohort of 154 patients diagnosed with PSC was studied retrospectively. Laboratory tests and the histological stage were scored. Results: The mean AST/ALT ratio in the cirrhotic patients at the time of the first ( n =117) as well as the last ( n =72) histological examination was higher (1.3±0.5 and 1.6±0.7, respectively) than in the non‐cirrhotic patients (0.7±0.4 and 1.0 ±0.4, respectively) ( P <0.0001 and P =0.0002, respectively). An AST/ALT ratio ≥1 was a strong predictor for liver‐related death/orthotopic liver transplantation and liver‐related death, being associated with a double and an almost fourfold higher risk, respectively. Conclusion: An AST/ALT ratio ≥1 is significantly associated with the presence of cirrhosis and poor outcome in PSC. It may therefore be a valuable non‐invasive method for indicating cirrhosis in patients with PSC.