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Adv Lab Med Int. 2014; 4(2): 26-36

Evaluation of Albumin/Globulin and De Ritis ratios as the cost effective tools for differential diagnosis of hepatitis

Gadasala Soma Sekhar, Srinivasan AR, Mohamed Hanifah, Niranjan Gopal.

The study was primarily undertaken to check the efficacy of De Ritis ratio as a simple, sensitive, reliable and economical biochemical indicator of liver diseases especially alcoholic liver disease. The study was also focused on the controversy surrounding De Ritis ratio as an unequivocal marker of liver diseases. Our study indicated that the De Ritis ratio based on the levels of non-functional proteins is a better indicator of liver diseases in comparison to the ratio of Albumin and Globulin (based on plasma functional proteins). De Ritis ratio values were 1.01+ 0.24, 1.49+ 0.74 and 2.39+ 0.94** respectively with viral hepatitis, non viral hepatitis and Alcoholic liver disease. De Ritis ratio was highly significant as also the Total bilirubin (p-value 0.000 for both). Hence, the De Ritis ratio could be used in association with serum total bilirubin in differentiating Alcoholic liver disease (ALD) from viral (VH) and non viral hepatitis (NVH). The levels of Total protein and Albumin in serum and also the Albumin/ Globulin ratio were insignificant, thereby implying that the ratio of the Non-functional proteins (AST/ALT—the de Ritis ratio) could be used as an independent and reliable indicator of liver diseases in general and ALD in particular.

Key words: De Ritis ratio, hepatitis, Alcoholic liver disease

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