The estimation of aminotransferases which include Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT), in serum, is an established liver function test which helps in the differential diagnosis of hepatobiliary diseases. Though both the enzymes are present in the liver, ALT is more specific for the liver. There are contradictory reports on the usefulness of De Ritis ratio (AST/ALT) in differentiating the various types of liver diseases. This prospective study was undertaken primarily to compare the De Ritis ratio in three groups of patients, namely viral hepatitis, non viral hepatitis and alcoholic liver disease (ALD). In this prospective study we included 110 patients, in the age group of 25 to 40, and with abnormal liver function. Patients were classified into 3 groups, namely, those with viral hepatitis (n=40), non viral hepatitis (n=30) and ALD (n=40). Patients with ischemic heart disease, skeletal muscle disorders, and patients with cirrhosis as depicted by ultrasonography were excluded from the study. Serum ALT levels were significantly high (p=0.004) in viral hepatitis group as compared to ALD and non-viral hepatitis groups. When we compared De Ritis ratio among the three groups, ALD group showed significantly high values compared to the other two groups (p= 0.000).The De Ritis ratios were lesser than 1, greater than 1 but lesser than 2 and greater than 2 in viral hepatitis, non viral hepatitis and ALD respectively. We did not find any significant differences in serum AST levels among the three groups. De Ritis ratio can be a simple reliable and economically viable biochemical indicator for the diagnosis of alcoholic liver diseases.
Alcoholic liver disease, de Ritis ratio, Transaminases, Aspartate Aminotransferase , and Alanine Aminotransferase