AST/ALT Ratio (De Ritis)

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Differentiate causes of liver injury using enzyme ratios.

Enzyme Profile

AST (U/L)

ALT (U/L)

Ratio Interpretation

AST/ALT Ratio2.00

AnalysisSuggests Alcoholic Etiology

Highly suggestive of alcoholic liver disease (AST usually > 2x ALT).

Clinical Pattern

About this calculator

Overview

The AST/ALT ratio, also known as the De Ritis ratio, is a helpful tool for differentiating between various forms of liver disease. While both enzymes are markers of liver inflammation, their relative elevation patterns can point toward specific etiologies like alcohol use or chronic viral hepatitis.

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Pro Tips

Ratios are most useful when the enzymes are elevated (above the normal reference range).
A ratio > 1 in a patient with chronic viral hepatitis often indicates the progression to cirrhosis.
Always evaluate alongside GGT, bilirubin, and clinical history.

Fun Facts

"ALT is found primarily in the liver, making it more specific for liver injury."
"AST is found in the liver, heart, muscle, and brain."
"In most acute viral hepatitis, ALT is higher than or equal to AST (Ratio ≤ 1)."
"In alcoholic liver disease, AST is often twice as high as ALT (Ratio ≥ 2)."

Formula: De Ritis Ratio = AST level / ALT level.