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The proportion of AST to ALT in hepatocytes is about 2.5:1, but because AST is removed from serum by the liver sinusoidal cells twice as quickly (serum half-life t 1/2 = 18 hr) compared to ALT (t 1/2 = 36 hr), so the resulting serum levels of AST and ALT are about equal in healthy individuals, resulting in a normal AST/ALT ratio around 1.
[10] [11] [12] Levels in the third trimester can be as much as 2-fold greater than in non-pregnant women. [10] As a result, ALP is not a reliable marker of hepatic function in pregnant women. [10] In contrast to ALP, levels of ALT, AST, GGT, and lactate dehydrogenase are only slightly changed or largely unchanged during pregnancy. [10]
Serum ALT level, serum AST (aspartate transaminase) level, and their ratio (AST/ALT ratio) are routinely measured clinically as biomarkers for liver health. [2] The half-life of ALT in the circulation approximates 47 hours. [3] Aminotransferase is cleared by sinusoidal cells in the liver. [3]
Serum AST level, serum ALT (alanine transaminase) level, and their ratio (AST/ALT ratio) are commonly measured clinically as biomarkers for liver health. The tests are part of blood panels. The half-life of total AST in the circulation approximates 17 hours and, on average, 87 hours for mitochondrial AST. [4]
Most disease processes cause ALT to rise higher than AST; AST levels double or triple that of ALT are consistent with alcoholic liver disease. [citation needed] When the AST is higher than ALT, a muscle source of these enzymes should be considered. For example, muscle inflammation due to dermatomyositis may cause AST>ALT.
Enzyme activity is commonly used for e.g. liver function tests like AST, ALT, LD and γ-GT in Sweden. [ 5 ] Percentages and time-dependent units (mol/s) are used for calculated derived parameters, e.g. for beta cell function in homeostasis model assessment or thyroid's secretory capacity .
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[70] [71] Generally, AST and ALT are elevated in most cases of hepatitis regardless of whether the person shows any symptoms. [32] The degree of elevation (i.e. levels in the hundreds vs. in the thousands), the predominance for AST vs. ALT elevation, and the ratio between AST and ALT are informative of the diagnosis. [32]
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