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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.
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.
ALT is found in plasma and in various body tissues but is most common in the liver. It catalyzes the two parts of the alanine cycle. Serum ALT level, serum AST (aspartate transaminase) level, and their ratio (AST/ALT ratio) are routinely measured clinically as biomarkers for liver health. [2]
When ALT rises to more than 500 IU/L, causes are usually from the liver. It can be due to hepatitis, ischemic liver injury, and toxins that causes liver damage. The ALT levels in hepatitis C rises more than in hepatitis A and B. Persistent ALT elevation more than 6 months is known as chronic hepatitis.
The Cahill cycle requires the presence of alanine aminotransferase (alanine transaminase, ALT), which is restricted to tissues such as muscle, liver, and the intestine. Therefore, this pathway is used instead of the Cori cycle only when an aminotransferase is present, when there is a need to transfer ammonia to the liver and when the body is in ...
The alcohol tolerance is also connected with activity of alcohol dehydrogenases (a group of enzymes responsible for the breakdown of alcohol) in the liver, and in the bloodstream. High level of alcohol dehydrogenase activity results in fast transformation of ethanol to more toxic acetaldehyde.