AST ALT Ratio Calculator De Ritis SGOT SGPT

What Is the AST/ALT Ratio?

The AST/ALT ratio, also called the De Ritis ratio, divides aspartate aminotransferase (AST, SGOT) by alanine aminotransferase (ALT, SGPT). It helps characterize liver injury patterns when enzymes are elevated. For related liver tools, see the APRI Calculator and Albumin Creatinine Ratio Calculator.

AST/ALT Ratio Formula

$$Ratio = \frac{AST}{ALT}$$

Both enzymes are measured in IU/L (U/L) from the same blood draw. The ratio is unitless. A healthy individual often has a ratio near 1.0.

Clinical Interpretation

A ratio below 1 suggests ALT-predominant injury seen in NAFLD and viral hepatitis. Ratios of 1 to 2 may reflect cirrhosis or mixed injury. A ratio of 2 or higher classically suggests alcoholic liver disease when enzymes are elevated; ratios above 3 strongly suggest alcoholic hepatitis.

Frequently Asked Questions

What is a normal AST/ALT ratio?

Most healthy adults have a ratio of approximately 0.7 to 1.2. The ratio is most informative when at least one enzyme is elevated.

Does a high ratio always mean alcohol-related liver disease?

No. Advanced cirrhosis from any cause, muscle injury, and certain medications can also raise AST relative to ALT. Clinical context is essential.

What if both AST and ALT are normal?

When both enzymes are within the reference range, the ratio has limited diagnostic value regardless of its numeric result.

What is the difference between AST and ALT?

ALT is more liver-specific. AST is found in liver, heart, muscle, and red blood cells, so non-hepatic conditions can elevate AST disproportionately.

Can this ratio replace a full liver workup?

The AST/ALT ratio is one adjunct among many. Complete evaluation includes bilirubin, alkaline phosphatase, GGT, INR, imaging, and clinical history.

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AST ALT Ratio Calculator

What Is the AST/ALT Ratio?

AST/ALT Ratio Formula

Clinical Interpretation

Frequently Asked Questions

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