The ratio of two liver enzymes, used to characterise liver conditions.
The De Ritis ratio is a calculated value, not a separate blood test. It is AST divided by ALT, two liver enzymes. Named after the doctor who described it, it has been used for decades to read the pattern behind raised liver enzymes.
A ratio below 1 (ALT higher than AST) is common in fatty liver and mild liver irritation. A ratio above 1 can suggest more advanced scarring, and a ratio above 2 strongly points to alcohol-related liver disease. A high ratio with high enzymes can also reflect muscle injury rather than the liver.
Aniva reads your result against research-backed ranges, not just the lab's wide normal. The reference shown below is specific to this biomarker.
These are interpretive cut-offs, not lab ranges, and they are read with the actual enzyme values.
| De Ritis (AST/ALT) | Interpretation |
|---|---|
| Below 1 | Often non-alcoholic fatty liver or mild injury |
| Above 1 | Possible fibrosis or more advanced liver disease |
| Above 2 | Strongly suggestive of alcohol-related liver disease |
Anything affecting AST or ALT affects the ratio: recent alcohol, strenuous exercise or muscle injury (raises AST), vitamin B6 status, and some medicines. The ratio can be normal even when liver disease is present.
Best read with its components, AST and ALT, plus GGT, the full liver panel, and CK if muscle is a concern.
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