What is AST / ALT Ratio?
This ratio is used as supportive context when liver enzymes are elevated. The ratio alone is rarely sufficient: absolute AST and ALT levels, plus GGT and bilirubin, remain most informative. Muscle-related increases can also influence the ratio.
Why is AST / ALT Ratio relevant?
The AST/ALT ratio (also known as the De Ritis ratio) tries to distinguish where elevated liver enzymes are coming from. A ratio below 1 classically points more toward lifestyle-related liver load; a ratio above 1 — combined with symptoms or intensive training — can suggest other causes. The ratio is a supporting tool, not a standalone conclusion.
How to read AST / ALT Ratio in context
Interpret the ratio only when ALT or AST are abnormal — if both sit comfortably within range, the ratio is not very informative. Recent training can lift AST and skew the ratio. For interpretation, the full picture (ALT, AST, GGT, bilirubin, ALP, symptoms, and context) always weighs more than the ratio in isolation.