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Abstract
Background
The aspartate transaminase (AST)/alanine transferase (ALT) ratio increases with alcohol consumption. This study investigated AST/ALT ratio according to alcohol drinking and predictive power of AST/ALT ratio for heavy drinking in Korean men.
Methods
In 2015, 830 men with no history of disease or medication affecting liver function values were selected. Using 14 g of alcohol as the standard glass, odd ratios (ORs) of AST/ALT ratio over 1 among the drinking group were compared with the non-drinking group by multiple logistic analyses. Screening of heavy drinkers was conducted according to both NIAAA and Korean guidelines. Using AST/ALT ratio >1, sensitivity, specificity, positive predictive values, negative predictive values, positive likelihood ratios, negative likelihood ratios and odds ratios were investigated.
Results
After correcting for age, body mass index, exercising, and smoking history, ORs (95% confidence interval) of AST/ALT >1 were 1.607 (1.048-2.464) in <8 glasses group, 2.172 (1.160-4.065) in the 14 glasses group, and 3.670 (2.218-6.053) in the >14 glasses group. When AST/ALT >1 in the drinking group, sensitivity, specificity, positive predictive values, negative predictive values, likelihood ratios (LR)+, LR- and OR according to NIAAA guidelines, were 57.2%, 52.7%, 23.2%, 76.8%, 1.21 (1.04-1.41), 0.81 (0.67-0.98), and 1.49 (1.05-2.01), respectively. By Korean guidelines, these values were 55.2%, 55.3%, 33.7%, 66.3%, 1.24 (1.03-1.36), 0.84 (0.72-0.98), and 1.40 (1.04-1.89), respectively.
Figures and Tables
Table 4
Usefulness of AST/ALT >1 for screening of heavy drinking considering NIAAA guideline and Korean guideline
Abbreviations: AST, aspartate transaminase; ALT, alanine transferase; NIAAA, National Institute on Alcohol Abuse and Alcoholism; CI, confidence interval.
Values are presented as number (%), unless otherwise stated.
Calculated by Likelihood ratio test for LR(+/-) and logistic regression test for odds ratio (95% CI).
Table 5
Cut-off point of AST/ALT ratio for predicting heavy drinking according to NIAAA guideline and Korean guideline
Abbreviations: AST, aspartate transaminase; ALT, alanine transferase; NIAAA, National Institute on Alcohol Abuse and Alcoholism; AUROC, area under the receiver operating characteristic curve; CI, confidence interval.
Proper cut off value calculated by receiver operating characteristic (ROC) curves analysis.
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