Feasibility of alanine aminotransferase/aspartate aminotransferase ratio in predicting hepatic steatosis in chronic hepatitis C patients / 临床肝胆病杂志

ABSTRACT

Objective To investigate the feasibility of alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio in predicting the degree of hepatic steatosis in chronic hepatitis C (CHC) patients.Methods A total of 231 CHC patients who visited The First People's Hospital of Nanyang from May 2012 to June 2016 were enrolled,among whom 105 (45.45％) had nonalcoholic fatty liver disease (NAFLD) and 126 (54.55％) did not have NAFLD.According to the ultrasound score,the NAFLD group was divided into mild-to-moderate (1-2 points) hepatic steatosis group (n =67) and severe (3 points) hepatic steatosis group (n =38).The two groups were compared in terms of demographic data and disease data including creatinine,fasting blood glucose,ALT,AST,ALT/AST ratio,γ-glutamyltransferase (GGT),uric acid,low-density lipoprotein,high-density lipoprotein (HDL),cholesterol (CHO),and triglyceride (TG) to screen out independent risk factors for NAFLD in CHC patients.The independent samples t-test was used for comparison of normally distributed continuous data between groups,and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical data between groups;with severe NAFLD as the dependent variable,different factors were introduced into the logistic regression equation to screen out independent risk factors.Results Compared with the non-NAFLD group,the NAFLD group had significantly higher systolic pressure,diastolic pressure,fasting blood glucose,ALT/AST ratio,and levels of ALT,GGT,HDL,CHO,and TG,as well as a significantly higher proportion of patients with diabetes,hypertension,or metabolic syndrome (all P ＜ 0.05).Compared with the severe hepatic steatosis group,the mild-to-moderate hepatic steatosis group had significantly lower systolic pressure,diastolic pressure,fasting blood glucose,ALT/AST ratio,and levels of ALT,GGT,HDL,CHO,and TG,as well as a significantly lower proportion of patients with diabetes,hypertension,or metabolic syndrome (all P ＜ 0.05).The logistic regression analysis showed that metabohc syndrome,ALT,and ALT/AST ratio were independent risk factors for NAFLD (all P ＜0.05),and metabolic syndrome,ALT,ALT/AST ratio,and GGT were independent risk factors for severe NAFLD (all P ＜ 0.05).Conclusion ALT/AST ratio is an independent risk factor for NAFLD in CHC patients and has a certain value in evaluating the degree of NAFLD.