Feasibility of alanine aminotransferase/aspartate aminotransferase ratio in predicting hepatic steatosis in chronic hepatitis C patients

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 metabolic 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.