Laboratory abnormalities in alcoholic liver disease

Abnormality	Diagnostic characteristics*
Serum AST>ALT (ratio usually >2.0, both usually <300 international units/L, and almost never >500 international units/L)	Sensitivity and specificity have not been well studied, but may vary with the magnitude of the ratio
Elevated serum AST	Sensitivity 50 percent
Elevated serum AST	Specificity 82 percent
Elevated serum ALT	Sensitivity 35 percent
Elevated serum ALT	Specificity 86 percent
Elevated serum GGT	Sensitivity approximately 70 percent
Elevated serum GGT	Specificity approximately 60 to 80 percent
High MCV	Sensitivity approximately 30 to 50 percent
High MCV	Specificity approximately 85 to 90 percent
Elevated carbohydrate-deficient transferrin	Sensitivity approximately 60 to 70 percent (lower values have been reported)
Elevated carbohydrate-deficient transferrin	Specificity approximately 80 to 90 percent

AST: aspartate aminotransferase; ALT: alanine aminotransferase; GGT: gamma-glutamyl transpeptidase; MCV: mean corpuscular volume.
* The sensitivity and specificity figures all assume chronic alcohol use, although the definitions have varied among studies.

Graphic 64489 Version 2.0