Perspectives in Medical Research

Volume: 13 Issue: 1

  • Open Access
  • Original Article

Evaluation of De Ritis Ratio, GGT, and hs-CRP as Biomarkers in Alcohol Dependence: A Case-Control Study

Syeda Ayesha Quadri1 , Sayed Ashfak Ahmed Hussain2∗ , Bharti Rathi3 , Mohammad Laeeque4

1Assistant Professor, Department of Biochemistry, IIMSR Medical College, Warudi, Badnapur, Jalna, Maharashtra, India
2Associate Professor, Department of Physiology, Government Medical College, Aurangabad, Chh. Sambhajinagar, Maharashtra, India 3Associate Professor, Department of Biochemistry, RK Damani SRIMS Medical College, Aurangabad, Chh. Sambhajinagar, Maharashtra, India
4Associate Professor, Department of Anatomy, Government Medical College, Aurangabad, Chh. Sambhajinagar, Maharashtra, India

*Corresponding Author: Sayed Ashfak Ahmed Hussain, Associate Professor, Department of Physiology, Government Medical College, Aurangabad, Chh. Sambhajinagar, Maharashtra, India E-MAIL: [email protected]

Year: 2025, Page: 25-28, Doi: https://doi.org/10.47799/pimr.1301.06

Received: March 12, 2024 Accepted: Jan. 11, 2025 Published: Jan. 17, 2025

Abstract

Background: Alcoholic liver disease is characterized by elevated levels of liver enzymes and inflammatory markers. The aspartate transaminase (AST) to alanine transaminase (ALT) ratio, known as the De Ritis ratio, is altered in alcoholic liver disease. This study aimed to evaluate and compare the AST/ALT ratio, gamma-glutamyl transferase (GGT), and high-sensitivity C-reactive protein (hs-CRP) in individuals with alcohol dependence versus non-alcoholic controls. Methods: This case-control study was conducted at a tertiary care center in Aurangabad, Maharashtra, India. Sixty adult males aged 18 years and above with alcohol dependence, diagnosed per DSM-V criteria, were enrolled as cases from the Medicine ward or outpatient department. Sixty socioeconomic status-matched non-alcoholic males served as controls. Serum levels of AST, ALT, GGT, and hs-CRP were measured, and the AST/ALT ratio was calculated. Parameters were compared between groups using unpaired t-tests. Results: The mean AST was 206.81 ± 85.07 U/L in cases and 25.81 ± 8.31 U/L in controls. The mean ALT was 93.25 ± 39.17 U/L in cases and 30.82 ± 8.21 U/L in controls. The mean AST/ALT ratio was 2.18 ± 0.43 in cases and 1.27 ± 0.51 in controls. The mean GGT was 90.8 ± 24.8 U/L in cases and 30.8 ± 8.2 U/L in controls. The mean hs-CRP was 3.08 ± 1.1 mg/dL in cases and 0.15 ± 0.1 mg/dL in controls. All parameters were significantly higher in the alcoholic group compared to the control group (p < 0.05). Conclusions: The De Ritis ratio, serum AST, ALT, GGT, and hs-CRP are significantly elevated in individuals with alcohol dependence compared to non-alcoholic controls, suggesting their utility as markers of alcoholic liver disease.

Keywords: De Ritis ratio, Liver enzymes, Alcoholic liver disease, Gamma-glutamyl transferase, High-sensitivity C-reactive protein, Alcohol dependence

References

  1. Majhi, S, Baral, N, Lamsal, M & Mehta, K D . 2006. De Ritis ratio as diagnostic marker of alcoholic liver disease. Nepal Medical College Journal 8(1):40–42.

  2. Botros, M & Sikaris, K A . 2013. The de ritis ratio: the test of time. Clinical Biochemist Reviews 34(3):117–130.

  3. Ritis, F De, Coltorti, M & Giusti, G . 1957. An enzymic test for the diagnosis of viral hepatitis; the transaminase serum activities. Clinica Chimica Acta 2(1):70–74.

  4. Shaikh, S M, Varma, A, Kumar, S, Acharya, S & Patil, R . 2024. Navigating Disease Management: A Comprehensive Review of the De Ritis Ratio in Clinical Medicine. Cureus 16(7).

  5. Niemelä, O . 2016. Biomarker-Based Approaches for Assessing Alcohol Use Disorders. International Journal of Environmental Research and Public Health 13(2):1–19.

  6. Xu, S J, Jiang, C Q, Zhang, W S, Cheng, K K, Schooling, C M & Xu, L . 2016. Alcohol sensitivity, alcohol use and high-sensitivity C-reactive protein in older Chinese men: The Guangzhou Biobank Cohort Study. Alcohol 57:41–48.

  7. 2013. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association

  8. Cohen, J A & Kaplan, M M . 1979. The SGOT/SGPT ratio-an indicator of alcoholic liver disease. Digestive Diseases and Sciences 24(11):835–838.

  9. Salaspuro, M . 1987. Use of enzymes for the diagnosis of alcohol-related organ damage. Enzyme 37(1-2):87–107.

  10. Alves, P S, Camilo, E A & Correia, J P . 1981. The SGOT/SGPT ratio in alcoholic liver disease. Acta Médica Portuguesa 3(4):255–260.

  11. Hietala, J, Puukka, K, Koivisto, H, Anttila, P & Niemelä, O . 2005. Serum gamma-glutamyl transferase in alcoholics, moderate drinkers and abstainers: effect on gt reference intervals at population level. Alcohol and Alcoholism 40(6):511–514.

  12. Sharpe, P C . 2001. Biochemical detection and monitoring of alcohol abuse and abstinence. Annals of Clinical Biochemistry 38(Pt 6):652–664.

  13. Rosman, A S & Lieber, C S . 1994. Diagnostic utility of laboratory tests in alcoholic liver disease. Clinical Chemistry 40(8):1641–1651.

  14. Lim, S S, Vos, T, Flaxman, A D, Danaei, G, Shibuya, K, Adair-Rohani, H & Amann, Markus . 2012. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2224–2260.

  15. Younossi, Z M, Koenig, A B, Abdelatif, D, Fazel, Y, Henry, L & Wymer, M . 2016. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 64(1):73–84.

  16. Niemelä, O, Niemelä, M, Bloigu, R, Aalto, M & Laatikainen, T . 2017. Where should the safe limits of alcohol consumption stand in light of liver enzyme abnormalities in alcohol consumers? PLoS ONE 12(12):1–15.

  17. Diehl, A M, Potter, J, Boitnott, J, Duyn, M A Van, Herlong, H F & Mezey, E . 1984. Relationship between pyridoxal 5′-phosphate deficiency and aminotransferase levels in alcoholic hepatitis. Gastroenterology 86(4):632–636.

  18. Matloff, D S, Selinger, M J & Kaplan, M M . 1980. Hepatic transaminase activity in alocholic liver disease. Gastroenterology 78(6):1389–1392.

  19. Nalpas, B, Vassault, A, Guillou, A Le, Lesgourgues, A, Ferry, N & Lacour, B . 1984. Serum activity of mitochondrial aspartate aminotransferase: a sensitive marker of alcoholism with or without alcoholic hepatitis. Hepatology 4(5):893–896.

  20. Nyblom, H, Berggren, U, Balldin, J & Olsson, R . 2004. High AST/ALT ratio may indicate advanced alcoholic liver disease rather than heavy drinking. Alcohol Alcoholism 39(4):336–339.

  21. Hourigan, K J & Bowling, F G . 2001. Alcoholic liver disease: a clinical series in an Australian private practice. Journal of Gastroenterology and Hepatology 16(10):1138–1143.

  22. Archer, Mari, Niemelä, Onni, Luoto, Kaisa, Kultti, Johanna, Hämäläinen, Mari, Moilanen, Eeva, Koivukangas, Antti, Leinonen, Esa & Kampman, Olli . 2019. Status of inflammation and alcohol use in a 6-month follow-up study of patients with major depressive disorder. Alcohol 81:21–26.

Cite this article

Quadri SA, Hussain SAA, Rathi B, Laeeque M. EvaluaƟon of De Ritis Ratio, GGT, and hs-CRP as Biomarkers in Alcohol Dependence: A Case-Control Study. Perspectives in Medical Research. 2025;13(1):25- 28 DOI: 10.47799/pimr.1301.06

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