Question

What enzyme is very elevated in alcoholic cirrhosis and how do levels of ALT and AST compare to each other?

a) Alkaline phosphatase; ALT > AST
b) Aspartate transaminase (AST); ALT > AST
c) Alanine transaminase (ALT); ALT > AST
d) Gamma-glutamyl transferase (GGT); AST > ALT

Answer 1

In alcoholic cirrhosis, gamma-glutamyl transferase (GGT) is highly elevated, and aspartate transaminase (AST) is typically higher than alanine transaminase (ALT), with a ratio of AST to ALT often greater than 2.

Step-by-step explanation:

The enzyme that is very elevated in alcoholic cirrhosis is gamma-glutamyl transferase (GGT), which is a sensitive marker for cholestatic liver damage and is particularly raised in cases of chronic alcohol toxicity. When comparing the levels of alanine transaminase (ALT) and aspartate transaminase (AST), in the context of alcoholic liver disease, typically the AST level is higher than the ALT level, usually by a factor greater than 2. Thus, the correct answer is AST; AST > ALT. These enzymes, ALT and AST, are types of transaminases that increase in plasma following liver damage, with ALT being more liver specific, and AST being found in other tissues as well, such as cardiac and skeletal muscles.