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Evaluation of De Ritis ratio in liver-associated diseases

Kumari Shipra Parmar, Ganesh Kumar Singh, Govind Prasad Gupta, Tanuja Pathak, Sandeep Nayak.

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Background: Liver diseases are one of the common disorders encountered in clinical practice. Investigations in liver-associated diseases are used to detect type of hepatic abnormality, to measure its severity, to define its structural effect on the liver, to find out etiology of disorder, to assess prognosis, and to evaluate therapy. One should aim at a diagnosis with simple and possibly noninvasive means, avoiding extensive examinations. De Ritis ratio (the ratio of serum aspartate aminotransferase to serum alanine aminotransferase) has been proposed a valuable diagnostic marker to screen liver disorder.

Objective: To assess the significance of De Ritis ratio as a diagnostic marker in population of hepatic disorder.

Materials and Method: This is a retrospective study performed on records of 102 patients with liver diseases who were treated at the out-patient clinic or admitted to Nobel Medical College, Biratnagar, Nepal, between June 15, 2015 and July 15, 2015. De Ritis ratio of all the patients were calculated from documented biochemical tests of AST and ALT. De Ritis ratio and demographic profile of all the patients were analyzed by independent t -test and one-way ANOVA using software SPSS 20 version.

Results: De Ritis ratio was significantly decreased (p < 0.05) in viral hepatitis (0.8006 ± 0.14811) than the control group (1.0934 ± 0.13508) and markedly increased (p = 0.000) in alcoholic liver disorder. Similarly, It is significantly increased (p < 0.05) in nonalcoholic fatty liver disorder (1.2204 ± 0.17954), whereas insignificantly increased (p = 0.408) in cholestasis (1.1378 ± 0.18045).

Conclusion: De Ritis ratio can be used as a prognostic marker of liver disorder and can be considered as a noninvasive, cost–effective means of screening liver diseases.

Key words: De Ritis ratio, alcoholic liver disorder, viral hepatitis, nonalcoholic, fatty liver disorder, cholestasis

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