Elevated AST and ALT levels are non-specific markers of hepatocyte injury.

• In the absence of other causes of liver damage, these enzymes are useful indicators of heavy drinking.
• AST is also released from skeletal and cardiac muscle (in heavy drinkers a significant proportion of the increased AST may come from these non-hepatic sources .
• Alcohol abuse is a likely cause for abnormal liver enzymes in hospital in-patients where the AST:ALT ratio is greater than 1 and very likely if the ratio is greater than 2.

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