AST/ALT Ratio — What It Means in Your Blood Test
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This ratio compares two liver enzymes to help show the pattern behind a raised enzyme result.
The AST/ALT Ratio pairs two readings so their relationship, not just their size, comes into view. That paired angle can hint at where a shift may be coming from.
Also known as: De Ritis Ratio, AST:ALT Ratio, SGOT/SGPT Ratio
This isn't a case where higher or lower is better. Your body keeps it in a narrow band, and both directions can matter.
Last reviewed: 2026-08-16
What does AST/ALT Ratio do in your body?
The value here is the pattern, not the size. How the two enzymes sit relative to each other can hint at the kind of strain behind a rise. That shape helps your care team narrow the story rather than name it. It reads best next to the two enzyme numbers and your wider picture [AASLD, 2023].
What is AST/ALT Ratio?
This divides the AST level by the ALT level to give a proportion rather than a single number. Because each enzyme sits in different amounts across tissues, their proportion hints at the source of injury.
Why is AST/ALT Ratio tested?
You have this test alongside the single enzyme levels to help show what may be raising your liver enzymes.
What is a normal AST/ALT Ratio range?
- India
- No India-specific national reference interval is published for this parameter; your lab's printed range is the most reliable comparison.
- Global
- 0.8–1.0 (typical in healthy adults)
Ranges vary by lab, method and equipment — the range printed on your own report is the one that applies to your result.
Source: [AASLD, 2023]
What does your AST/ALT Ratio value mean?
There is no widely-accepted set of value bands for this parameter. Compare your result with the reference range printed on your own report, and discuss it with your doctor.
What does a high AST/ALT Ratio result mean?
A higher ratio can go with alcohol-related liver strain or other patterns of liver cell injury. It is worth discussing with your doctor.
What does a low AST/ALT Ratio result mean?
A lower ratio can reflect a different pattern of liver involvement, often seen with liver conditions not linked to alcohol.
What can affect your AST/ALT Ratio result?
- Type of liver cell injury
- Alcohol
- Muscle involvement
- Vitamin B6 levels
- Liver scarring
Questions to ask your doctor
About this result
- What does my AST/ALT Ratio result mean for me specifically, given my age and health?
- Is my AST/ALT Ratio in the range that is right for me, not just the lab's general range?
What to do next
- Could anything I eat, do, or take have affected my liver enzyme ratio result?
- Is there anything I should do about my AST/ALT Ratio, or is it fine to leave as it is?
About retesting
- Does my AST/ALT Ratio need to be repeated, and if so, when?
- The typical range for AST/ALT Ratio can vary between labs — should I compare my result against my own lab's printed range?
The bigger picture
- Should my AST/ALT Ratio be looked at together with my Total Bilirubin and Direct Bilirubin result?
- Does my AST/ALT Ratio connect to any condition I already have, or to anything I have noticed in how I feel?
Frequently asked questions
- What is AST/ALT Ratio?
- This divides the AST level by the ALT level to give a proportion rather than a single number. Because each enzyme sits in different amounts across tissues, their proportion hints at the source of injury. You have this test alongside the single enzyme levels to help show what may be raising your liver enzymes.
- What is a normal liver enzyme ratio range?
- A typical adult range is around 0.8–1.0 (typical in healthy adults). No India-specific national reference interval is published for this parameter; your lab's printed range is the most reliable comparison. Ranges vary by lab, method and equipment — the range printed on your own report is the one that applies to your result.
- What does a high AST/ALT Ratio result mean?
- A higher ratio can go with alcohol-related liver strain or other patterns of liver cell injury. It is worth discussing with your doctor.
- What does a low AST/ALT Ratio result mean?
- A lower ratio can reflect a different pattern of liver involvement, often seen with liver conditions not linked to alcohol.
- What can affect your AST/ALT Ratio result?
- Several everyday factors can influence it, including Type of liver cell injury, Alcohol, Muscle involvement, Vitamin B6 levels, Liver scarring.
Sources
- AASLD (2023) — Practice Guidance on Evaluation of Hepatic Function Tests
Part of the Liver Function
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