As well as any reference range difficulties, I think ALT is more sensitive
than AST for mild degrees of liver damage (?possibly due to its subcellular
distribution). We use ALT in our standard LFT profile, but keep AST
available. Our Gastroenterology team find it helpful to distinguish problems
worth a biopsy (AST and ALT raised) from mild cases of fatty liver
associated with obesity etc (ALT raised, AST normal).
Regards
Angela Woods
Watford General Hospital
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