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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/15827

Title: Pattern of AST and ALT Changes in Relation to Hemolysis in Sickle Cell Disease
Authors: Nsiah, K.
Dzogbefia, V.P.
Ansong, D.
Osei-Akoto, Alex
Boateng, H.
Ocloo, D.
Keywords: sickle cell
AST:ALT ratio
hemolytic marker
Issue Date: 2014
Publisher: Clinical Medicine Insights: Blood Disorders
Citation: Clinical Medicine Insights: Blood Disorders
Abstract: Background: Elevated aminotransferase levels are commonly associated with compromised hepatic integrity from various insults. In sickle cell disease, aspartate transaminase (AST) is also released via intravascular hemolysis. This study was done to determine the pattern of changes in AST and alanine transaminase (ALT), in particular the AST:ALT ratio, and to relate these to the hemolytic state, which we consider to be more important than hepatic and cardiac dysfunction in some individuals with sickle cell disease. Methods: Serum aminotransferase levels were measured in 330 subjects with sickle cell disease, as well as hemoglobin, reticulocytes, and lactate dehydrogenase. The AST:ALT ratio was designated as a hemolytic marker, and simple and multivariate regression analyses were carried out between this ratio and other hemolytic markers. Results: Mean AST and ALT levels were 48.24 ± 27.78 and 26.48 ± 22.73 U/L, respectively. However, for 49 subjects without sickle cell disease, mean AST and ALT levels were the same, ie, 23.0 U/L. In the subjects with sickle cell disease, the increases in AST levels were far higher than for ALT, supporting its release via intravascular hemolysis. In 95.8% of the subjects with sickle cell disease, the AST:ALT ratio was .1, but our results did not suggest overt malfunctioning of the liver and heart in the majority of subjects. Conclusion: Regression analyses support the use of the AST:ALT ratio as a hemolytic marker, because it has an inverse association with the hemoglobin level. Whether in steady state or in crisis, provided hepatic and cardiac integrity has not been compromised, subjects with sickle cell disease would have higher AST levels due to the hemolytic nature of the condition. This is the first report highlighting the AST:ALT ratio in sickle cell disease.
Description: This article is published by Clinical Medicine Insights: Blood Disorders and is also available at doi: 10.4137/CMBD.S3969
URI: 10.4137/CMBD.S3969
Appears in Collections:College of Health Sciences

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