조영희, 김종성, 김성수, 정진규, 윤석준, 김현영, 배윤경

충남대학교 의학전문대학원 의학연구소 가정의학교실

Background: The aspartate transaminase (AST)/alanine
transferase (ALT) ratio increases with alcohol
consumption. This study investigated AST/ALT ratio
according to alcohol drinking and predictive power of
AST/ALT ratio for heavy drinking in Korean men
Methods: In 2015, 830 men with no history of disease or
medication affecting liver function values were
selected. Using 14 g of alcohol as the standard glass, odd
ratios (ORs) of AST/ALT ratio over 1 among the
drinking group were compared with the non-drinking group
by multiple logistic analyses. Screening of heavy
drinkers was conducted according to both NIAAA and
Korean guidelines. Using AST/ALT ratio >1, sensitivity,
specificity, positive predictive values, negative predictive
values, positive likelihood ratios, negative likelihood
ratios and odds ratios were investigated.
Results: After correcting for age, body mass index,
exercising, and smoking history, ORs (95% confidence
interval)
of AST/ALT >1 were 1.607 (1.048-2.464) in <8 glasses
group, 2.172 (1.160-4.065) in the 14 glasses
group, and 3.670 (2.218-6.053) in the >14 glasses group.
When AST/ALT >1 in the drinking group, sensitivity,
specificity, positive predictive values, negative predictive
values, likelihood ratios (LR)+, LR- and OR according
to NIAAA guidelines, were 57.2%, 52.7%, 23.2%, 76.8%,
1.21 (1.04-1.41), 0.81 (0.67-0.98), and 1.49
(1.05-2.01), respectively. By Korean guidelines, these
values were 55.2%, 55.3%, 33.7%, 66.3%, 1.24
(1.03-1.36), 0.84 (0.72-0.98), and 1.40 (1.04-1.89),
respectively.
Conclusions: Healthy male adults showed a positive
correlation between risk of AST/ALT >1 and drinking
amount compared to the non-drinking group. Use of the
AST/ALT >1 in combination with other blood markers
to predict excessive drinking is advisable.
Korean J Health Promot 2017;17(2):64-70
Keywords: Alcohol drinking, Aspartate aminotransferase,
Alanine transaminase, National Institute on Alcohol
Abuse and Alcoholism (U.S.)