The Relationship Between the Serum Aspartate Aminotransferase/Alanine Aminotransferase Ratio and the Occurrence and Progression of Abdominal Aortic Aneurysms: A Cross-Sectional Study.

introductionThis study investigated the relationship between the serum aspartate aminotransferase to alanine aminotransferase (AST/ALT) ratio, the presence and progression of abdominal aortic aneurysms (AAA), assessing its potential as an accessible biochemical marker for patients at risk of rapid aneurysmal growth.

methodsA total of 180 patients were retrospectively analyzed: 90 with AAA and 90 ageand risk factor-matched controls. Demographic characteristics, risk factors, laboratory parameters, and imaging data were reviewed. The AAA group was divided into rapid and slow enlargement subgroups based on six-month computed tomography measurements. Logistic regression, receiver operating characteristic (ROC) analyses were used to evaluate predictive and discriminative performance, and quartile analysis explored potential threshold effects.

resultsAST/ALT ratio, triglycerides, low-density lipoprotein (LDL) cholesterol, and white blood cell (WBC) count were significantly higher in patients with AAA. Rapid AAA enlargement group had higher AST/ALT ratios, triglycerides, LDL cholesterol, and WBC counts. The AST/ALT ratio was independently associated with AAA presence (odds ratio 2.63; 95% confidence interval [CI] 1.44 - 5.09; P = 0.002) but not with rapid progression (P = 0.10). ROC analysis showed good discrimination for AAA presence (area under the curve [AUC] = 0.72; 95% CI 0.65 - 0.79) and moderate ability for rapid enlargement (AUC = 0.65; 95% CI 0.54 - 0.76). Quartile-based analysis revealed a stepwise increase in AAA prevalence with higher AST/ALT categories.

conclusionAn elevated AST/ALT ratio is associated with AAA presence but does not independently predict progression, suggesting it reflects hepatic-vascular inflammatory interaction rather than serving as a prognostic marker.