Hello doctor,Three years ago I was diagnosed with non-alcoholic fatty liver and at that time my liver enzymes were 3 to 4 times of the upper ranges. I then lost weight and with time my enzymes got normalized. However, in last test, I have noticed a pattern where AST is greater than ALT, though they are in the normal range. AST is always greater than ALT a few points and in the last test, this increased more though the enzymes are normal. I have read the AST/ALT>1 is a sign of advanced liver disease or cirrhosis. Is this valid when the enzymes are in the normal range also? It is in the last three years that my platelet count changes in 128 to 180 range always.
Hi. No, the concept of AST: ALT is not valid when the enzymes are in normal range. However, low platelet count can be an early sign of liver cirrhosis. It is not very uncommon to get liver cirrhosis in cases of NAFLD (non-alcoholic fatty liver disease). I would recommend you upper GI endoscopy to look for any varices, a sign of chronic liver disease, fibroscan of the liver. I would also advice you to get tested for hepatitis B and C, in case you have never been tested for that.