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| Predictive Value of the AST/ALT Combined with Cholinesterase for Progression to Cirrhosis in Patients with Alcoholic Liver Disease |
| YANG Fei, ZHANG Gaiyun |
| Department of Clinical Laboratory, Changge People's Hospital, Changge Henan 461500 |
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Abstract 【Objective】 To investigate the predictive value of the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) combined with serum cholinesterase (ChE) for progression to cirrhosis in patients with alcoholic liver disease (ALD). 【Methods】 A total of 98 patients with ALD admitted between January 2023 and June 2024 were categorized into a cirrhosis group (n=35) and a non-cirrhosis group (n=63) according to whether cirrhosis developed. Additionally, 50 healthy volunteers were enrolled as the control group. Differences in the AST/ALT and ChE levels among the three groups were compared, and their correlations with liver stiffness measurement (LSM) and Child-Pugh class were analyzed. Receiver operating characteristic (ROC) curves were constructed to evaluate the predictive performance of these indicators for progression to cirrhosis. 【Results】 The serum AST/ALT in the cirrhosis group was higher, whereas the ChE level in the cirrhosis group was lower than those in the non-cirrhosis and control groups (all P<0.05). The serum AST/ALT was higher in patients with Child-Pugh class C than in those with class A or B (P<0.05). LSM values in the inferior segments of the right anterior and posterior hepatic lobes were higher in the cirrhosis group than in the non-cirrhosis group (P<0.05). Pearson correlation analysis showed that the AST/ALT was positively correlated with LSM in the above hepatic regions and Child-Pugh class, whereas ChE was negatively correlated with those hepatic regions and Child-Pugh class (P<0.05). The combination of the serum AST/ALT and ChE yielded an area under the curve (AUC) of 0.919 for predicting progression to cirrhosis in patients with ALD, with a sensitivity of 88.6% and a specificity of 79.4%. 【Conclusion】 An elevated AST/ALT and reduced ChE level are closely associated with cirrhotic progression in patients with ALD. The combined assessment of both AST/ALT and ChE can effectively predict the risk of cirrhosis and provide reference for early clinical intervention.
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Received: 13 June 2025
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2026, Vol. 43 
