AST/ALT Ratio Calculator (De Ritis Ratio)

Your details

Aspartate aminotransferase (also reported as SGOT on older panels). Typical adult reference range: 10-40 U/L.
U/L
Alanine aminotransferase (also reported as SGPT on older panels). Typical adult reference range: 7-56 U/L.
U/L
AST/ALT RatioBalanced
1.25

De Ritis ratio (AST divided by ALT)

AST statusNormal (35 U/L, ref: 10-40 U/L)
ALT statusNormal (28 U/L, ref: 7-56 U/L)
Enzyme patternBalanced/mild AST elevation (ratio 1-2): seen in chronic hepatitis, early alcohol injury, or cirrhosis
1.25
ALT-predominant<1Balanced1-2AST-predominant2-3Marked AST elevation3+

Ratio 1.25: balanced pattern, seen in chronic hepatitis, early alcohol injury, or cirrhosis.

  • Both AST and ALT are within the standard adult reference ranges, so the ratio alone has limited diagnostic weight when absolute levels are normal.
  • A ratio between 1 and 2 is non-specific: it appears in chronic hepatitis B and C, moderate alcohol use, some stages of cirrhosis, and even vigorous exercise.
  • The ratio is a pattern-recognition tool, not a diagnosis. Both enzymes also rise with non-hepatic causes such as strenuous exercise (especially AST, which appears in skeletal muscle) and haemolysis.

Next stepConsider hepatitis B and C serology, a full metabolic panel, and a detailed alcohol history to guide further evaluation.

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