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

## TL;DR

This study explores how the AST/ALT blood ratio relates to abdominal aortic aneurysms and their progression.

## Contribution

The AST/ALT ratio is identified as a potential marker for AAA presence but not progression.

## Key findings

- AST/ALT ratio was independently associated with AAA presence (odds ratio 2.63).
- Higher AST/ALT ratios correlated with AAA but not with rapid progression.
- ROC analysis showed moderate discrimination for rapid aneurysm enlargement.

## Abstract

This 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.

A 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.

AST/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.

An 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.