PFLPhysiological Fitness Landscape

Biomarkers · Liver & Nutritional

Aspartate Aminotransferase (AST)

The published study could not tell whether risk rises or falls: its 95% interval includes no change. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 6% higher risk of death. We found the same pattern in NHANES

AST and risk of death

Published curve higher than the NHANES fitNHANES fit higher

Risk of death from our NHANES fit, relative to its reference value. The dotted vertical line marks the NHANES median.

Risk of death per SD (NHANES)1.06×95% CI 1.03–1.08 · 48,262 adults, 7,006 deaths
Published risk of death1.23×extreme thirds of baseline AST (top vs bottom third) (95% CI 0.80–1.88) · Meta-analysis of 19 prospective general-population cohorts (>9.24 million participants overall, all enzymes); AST subset
Value of the measurement+0.015gain in concordance within age bands; rank 24 of 56 · all tests

AST by age and sex

Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.

The percentiles as a table
Each row is one sex and age band: the values below which 5%, 25%, 50%, 75% and 95% of people fall (U/L), from the survey named in the row. Not a reference range or a target.
SexAge5th25thMedian75th95thnCycle / source
All20-3912.016.019.024.045.01,427NHANES 2017-2018
All40-5913.017.020.024.039.01,543NHANES 2017-2018
All60+13.016.019.024.035.01,885NHANES 2017-2018
Allall13.016.019.024.039.04,855NHANES 2017-2018
Men20-3914.018.021.026.053.0682NHANES 2017-2018
Men40-5915.018.021.026.043.8718NHANES 2017-2018
Men60+14.017.020.025.039.0956NHANES 2017-2018
Menall14.018.021.026.045.92,356NHANES 2017-2018
Women20-3912.014.017.020.035.0745NHANES 2017-2018
Women40-5912.016.018.022.037.0825NHANES 2017-2018
Women60+13.016.019.022.033.0929NHANES 2017-2018
Womenall12.015.018.022.035.02,499NHANES 2017-2018

What studies found when this marker was changed

They describe what happened in those study groups, not a recommendation. See all catalogued interventions.

Measured changes in AST, study by study

5 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Study results in the groups studied, not predictions for a person.

Each row is one study: what was changed, the effect it reported on this marker, and the source.
TypeInterventionReported effectEvidenceSource
behavioralAlcohol abstinence (1 month) in alcohol dependence with alcoholic liver diseaseAST fell from 159.50 to 62.20 after 1 month of abstinence (p < 0.001)prospective cohortSingh S, et al. Impact of alcohol abstinence on hepatic enzymes: A clinical…
dietMediterranean diet (RCTs, including NAFLD populations)AST WMD -0.38 IU/L (95% CI -0.73 to -0.03) vs control in ten RCTs; effect sensitive to removal of some studiesmeta-analysisSangouni AA, et al. Effect of Mediterranean diet on liver enzymes: a systematic…
nutraceuticalVitamin E supplementation (800 IU/day) in non-diabetic NASHSerum AST reduced vs placebo over 96 weeks (P<0.001; effect size not reported)RCTSanyal AJ, et al. N Engl J Med. 2010;362:1675-1685.
nutraceuticalOral berberine supplementation in adults with metabolic disorders (12 RCTs)No significant effect on AST: -0.87 U/L (95% CI -2.56 to 0.82)meta-analysisAsbaghi O, et al. Clinical nutrition ESPEN. 2020. The effect of berberine…
pharmacologicCotadutide 600 ug daily for 19 weeks in biopsy-proven noncirrhotic MASH with fibrosis (PROXYMO phase 2)Lowers AST by 16.8 U/L (95% CI -33.0 to -0.8) vs placebo at 19 weeksRCTShankar SS, et al. Clinical gastroenterology and hepatology : the official…
supplementOral vitamin E 298-1000 IU/day for 2-24 months in people with NAFLD, vs placebo or no intervention (Cochrane review, 11 trials)Lowers AST by 4.90 U/L (95% CI -7.24 to -2.57) vs placebo/no intervention (moderate certainty)meta-analysisWen H, et al. The Cochrane database of systematic reviews. 2024. Vitamin E for…

Things that worsen it

Each row is one study: what was changed, the effect it reported on this marker, and the source.
TypeCondition or exposureReported effectEvidenceSource
clinicalIschemic/hypoxic hepatitis ('shock liver') from cardiac, circulatory or respiratory failureHypoxic hepatitis causes a sudden AST rise, defined as peak AST > 5 times ULN; subsets exceed 20× ULN (1116 ICU patients)cohortVan den Broecke A, et al. Epidemiology, causes, evolution and outcome in a…
physiologicalSevere unaccustomed muscular exercise (weightlifting)1 h weightlifting significantly increased AST (with CK, myoglobin) for at least 7 days in 15 healthy men (effect size not reported)non-randomised trialPettersson J, et al. Br J Clin Pharmacol. 2008;65:253-259.

What else moves this marker

They describe those study groups, not an individual, and an association is not a cause.

Diseases and conditions

Each row is one study: what it compared and the change it reported in this marker.
WhatEffect on the markerComparison · populationSource
↑ Progression to severe dengue · AST in the first 4 days of fever, progressors vs non-progressorsSMD +1.06 (95% CI 0.54 to 1.57)patients progressing to severe dengue vs those who did not · Dengue patients (children and adults), 122 studies in the meta-analysesmeta analysis · PMID 33640077

Genetic predisposition

Each row is one study: what it compared and the change it reported in this marker.
WhatEffect on the markerComparison · populationSource
↑ rs661899 near MGAT5/TMEM163 (2q21.3) · TT vs CC genotype in UDCA-treated primary biliary cholangitis+25 U/LTT genotype (53.5 U/L) vs CC genotype (28.5 U/L) · 347 Chinese patients with primary biliary cholangitis treated with ursodeoxycholic acid for >=1 yearcross sectional · PMID 37845416

Sources

Map Aspartate Aminotransferase (AST) against another biomarker.

Related markers: Alanine Aminotransferase (ALT) · Albumin:Globulin Ratio (A/G) · Alkaline Phosphatase (ALP) · De Ritis Ratio (AST/ALT) · FIB-4 Index (NAFLD Fibrosis Score) · Gamma-Glutamyl Transferase (GGT) · Serum Albumin · Serum Total Bilirubin

Map AST against another marker