AST/ALT Ratio (De Ritis Ratio) Calculator

Calculate the AST/ALT ratio (De Ritis ratio) to aid liver disease differentiation.

Aug 31, 2026 Clinical Chemistry #ast-alt-ratio #de-ritis #liver #transaminases

Calculate

All fields required unless noted

AST (U/L)

ALT (U/L)

Calculating...

Enter your values and press Calculate to see the result.

Formula & Clinical Notes

Formula

AST/ALT Ratio = AST ÷ ALT

Clinical Notes

The De Ritis ratio is AST/ALT. A ratio > 2.0 is classically associated with alcoholic liver disease; a ratio of 1.0–2.0 is seen in cirrhosis and NASH; a ratio < 1.0 is typical of acute viral hepatitis and acute hepatocellular injury. A falsely high ratio can occur with macro-AST, haemolysis, or muscle injury.

Sources

De Ritis et al. (1957) — An enzymatic test in differential diagnosis of jaundice