Abstract

1Dr. P Sai Koushik, 1Dr Shreyansh patil, 2Dr. Karnish Thakker,

ABSTRACT

Introduction: Alcoholic Liver Disease (ALD) is a leading cause of global morbidity and mortality, progressing from steatosis to cirrhosis. Early diagnosis is critical to mitigate irreversible damage. This study evaluates Gamma-glutamyl transferase (GGT) and the AST/ALT ratio (De Ritis ratio) as early biomarkers for ALD, correlating their levels with alcohol consumption duration and ultrasonographic findings. Material & Methods: This 18-month cross-sectional study at Dhiraj Hospital, Vadodara, included 60 ALD patients (18–60 years, >2 years of alcoholism) and 60 controls, excluding comorbidities. Biochemical markers (GGT, AST/ALT, bilirubin, etc.) and imaging were analyzed using SPSS v25, with ethical compliance. Statistical tests (t-tests, ROC analysis) evaluated diagnostic utility. Results: A significantly elevated GGT (180 ± 50 U/L vs. 60 ± 20 U/L, *p* = 0.0045) and AST/ALT ratios (1.2 ± 0.4 vs. 1.0 ± 0.3, *p* = 0.02) in ALD patients were seen. GGT showed strong correlation with alcoholism duration (*r* = 0.68, *p* = 0.001), while AST/ALT ratios were less duration-dependent but highly specific for advanced ALD. ROC analysis demonstrated superior diagnostic accuracy for combined markers (AUC = 0.95) versus individual tests (GGT AUC = 0.92; AST/ALT AUC = 0.78). At a threshold of >100 U/L, GGT achieved 85% sensitivity and 90% specificity, whereas an AST/ALT ratio >1.0 had 75% sensitivity and 80% specificity. Clinical and biochemical findings (jaundice, hepatomegaly, hypoalbuminemia) aligned with biomarker elevations, reinforcing their utility. Subgroup analysis highlighted higher GGT/AST in patients with >10 years of alcohol use (*p* < 0.05), underscoring cumulative hepatotoxicity. Conclusion: GGT and AST/ALT ratios are robust, accessible biomarkers for early ALD detection, with combined use enhancing diagnostic precision. Integration into screening protocols could facilitate timely intervention, particularly in resource-limited settings.