Evaluation of De Ritis Ratio, GGT, and hs-CRP as Biomarkers in Alcohol Dependence: A Case-Control Study

Background: Alcoholic liver disease is characterized by elevated levels of liver enzymes and inflammatory markers. The aspartate transaminase (AST) to alanine transaminase (ALT) ratio, known as the De RiƟs ratio, is altered in alcoholic liver disease. This study aimed to evaluate and compare the AST/ALT ratio and gamma-glutamyl transferase (GGT), and high-sensitivity C-reactive protein (hs-CRP) in individuals with alcohol dependence versus non-alcoholic controls. Methods: This case-control study was conducted at a tertiary care center in Aurangabad, Maharashtra, India. Sixty adult males aged 18 years and above with alcohol dependence, diagnosed per DSM-V criteria, were enrolled as cases from the medicine ward or outpatient department. Sixty socioeconomic status-matched non-alcoholic males served as controls. Serum levels of AST, ALT, GGT, and hsCRP were measured, and the AST/ALT raƟo was calculated. Parameters were compared between groups using unpaired t-tests. Results: The mean AST was 206.81 ± 85.07 U/L in cases and 25.81 ± 8.31 U/L in controls. The mean ALT was 93.25 ± 39.17 U/L in cases and 30.82 ± 8.21 U/L in controls. The mean AST/ALT ratio was 2.18 ± 0.43 in cases and 1.27 ± 0.51 in controls. The mean GGT was 90.8 ± 24.8 U/L in cases and 30.8 ± 8.2 U/L in controls. The mean hsCRP was 3.08 ± 1.1 mg/dL in cases and 0.15 ± 0.1 mg/dL in controls. All parameters were significantly higher in the alcoholic group compared to the control group (p < 0.05). Conclusions: The De Ritis ratio, serum AST, ALT, GGT, and hs-CRP are significantly elevated in individuals with alcohol dependence compared to non-alcoholic controls, suggesting their utility as markers of alcoholic liver disease. KEYWORDS: De Ritis ratio, Liver enzymes, Alcoholic liver disease, Gamma-glutamyl transferase, High-sensitivity C-reactive protein, Alcohol dependence