What could be the reason for high AST and ALT levels for the past five years?

Hi doctor,

I have reported high ALT and AST levels for the past five years. I have a normal weight and attached my blood tests and liver ultrasound reports. My doctor says that the levels are not getting down and recommended to consult with a liver specialist. Three months ago, my ALT was 108 and my AST was 63; but last month, my ALT was 93, and my AST was 56. My GGT 31 X-Enhanced Liver Fibrosis (ELF) score was 9.01 and the abdominal ultrasound depicted elevated liver enzymes with no surgical history. When technique transabdominal ultrasound was performed, then the liver was normal in size and measures 141 mm. It demonstrates a smooth border and appears slightly echogenic, with no evidence of intrahepatic ductal dilatation. Hepatic veins were patent. The main portal vein shows normal hepatopetal flow. The gallbladder shows normal morphology with no stones. The gallbladder wall is not thickened and measures 1.6 mm. The sonographic Murphy sign is negative. The common bile duct measures 2.4 mm anteroposteriorly, which is normal. The pancreas appears to be normal in size and echotexture. The right kidney demonstrates normal morphology and cortical echogenicity, with no evidence of stones, masses, or hydronephrosis. The right kidney measures 90 x 43 x 43 mm. The cortex measures 11 mm. No free fluid is seen. There is fatty infiltration of the liver parenchyma. I have presented my reports from the past five years. Please tell me what my reports depict.

Thank you.

Hi doctor,

Thank you doctor for answering. My current weight is 157 Ib and I am 5 feet 11 inches. I do have a pot belly but the rest of my body is in normal shape. I also want to mention that in the past five years, I have lost muscle mass in my glutes and side hips, and back muscles. I cannot climb stairs or run but I can walk for miles easily with no problem. I have undergone a spine MRI but have reported nothing but my surgeon advised me to work on building up core muscles. I wonder if this is related. Also, I am diabetic for the last four years and have thyroid issues. I take 2000 mg of Metformin with 100 mg of Levothyroxine and take 10 mg of Atorvastatin for cholesterol. I also want to ask do I have to go for other tests, and should I get them? Please tell me what are the other test I have to do.

Thank you.

Thank you for the reply doctor,

I am a man. Does gender make a difference? I am not taking any protein supplements, and I have also found a previous year's ANA test report. Is that okay? Kindly suggest.

Thank you doctor for the prompt reply.