Does AST/ALT more than 1 mean liver disease or cirrhosis?

Hello doctor,

Three years ago, I was diagnosed with non-alcoholic fatty liver, and at that time, my liver enzymes were 3 to 4 times the upper ranges. I then lost weight, and with time, my enzymes got normalized. However, in the last test, I have noticed a pattern where AST is greater than ALT, though they are in the normal range. AST is always greater than ALT by a few points, and in the last test, this increased more, though the enzymes are normal. I have read that AST/ALT>1 is a sign of advanced liver disease or cirrhosis. Is this valid when the enzymes are in the normal range also? It is in the last three years that my platelet count has always changed in the 128 to 180 range.

Kindly guide.

Thank you doctor,

I would not worry about platelet count, as the platelet count was always in range at all tests over three years. I think it is my normal count. Hepatitis B and C are negative. So far, I have had three ultrasounds and one CT scan; two ultrasounds (one with Doppler) were totally normal. In the last one, the report said hepatofugal flow in the hepatic veins, with flattening of the flow curve and loss of systolic flow reversal and triphasic aspect of the flow curve in the hepatic vein, pointing to increased liver stiffness. The decision was increased slightly from what is seen in steatosis, and the Doppler flow findings were compatible with increased liver stiffness. My main question was whether the ratio of AST/ALT is important when the enzymes are in the normal range. I was worrying about this.