Which enzyme is most consistently elevated in cases of alcoholic liver disease?

In the context of alcoholic liver disease, aspartate aminotransferase (AST) is the enzyme that is most consistently elevated. When alcohol affects the liver, it leads to hepatocellular damage, which results in the release of various enzymes into the bloodstream. AST is particularly notable for its elevation in alcoholic liver disease due to the toxicity of alcohol on liver cells, leading to their breakdown.

Typically, in alcoholic liver disease, the AST level is observed to be higher than that of alanine aminotransferase (ALT), a phenomenon referred to as the AST/ALT ratio, which tends to be greater than 2:1 in chronic alcohol abuse. This differential elevation is due to the different pathways through which these enzymes function and their responses to liver cell injury associated with alcohol.

The other enzymes mentioned also have relevance in liver function tests but do not show the same consistent elevation specifically tied to alcoholic liver disease. Gamma-glutamyl transferase (GGT) can be elevated in many liver disorders and is sensitive to alcohol use but is not as specific as AST. Alkaline phosphatase (ALP) is mainly linked to cholestatic liver conditions and does not specifically reflect hepatocellular damage from alcohol. Thus, AST is