What are the causes and risks of elevated aspartate aminotransferase (AST)?

Under normal circumstances, aspartate aminotransferase (AST) is primarily distributed in tissues such as the myocardium, liver, skeletal muscle, and kidneys. It plays multiple important roles in the human body, including catalyzing the production of pyruvate, participating in energy metabolism, promoting protein synthesis, regulating hepatocyte injury, and maintaining liver function. Elevated AST levels may result from intense physical exercise, chronic sleep deprivation, excessive alcohol consumption, hepatitis, or fatty liver disease, and could lead to various health risks such as fatigue, impaired digestive function, jaundice, progression to liver cirrhosis, and portal hypertension. If discomfort symptoms occur, prompt medical consultation is recommended. Specific analyses are as follows:

1. Intense Physical Exercise

During intense exercise, increased cell membrane permeability allows AST to leak from muscle cells into the bloodstream, causing elevated AST levels. After exercise, adequate rest and appropriate intake of protein and vitamins are necessary to support muscle recovery.

2. Chronic Sleep Deprivation

Prolonged lack of sleep disrupts normal sleep cycles, preventing the body from sufficient rest and impairing the liver’s metabolic and repair functions, which may elevate AST levels. It is important to maintain 7–8 hours of sleep daily and avoid staying up late or overexertion.

3. Excessive Alcohol Consumption

Harmful substances produced during alcohol metabolism can damage liver cells, leading to the release of AST from the liver into the bloodstream and resulting in elevated levels. Alcohol intake should be reduced in daily life, and excessive drinking should be avoided.

4. Hepatitis

Hepatitis may be caused by factors such as excessive alcohol consumption, drug-induced injury, or immune system abnormalities. Inflammation and damage to liver cells cause AST to be released into the circulation, increasing its blood levels. Symptoms may include abdominal distension and jaundice. Under medical guidance, medications such as entecavir dispersible tablets, polyene phosphatidylcholine capsules, and ursodeoxycholic acid tablets may be used for treatment.

5. Fatty Liver Disease

Fatty liver disease is commonly associated with poor diet, obesity, and lack of physical activity. Fat accumulation within liver cells can lead to metabolic disturbances, inflammation, and oxidative stress, resulting in elevated AST levels. It is often accompanied by symptoms such as abdominal pain and weight gain. Treatment may include medications such as simvastatin tablets, bicyclol tablets, and orlistat capsules, as prescribed by a physician.

A balanced diet rich in vitamins and minerals—such as fresh vegetables, fruits, and whole grains—is recommended in daily life.

II. Potential Risks

1. Fatigue

When liver function is impaired, overall metabolism and energy supply may be affected, leading to symptoms such as fatigue and tiredness. Work and rest schedules should be reasonably arranged to avoid excessive strain.

2. Digestive Dysfunction

Elevated AST levels may reduce bile secretion, thereby impairing digestion and causing symptoms such as decreased appetite and nausea. A balanced diet with sufficient intake of vitamin- and mineral-rich foods is essential.

3. Jaundice

Elevated AST levels may increase serum bilirubin concentration, leading to jaundice. Medications such as Yinzhihuang granules, Qinggan Lidan oral solution, and Hugan tablets may be used under medical advice.

4. Promotion of Liver Cirrhosis

Elevated AST is one indicator of liver damage. Without timely treatment, persistent hepatocyte injury may progress to liver cirrhosis. Medications such as diammonium glycyrrhizinate injection, Anluo Huaxian pills, and Hugan tablets may be used under medical supervision.

5. Portal Hypertension

Persistent elevation of AST and ongoing liver dysfunction may lead to portal hypertension, increasing the risk of serious complications such as gastrointestinal bleeding, varices, and shock. Medications such as nifedipine tablets, furosemide tablets, and spironolactone tablets may be used as directed by a physician.

Regular liver function tests are recommended to monitor changes in AST and other indicators. Any abnormalities should be promptly evaluated by a healthcare provider, and treatment should be administered according to medical advice.