What are the causes of elevated aspartate aminotransferase?

Generally, elevated aspartate aminotransferase (AST) levels may be caused by excessive alcohol consumption, a high-fat diet, alcoholic hepatitis, drug-induced liver injury, or biliary obstruction. Depending on the specific situation, improvements can be achieved through lifestyle adjustments, medication, or surgical treatment. A detailed analysis is as follows:

1. Excessive Alcohol Consumption

Alcohol is primarily metabolized in the liver, and its metabolite acetaldehyde damages liver cells, leading to the release of enzymes into the bloodstream. Immediately stop drinking alcohol, drink plenty of warm water to promote metabolism, and consume a light diet consisting mainly of porridge and vegetables to reduce the burden on the liver.

2. High-Fat Diet

A long-term high-fat diet causes fat accumulation in liver cells, impairing their function and resulting in enzyme leakage. Adjust dietary habits by reducing intake of fried foods, increasing consumption of fruits and vegetables such as celery and apples, and engaging in a daily 30-minute brisk walk.

3. Alcoholic Hepatitis

Chronic alcohol use triggers liver inflammation, causing liver cell degeneration and necrosis, which leads to a significant release of enzymes. Complete abstinence from alcohol is essential. Under medical guidance, medications such as metadoxine capsules, silibinin glucuronate tablets, or polyene phosphatidylcholine capsules may be taken, with regular follow-up liver function tests.

4. Drug-Induced Liver Injury

Long-term use of hepatotoxic drugs directly damages liver cell structures, resulting in elevated enzyme levels. Discontinue any suspected medication immediately. Follow a doctor’s advice when taking medications such as diammonium glycyrrhizinate enteric-coated capsules, reduced glutathione tablets, or tiopronin enteric-coated tablets, and always consult a physician before starting treatment.

5. Biliary Obstruction

Bile duct blockage due to stones or tumors causes bile stasis and reflux into the liver, damaging liver cells. Under medical supervision, medications such as ursodeoxycholic acid capsules, anti-inflammatory and cholagogue tablets, or cefaclor sustained-release tablets may be used. In severe cases, procedures like endoscopic stone removal or cholangiojejunostomy may be required.

Liver health requires daily care—maintain a balanced diet and regular作息 (routine), avoid excessive drinking, and refrain from indiscriminate medication use. If liver enzyme levels remain abnormal, seek prompt medical evaluation to identify the underlying cause and follow professional recommendations for proper management and treatment to protect liver health.