A 2024 guideline from the US-based American College of Gastroenterology uses the ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) only as one part of an alcohol-associated hepatitis assessment. Raw values, symptoms, exposure history and other tests determine follow-up.
The European Food Safety Authority sets a reference intake of 0.83 grams of protein per kilogram of body weight a day for adults. Athletes, some older people and those with chronic kidney disease need different evidence and, in some cases, clinical guidance.
European guidance sets adult adequate intakes for total water at 2.0 liters a day for women and 2.5 liters for men. Those figures include food moisture and all beverages, while heat, exercise, pregnancy, illness and fluid restrictions change the calculation.
A 2026 analysis of three cohorts found that lean adults with MASLD had higher relative rates of liver-related events and death than non-lean patients. Normal liver enzyme results cannot rule out fibrosis, while treatment goals differ according to weight, fibrosis and other metabolic risks.
KDIGO's 2024 guideline defines chronic kidney disease by abnormalities that persist for at least three months, not by one eGFR result. The estimate needs to be read with urine albumin, prior results and factors that can distort creatinine-based calculations.
Current clinical guidance treats ALT and AST as markers of liver-cell injury, not a complete measure of liver function. Results must be read against the laboratory range, symptoms, medical history and other tests because serious liver disease can occur with normal enzyme levels.
