Can Fatty Liver Cause Elevated Transaminase Levels?

Fatty liver disease can indeed lead to elevated transaminase levels in many cases. However, it's important to note that not all individuals with fatty liver will experience abnormal liver enzymes. In most cases of mild to moderate fatty liver disease, transaminase levels remain within the normal range. On the other hand, severe fatty liver may cause more noticeable changes in liver enzyme levels.

There are two primary types of fatty liver disease—non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD). In non-alcoholic fatty liver disease, liver function tests may show normal or slightly elevated levels of serum transaminases and gamma-glutamyl transferase (GGT). Among these, alanine aminotransferase (ALT), also known as glutamic-pyruvic transaminase (GPT), tends to be the enzyme most frequently elevated.

In alcoholic fatty liver disease, there is often a characteristic pattern in enzyme levels. Both ALT and aspartate aminotransferase (AST), or glutamic-oxaloacetic transaminase (GOT), may be mildly elevated, with AST levels rising more prominently than ALT. This often results in an AST-to-ALT ratio greater than 2. However, these enzyme levels rarely exceed 500 U/L. If they do, it may indicate the presence of another underlying liver condition or additional liver damage.

Gamma-glutamyl transferase (GGT) is also commonly elevated in cases of alcoholic fatty liver disease. For individuals with simple fatty liver disease, early intervention and lifestyle changes can lead to full recovery. Even in cases of fatty liver inflammation, timely diagnosis and treatment can often reverse the condition.

If left untreated, however, some forms of fatty liver disease can progress to more severe conditions such as cirrhosis. The prognosis for cirrhosis caused by fatty liver disease is similar to that of cirrhosis resulting from viral hepatitis. For those with alcoholic fatty liver disease, the outlook is generally positive if alcohol consumption is stopped completely. In many cases, liver function can improve significantly after abstinence from alcohol and with appropriate medical care.