What exactly is a normal value for alanine aminostransferase? That question is at the heart of a new guideline on the evaluation of abnormal liver chemistries issued by the American College of Gastroenterology (Am J Gastroenterol 2017;112:18-35).
The guideline includes a new definition of normal ALT: a range of 19 to 25 IU/L for women and 29 to 33 IU/L for men. These values capture 95% of the healthy population.
If the new definition is implemented widely, clinicians should detect more patients with undiagnosed chronic hepatitis and hepatitis C; non-alcoholic fatty liver disease; advanced liver disease; and less common liver ailments, including hemochromatosis and alpha1-antitrypsin deficiency. Early identification of these patients could prevent development of advanced fibrosis and death.