{"id":13824,"date":"2026-10-29T06:00:00","date_gmt":"2026-10-29T06:00:00","guid":{"rendered":"https:\/\/bioprofile.com\/?page_id=13824"},"modified":"2026-11-05T09:38:41","modified_gmt":"2026-11-05T09:38:41","slug":"de-ritis-ratio","status":"publish","type":"page","link":"https:\/\/bioprofile.com\/en\/biomarkers\/de-ritis-ratio\/","title":{"rendered":"De Ritis ratio"},"content":{"rendered":"\n<div id=\"content\" tabindex=\"-1\"><\/div>\n<style>@import url('https:\/\/fonts.googleapis.com\/css2?family=Poppins:ital,wght@0,400;0,600;0,700;0,800;1,400&display=swap');\n\/* ===========================================================================\n   BioProfile advertorial, the design Jesse approved on 2026-07-30, expressed\n   as a WordPress design system.\n\n   THE @import IS LOAD BEARING and must stay the first thing in this sheet (a\n   CSS @import after any rule is dropped by the parser). elementor_canvas does\n   not enqueue the theme's fonts, so without it the whole page falls back to the\n   system font. Caught by LOOKING at the live page on 2026-07-30, right after\n   the template was switched to canvas.\n\n   Everything is scoped to `.bp-adv`, so nothing here can reach the rest of\n   bioprofile.com, and core blocks are styled BY ELEMENT so a heading, a\n   paragraph, a quote, a list, an image or a button inserted by hand inside the\n   advertorial comes out on-design with no class to remember.\n\n   Jesse's design feedback, 2026-07-29 23:38, point by point:\n   1. the light green and the dark green are the preferred colours; grey may be\n      used but the page must NOT open grey;\n   2. more colour and variation across sections, e.g. a colour block on the left\n      or the right side of a section, without overdesign;\n   3. ONE H1, plain text on white; everything else H2 or H3; an H2 may carry its\n      own background colour so the page can be read from the headings alone; an\n      H3 keeps its section background and gets a bigger font size;\n   4. reuse the results page design feel;\n   5. Written by \/ Verified by, the placeholder blocks and noindex stay.\n\n   COLOUR PROVENANCE. Not one hex is invented.\n   - #b7cb32  LIGHT GREEN, brand manual \"colours rejuvenation protocol\"\n              (R183 G203 B51). Same value as --bp-lime in\n              brands\/bioprofile\/brand\/tokens.md.\n   - #006b62  DARK GREEN, brand manual, nourish the cells (R0 G107 B98).\n   - #005859  brand manual primary teal, the value the brand is built on.\n   - #228a62  brand manual, challenge the body (R34 G138 B98).\n   - #7ca64c  brand manual, calm the mind (R124 G166 B76).\n   - #dbd4cd  brand manual \"additional color\", the warm neutral.\n   - #B7CB3329 is the brand token --bp-lime-soft (light green at 16 percent).\n   - the gradients are the brand token layer's own, copied verbatim.\n\n   SPECIFICITY NOTE. Elementor's global kit emits `.elementor-kit-6 h2` style\n   rules at (0,1,1). Element rules below are written `.bp-adv h2`, also (0,1,1),\n   and win on source order because this sheet is inline in the body while the\n   kit is a <link> in the head. Component rules that MUST NOT lose carry two\n   classes, e.g. `.bp-adv .wp-block-button__link`.\n\n   LAYOUT NOTE. Vertical rhythm uses `margin-block` and never the `margin`\n   shorthand, so the measure rule `.bp-adv-sec > * { margin-inline: auto }` can\n   centre a block without being outranked by its own element rule.\n   =========================================================================== *\/\n\n.bp-adv {\n  --bp-ink: #212527;\n  --bp-teal: #005859;\n  --bp-forest: #006B62;\n  --bp-emerald: #228A62;\n  --bp-olive: #7CA64C;\n  --bp-lime: #B7CB33;\n  --bp-lime-soft: #B7CB3329;\n  --bp-sand: #DBD4CB;\n  --bp-white: #FFFFFF;\n  --bp-foot: #6b6b6b;\n  --bp-grad-dark: linear-gradient(237deg, rgba(0,88,89,0.00) 62.94%, #005859 100%), linear-gradient(90deg, rgba(34,138,98,0.00) 40%, #228A62 100%), #006B62;\n  --bp-grad-lime: linear-gradient(110deg, rgba(183,203,51,0.00) 36.06%, rgba(183,203,51,0.25) 97.65%), #FFFFFF;\n  --bp-font: 'Poppins','Segoe UI',Arial,sans-serif;\n  --bp-fs-h1: 44px; --bp-fs-h2: 31px; --bp-fs-h3: 24px; --bp-fs-pre: 15px;\n  --bp-fs-body: 17px; --bp-fs-small: 14px; --bp-fs-foot: 13px; --bp-fs-btn: 17px;\n  --bp-lh-body: 1.75;\n  --bp-s-1: 4px; --bp-s-2: 8px; --bp-s-3: 12px; --bp-s-4: 16px;\n  --bp-s-5: 24px; --bp-s-6: 32px; --bp-s-7: 44px; --bp-s-8: 72px;\n  --bp-measure: 760px; --bp-side: 40px;\n  --bp-radius-photo: 16px; --bp-radius-btn: 10px; --bp-radius-card: 20px;\n  --bp-shadow: 0 10px 30px rgba(0,88,89,0.10);\n  font-family: var(--bp-font);\n  font-size: var(--bp-fs-body);\n  line-height: var(--bp-lh-body);\n  color: var(--bp-ink);\n  background: var(--bp-white);\n  -webkit-font-smoothing: antialiased;\n}\n.bp-adv, .bp-adv * { box-sizing: border-box; }\n.bp-adv p, .bp-adv li, .bp-adv h1, .bp-adv h2, .bp-adv h3, .bp-adv blockquote,\n.bp-adv a, .bp-adv cite, .bp-adv span { overflow-wrap: break-word; min-width: 0; }\n\n\/* THE TOGGLE. One word in the block's own \"Additional CSS class(es)\" field\n   hides an optional component on the front end without deleting anything. *\/\n.bp-adv .bp-off { display: none !important; }\n\n\/* the page opens on green, never on grey (his point 1) *\/\n.bp-adv .bp-adv-rule {\n  height: 6px; border: 0; margin-block: 0; max-width: none;\n  background: linear-gradient(90deg, #005859 0%, #006B62 38%, #228A62 66%, #B7CB33 100%);\n}\n\n\/* --- section surfaces ------------------------------------------------------ *\/\n.bp-adv-sec { position: relative; background: var(--bp-white);\n  padding: var(--bp-s-8) var(--bp-side); margin-block: 0; }\n\/* the measure: every direct child of a section is the 760px text column *\/\n.bp-adv-sec > * { max-width: var(--bp-measure); margin-inline: auto; }\n.bp-adv-sec > *:last-child { margin-block-end: 0; }\n.bp-adv-sec--wash  { background: linear-gradient(180deg, #B7CB331F 0%, #B7CB3312 100%), #FFFFFF; }\n.bp-adv-sec--dark  { background: var(--bp-grad-dark); color: var(--bp-white); }\n.bp-adv-sec--dark p, .bp-adv-sec--dark cite, .bp-adv-sec--dark li { color: var(--bp-white); }\n.bp-adv-sec--offer { background: var(--bp-grad-lime); text-align: center; }\n.bp-adv-sec--hero  { padding-block-start: var(--bp-s-6); }\n.bp-adv-sec--disclosure { padding-block: var(--bp-s-6);\n  border-top: 1px solid var(--bp-sand); }\n\n\/* --- the side accent bar, his own example (\"a colour block on the left or the\n       right side of a section\"), design rev 3: a slim vertical bar hugging the\n       text column rather than a wide margin panel. Below 1100px the margin is\n       gone, so it becomes a slim top edge. ---------------------------------- *\/\n.bp-adv-rail { overflow: hidden; }\n.bp-adv-rail::before {\n  content: \"\"; position: absolute; top: var(--bp-s-7); bottom: var(--bp-s-7);\n  width: 6px; border-radius: 3px;\n  background: linear-gradient(180deg, var(--bp-forest) 0%, var(--bp-lime) 100%);\n}\n.bp-adv-rail--left::before  { left: calc((100% - var(--bp-measure)) \/ 2 - 34px); }\n.bp-adv-rail--right::before { right: calc((100% - var(--bp-measure)) \/ 2 - 34px); }\n@media (max-width: 1099px) {\n  .bp-adv-rail::before { left: 0; right: 0; width: auto; bottom: auto; top: 0;\n    height: 4px; border-radius: 0; background: var(--bp-lime); }\n}\n\n\/* --- CORE BLOCKS, styled by element. This is the part that makes an inserted\n       block come out on-design with no class. --------------------------------- *\/\n.bp-adv p { font-size: var(--bp-fs-body); line-height: var(--bp-lh-body);\n  margin-block: 0 var(--bp-s-5); }\n.bp-adv h1 { font-size: var(--bp-fs-h1); font-weight: 700; line-height: 1.22;\n  margin-block: 0 var(--bp-s-4); }\n\/* an H2 is its own colour band, so the page can be read from the headings\n   alone (his point 3). Dark green on light sections, light green on the dark\n   one, so a heading always wins against its own background. *\/\n.bp-adv h2 {\n  font-size: var(--bp-fs-h2); font-weight: 700; line-height: 1.28;\n  margin-block: 0 var(--bp-s-5);\n  background: var(--bp-grad-dark); color: var(--bp-white);\n  padding: var(--bp-s-4) var(--bp-s-5);\n  border-radius: var(--bp-radius-btn);\n  border-left: 6px solid var(--bp-lime);\n}\n.bp-adv-sec--dark h2 { background: var(--bp-lime); color: var(--bp-ink);\n  border-left-color: var(--bp-forest); }\n\/* H3: same background as its section, bigger font (his point 3, verbatim) *\/\n.bp-adv h3 { font-size: var(--bp-fs-h3); font-weight: 700; line-height: 1.35;\n  color: var(--bp-forest); background: transparent; margin-block: 0 var(--bp-s-3); }\n.bp-adv-sec--dark h3 { color: var(--bp-lime); }\n.bp-adv ul, .bp-adv ol { font-size: var(--bp-fs-body); line-height: var(--bp-lh-body);\n  margin-block: 0 var(--bp-s-5); padding-left: var(--bp-s-5); }\n.bp-adv li { margin-block-end: var(--bp-s-2); }\n.bp-adv a { color: var(--bp-teal); text-decoration: underline; }\n.bp-adv a:hover { color: var(--bp-olive); }\n.bp-adv-sec--dark a, .bp-adv-sec--dark strong { color: var(--bp-lime); }\n.bp-adv strong { font-weight: 700; }\n\/* the highlight pill. Colours ride on the inline style core writes, so only\n   the shape lives here and any <mark> in the article picks it up. *\/\n.bp-adv mark {\n  padding: 0 10px; border-radius: 10px; display: inline;\n  -webkit-box-decoration-break: clone; box-decoration-break: clone;\n}\n\/* figures match the approved page exactly: card radius plus the soft shadow,\n   and a left-aligned caption rather than core's centred one *\/\n.bp-adv .wp-block-image { margin-block: var(--bp-s-5); margin-inline: auto; }\n.bp-adv .wp-block-image img { display: block; width: 100%; height: auto;\n  border-radius: var(--bp-radius-card); box-shadow: var(--bp-shadow); }\n.bp-adv .wp-block-image figcaption { font-size: var(--bp-fs-foot); line-height: 1.55;\n  color: var(--bp-foot); text-align: left; margin-block: var(--bp-s-2) 0; }\n.bp-adv .wp-block-embed, .bp-adv .wp-block-video { margin-block: var(--bp-s-5); }\n.bp-adv .wp-block-embed iframe, .bp-adv .wp-block-video video {\n  width: 100%; border-radius: var(--bp-radius-photo); }\n.bp-adv .wp-block-separator:not(.bp-adv-rule) { border: 0; border-top: 1px solid var(--bp-sand);\n  margin-block: var(--bp-s-5); }\n\n\/* quotes: core pullquote and core quote both land on the lime rule. The\n   font-size reset undoes core's own 1.5em on the figure, which would otherwise\n   leak into anything inside the quote that has no size of its own. *\/\n\/* margin-inline is load bearing, and it must be `auto` rather than `0`.\n   `blockquote` and `figure` carry a 40px side margin in the browser's own\n   default stylesheet, which indents the quote inside its rule and makes the\n   copy wrap early on a phone. But these blocks are direct children of a\n   section, so zeroing the side margin also defeats the measure rule\n   `.bp-adv-sec > * { margin-inline: auto }` and pins them to the left edge. *\/\n.bp-adv .wp-block-pullquote, .bp-adv .wp-block-quote {\n  border: 0; border-left: 5px solid var(--bp-lime); background: transparent;\n  padding: var(--bp-s-2) 0 var(--bp-s-2) var(--bp-s-5);\n  margin-block: var(--bp-s-5); margin-inline: auto;\n  text-align: left; font-size: var(--bp-fs-body);\n}\n.bp-adv .wp-block-pullquote blockquote { border: 0; margin: 0; padding: 0; }\n.bp-adv .wp-block-pullquote p, .bp-adv .wp-block-quote p {\n  font-size: 24px; line-height: 1.45; font-weight: 600;\n  margin-block: 0 var(--bp-s-2); color: var(--bp-forest); }\n.bp-adv .wp-block-pullquote cite, .bp-adv .wp-block-quote cite {\n  display: block; margin: 0; font-size: var(--bp-fs-small); color: var(--bp-foot);\n  font-style: normal; text-transform: none; }\n\n\/* buttons: two classes so core's own .wp-block-button__link cannot win *\/\n.bp-adv .wp-block-buttons { display: flex; justify-content: center;\n  margin-block: 0 var(--bp-s-4); }\n.bp-adv .wp-block-button__link {\n  display: inline-flex; align-items: center; justify-content: center; min-height: 48px;\n  background: var(--bp-teal); color: var(--bp-white); font-size: var(--bp-fs-btn);\n  font-weight: 700; line-height: 1.2; border-radius: var(--bp-radius-btn);\n  padding: 15px 44px; text-decoration: none; transition: background 250ms ease;\n  box-shadow: var(--bp-shadow);\n}\n.bp-adv .wp-block-button__link:hover { background: var(--bp-olive); color: var(--bp-white); }\n\n\/* --- slot 1: pre-headline, headline, sub-headline (Jesse's headline skill) --- *\/\n.bp-adv .bp-adv-preheadline {\n  color: var(--bp-forest); font-size: var(--bp-fs-pre); font-weight: 600; line-height: 1.5;\n  border-left: 4px solid var(--bp-lime); padding-left: var(--bp-s-3);\n  margin-block: 0 var(--bp-s-4);\n}\n.bp-adv .bp-adv-subheadline { font-size: 21px; line-height: 1.5; font-weight: 600;\n  color: var(--bp-forest); margin-block: 0 var(--bp-s-5); }\n.bp-adv .bp-adv-standfirst { font-size: 19px; line-height: 1.65;\n  margin-block: 0 var(--bp-s-5); }\n.bp-adv .bp-adv-lede { font-size: 18px; line-height: 1.7;\n  margin-block: 0 var(--bp-s-5); }\n.bp-adv .bp-adv-byline { font-size: var(--bp-fs-small); color: var(--bp-foot);\n  line-height: 1.6; margin-block: 0 var(--bp-s-5); }\n.bp-adv .bp-adv-socialproof { font-size: var(--bp-fs-small); color: var(--bp-foot);\n  margin-block: 0 var(--bp-s-5); }\n\/* the offer headline above the CTA. Jesse asked for a second H1 here; the brand\n   doc's accessibility rule is one h1 per page, so it is rendered at H1 size and\n   stays an h2 element. Named in the close as the one design conflict. *\/\n.bp-adv h2.bp-adv-offerhead {\n  font-size: var(--bp-fs-h1); font-weight: 700; line-height: 1.22;\n  margin-block: 0 var(--bp-s-4); text-align: center; color: var(--bp-ink);\n  background: none; padding: 0; border: 0; border-radius: 0;\n}\n\n\/* --- Written by + Verified by. The avatar is the first child and spans the\n       three text rows, so the whole box is four ordinary paragraphs and stays\n       editable without nested columns. ---------------------------------------- *\/\n.bp-adv .bp-adv-authors {\n  background: var(--bp-white); border: 1px solid var(--bp-sand);\n  border-top: 4px solid var(--bp-lime); border-radius: var(--bp-radius-card);\n  box-shadow: var(--bp-shadow); padding: var(--bp-s-5);\n  margin-block: 0 var(--bp-s-4);\n  \/* auto-fit, so switching the verified box off leaves one full-width author\n     rather than a half-empty card *\/\n  display: grid; grid-template-columns: repeat(auto-fit, minmax(280px, 1fr));\n  gap: var(--bp-s-5); align-items: start;\n}\n.bp-adv .bp-adv-author {\n  display: grid; grid-template-columns: 62px 1fr; gap: 0 var(--bp-s-3);\n  align-items: start; min-width: 0;\n}\n.bp-adv .bp-adv-avatar {\n  grid-row: 1 \/ span 3; width: 62px; height: 62px; border-radius: 50%;\n  background: #B7CB331F; border: 2px dashed var(--bp-olive);\n  display: flex; align-items: center; justify-content: center;\n  font-size: 10px; font-weight: 700; letter-spacing: 0.06em; color: var(--bp-forest);\n  margin-block: 0;\n}\n.bp-adv .bp-adv-author.is-placeholder .bp-adv-avatar {\n  border-color: var(--bp-sand); background: #fff; color: var(--bp-foot); }\n.bp-adv .bp-adv-author-role {\n  font-size: 11px; font-weight: 700; letter-spacing: 0.08em; text-transform: uppercase;\n  color: var(--bp-forest); line-height: 1.6; margin-block: 0; }\n.bp-adv .bp-adv-author.is-placeholder .bp-adv-author-role { color: var(--bp-foot); }\n.bp-adv .bp-adv-author-name { font-size: 17px; font-weight: 700; line-height: 1.35;\n  margin-block: 0; }\n.bp-adv .bp-adv-author-cred { font-size: var(--bp-fs-foot); color: var(--bp-foot);\n  line-height: 1.55; margin-block: 0; }\n\/* the optional wrapper must not break the two-column grid of the box *\/\n.bp-adv .bp-adv-authors > .bp-optional { display: contents; }\n.bp-adv .bp-adv-authors > .bp-optional.bp-off { display: none !important; }\n\n\/* --- placeholders: image slot, video slot ---------------------------------- *\/\n.bp-adv .bp-slot {\n  display: flex; align-items: center; justify-content: center; text-align: center;\n  min-height: 180px; padding: var(--bp-s-4); margin-block: var(--bp-s-5) 0;\n  border: 2px dashed var(--bp-olive); border-radius: var(--bp-radius-photo);\n  background: #B7CB331F; color: var(--bp-forest);\n}\n.bp-adv .bp-slot p { font-size: var(--bp-fs-small); font-weight: 700; margin-block: 0; }\n.bp-adv .bp-slot--video { min-height: 260px; }\n\n\/* --- mid-article CTA band --------------------------------------------------- *\/\n.bp-adv .bp-adv-midcta {\n  background: var(--bp-grad-lime); border: 1px solid var(--bp-lime);\n  border-radius: var(--bp-radius-card); padding: var(--bp-s-5) var(--bp-s-4);\n  margin-block: var(--bp-s-6); text-align: center;\n}\n.bp-adv .bp-adv-midcta .wp-block-buttons { margin-block-end: var(--bp-s-2); }\n.bp-adv .bp-adv-midcta .bp-adv-foot { margin-block: 0; }\n\n\/* the closing CTA is one named unit in List View, so it moves and toggles as a\n   whole. It carries no box of its own: the spacing must read exactly as it does\n   on the approved page, where the three parts are plain siblings. *\/\n.bp-adv .bp-adv-ctablock { margin-block: 0 var(--bp-s-5); }\n.bp-adv .bp-adv-ctablock .wp-block-buttons { margin-block-end: var(--bp-s-4); }\n.bp-adv .bp-adv-ctablock .bp-adv-foot { margin-block: 0; }\n\n\/* --- the condition, slot 8: the results page reference-card shape ----------- *\/\n.bp-adv .bp-adv-condition {\n  background: var(--bp-white); border: 1px solid var(--bp-sand);\n  border-left: 5px solid var(--bp-lime); border-radius: var(--bp-radius-btn);\n  padding: var(--bp-s-4) var(--bp-s-5); font-weight: 600; box-shadow: var(--bp-shadow);\n}\n\n\/* --- the numbers card: the results page focus panel, same gradient, same\n       radius, same lime figures (\"use more of that design\") ------------------ *\/\n.bp-adv .bp-adv-numcard {\n  background: linear-gradient(135deg, var(--bp-teal) 0%, var(--bp-forest) 100%);\n  border-radius: var(--bp-radius-card);\n  padding: var(--bp-s-6) var(--bp-s-5) var(--bp-s-5);\n  box-shadow: var(--bp-shadow); margin-block: var(--bp-s-5) 0;\n  position: relative; overflow: hidden;\n}\n.bp-adv .bp-adv-numcard::after {\n  content: \"\"; position: absolute; right: -70px; top: -70px; width: 240px; height: 240px;\n  border-radius: 50%; background: rgba(255,255,255,0.05); pointer-events: none;\n}\n.bp-adv .bp-adv-numcard .wp-block-columns {\n  position: relative; z-index: 1; gap: var(--bp-s-5); margin-block: 0; }\n.bp-adv .bp-adv-numcard .wp-block-column { min-width: 0; }\n.bp-adv .bp-adv-num-v { font-size: 44px; font-weight: 700; line-height: 1.12;\n  color: var(--bp-lime); text-align: center; margin-block: 0 var(--bp-s-2); }\n.bp-adv .bp-adv-num-l { font-size: var(--bp-fs-small); line-height: 1.5;\n  color: rgba(255,255,255,0.92); text-align: center; margin-block: 0; }\n.bp-adv .bp-adv-numsrc { margin-block: var(--bp-s-5) 0; }\n\n\/* --- the proof slot: a dashed card until a consented quote exists. 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Lees wat een hoge of lage ratio kan betekenen voor je lever en wat de ratio be\u00efnvloedt.\",\"inLanguage\":\"nl-NL\",\"dateModified\":\"2026-10-27\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/bioprofile.com\/biomarkers\/de-ritis-ratio\/\"},\"isPartOf\":{\"@id\":\"https:\/\/bioprofile.com\/biomarkers\/de-ritis-ratio\/\"},\"publisher\":{\"@id\":\"https:\/\/bioprofile.com\/#organization\"},\"about\":{\"@id\":\"https:\/\/bioprofile.com\/biomarkers\/de-ritis-ratio\/#biomarker\"},\"citation\":[{\"@type\":\"CreativeWork\",\"name\":\"Botros M, Sikaris KA. The de ritis ratio: the test of time. Clin Biochem Rev. 2013;34(3):117-30.\",\"url\":\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24353357\/\"},{\"@type\":\"CreativeWork\",\"name\":\"BioProfile, de pakketten van het bloedonderzoek en de waarden in elk pakket.\",\"url\":\"https:\/\/bioprofile.com\/bloedonderzoek\/\"}]},{\"@type\":\"MedicalTest\",\"@id\":\"https:\/\/bioprofile.com\/biomarkers\/de-ritis-ratio\/#biomarker\",\"name\":\"De Ritis-ratio (ASAT\/ALAT)\",\"alternateName\":[\"De Ritis ratio\"]}]}<\/script>\n\n\n\n<section class=\"wp-block-group bp-adv bp-biomarker bp-biomarker--page is-layout-flow wp-block-group-is-layout-flow\">\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity bp-adv-rule\"\/>\n\n\n\n<div class=\"wp-block-group bp-adv-sec bp-adv-sec--hero is-layout-flow wp-block-group-is-layout-flow\">\n\n<p class=\"bp-bm-crumbs wp-block-paragraph\"><a href=\"https:\/\/bioprofile.com\/en\/\">Home<\/a> \u203a <a href=\"https:\/\/bioprofile.com\/en\/biomarkers\/\">Biomarkers<\/a> \u203a <span>De Ritis ratio<\/span><\/p>\n\n\n\n<h1 class=\"wp-block-heading bp-adv-h1\">De Ritis ratio<\/h1>\n\n\n\n<p class=\"bp-adv-standfirst wp-block-paragraph\">The De Ritis ratio is the balance between two enzymes in your blood: AST divided by ALT. If ALT is higher than AST, this can point to an acute inflammation of the liver caused by a virus. If AST is higher than ALT, this is often seen in inflammation of the liver caused by alcohol.<sup>[1]<\/sup><\/p>\n\n\n\n<p class=\"bp-adv-lede wp-block-paragraph\">On this page, you can read what the De Ritis ratio is, what the guidelines say about a value that is too low or too high, what affects your value and which other values are best looked at alongside it.<\/p>\n\n\n\n<p class=\"bp-bm-names wp-block-paragraph\">Also known as: AST\/ALT ratio, ASAT\/ALAT ratio. At the lab: n\/a.<\/p>\n\n\n\n<p class=\"bp-adv-byline wp-block-paragraph\">Updated on 27 October 2026<\/p>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec bp-adv-sec--wash is-layout-flow wp-block-group-is-layout-flow\">\n\n<div class=\"wp-block-group bp-bm-toc is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-inhoud\">On this page<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n\n<li><a href=\"#bp-in-het-kort\">In short<\/a><\/li>\n\n\n<li><a href=\"#bp-wat-is-de-ritis-ratio\">What is the De Ritis ratio?<\/a><\/li>\n\n\n<li><a href=\"#bp-waarom-het-ertoe-doet\">Why the ratio matters<\/a><\/li>\n\n\n<li><a href=\"#bp-wat-je-waarde-zegt\">What your De Ritis ratio tells you<\/a><\/li>\n\n\n<li><a href=\"#bp-wat-het-beinvloedt\">What affects your De Ritis ratio<\/a><\/li>\n\n\n<li><a href=\"#bp-welke-pakketten\">Which BioProfile packages measure the De Ritis ratio<\/a><\/li>\n\n\n<li><a href=\"#bp-waarden-die-erbij-horen\">Related values<\/a><\/li>\n\n\n<li><a href=\"#bp-hoe-gemaakt\">How this page was made<\/a><\/li>\n\n\n<li><a href=\"#bp-bronnen\">Sources<\/a><\/li>\n\n<\/ul>\n\n<\/div>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-in-het-kort\">In short<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n\n<li>The De Ritis ratio compares the enzymes AST and ALT in your blood.<sup>[1]<\/sup><\/li>\n\n\n<li>AST leaves your blood faster than ALT: half of it is gone after about 18 hours, compared with about 36 hours for ALT.<sup>[1]<\/sup><\/li>\n\n\n<li>This means the ratio says something about how long a liver condition has been going on and how severe it is.<sup>[1]<\/sup><\/li>\n\n\n<li>According to the review by Botros and Sikaris, a lab should ideally always calculate the ratio when ALT is abnormal.<sup>[1]<\/sup><\/li>\n\n<\/ul>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec bp-adv-sec--wash is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-wat-is-de-ritis-ratio\">What is the De Ritis ratio?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">AST and ALT are two enzymes measured in your blood. The De Ritis ratio is the AST value divided by the ALT value. So it is not a separate measurement, but a calculation from two measurements.<sup>[1]<\/sup><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">De Ritis described this ratio almost 50 years before the review by Botros and Sikaris was published. At first, the ratio was seen mainly as a sign of acute inflammation of the liver caused by a virus. Later, it also proved useful in inflammation of the liver caused by alcohol.<sup>[1]<\/sup><\/p>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-waarom-het-ertoe-doet\">Why the ratio matters<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The ratio shows how a liver condition develops over time. This is because AST stays in your blood for a shorter time than ALT. In this way, the ratio also says something about how severe the course is.<sup>[1]<\/sup><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In long-term inflammation of the liver caused by a virus, in long-term heavy drinking and in fatty liver not caused by alcohol, a raised ratio can predict long-term complications. These include scarring of the liver.<sup>[1]<\/sup><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Botros and Sikaris believe that every lab that reports an abnormal ALT should also report AST and calculate the ratio. This is because the ratio gives useful information about the cause and how things are likely to develop.<sup>[1]<\/sup><\/p>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec bp-adv-sec--wash is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-wat-je-waarde-zegt\">What your De Ritis ratio tells you<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">What the review by Botros and Sikaris says<\/h3>\n\n\n\n<figure class=\"wp-block-table bp-bm-table\"><table><thead><tr><th>Ratio<\/th><th>Can point to<\/th><th>Who it is for<\/th><\/tr><\/thead><tbody><tr><td>ALT higher than AST<sup>[1]<\/sup><\/td><td>acute viral inflammation of the liver, where this is the usual pattern<\/td><td>people with acute viral inflammation of the liver<\/td><\/tr><tr><td>AST higher than ALT<sup>[1]<\/sup><\/td><td>alcohol-related inflammation of the liver, where this is the usual pattern<\/td><td>people with alcohol-related inflammation of the liver<\/td><\/tr><tr><td>AST higher than ALT<sup>[1]<\/sup><\/td><td>a very severe course<\/td><td>people with acute viral inflammation of the liver<\/td><\/tr><tr><td>ALT higher than AST<sup>[1]<\/sup><\/td><td>a point when several days have already passed since drinking alcohol<\/td><td>people with alcohol-related inflammation of the liver<\/td><\/tr><tr><td>Raised ratio<sup>[1]<\/sup><\/td><td>a higher risk of long-term complications, such as scarring of the liver<\/td><td>people with long-term viral inflammation of the liver, long-term heavy alcohol use or a fatty liver not caused by alcohol<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"bp-bm-caption wp-block-paragraph\">Source: Botros and Sikaris, review article on the De Ritis ratio. The article gives no fixed cut-off values, only which of the two enzymes is higher.<sup>[1]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">De Ritis ratio too high<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">A high ratio means AST is higher than ALT. This is often seen in inflammation of the liver caused by alcohol. In acute inflammation caused by a virus, it can point to a severe course. In long-term liver conditions, a raised ratio can point to a higher chance of scarring.<sup>[1]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">De Ritis ratio too low<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">A low ratio means ALT is higher than AST. This is the usual picture in acute inflammation of the liver caused by a virus. It can also point to inflammation caused by alcohol where the drinking was a few days ago.<sup>[1]<\/sup><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">BioProfile is working on its own zones for each value, from risk to optimal. A doctor reviews those zones before they appear in your result.<\/p>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-wat-het-beinvloedt\">What affects your De Ritis ratio<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Time<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">After about 18 hours, half of the AST has left your blood. For ALT, that takes about 36 hours. The longer ago a liver condition started, the more this shifts the ratio.<sup>[1]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Alcohol<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">In inflammation of the liver caused by alcohol, AST is usually higher than ALT. If a few days have passed since drinking, ALT can actually be higher.<sup>[1]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">A vitamin deficiency and the measuring method<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Labs measure AST and ALT with or without added pyridoxal phosphate, a form of a vitamin. If you are low in this vitamin, that difference can affect the result. The effect on the ratio is usually small. A deficiency may be more common in older people and in people who drink a lot of alcohol.<sup>[1]<\/sup><\/p>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec bp-adv-sec--wash is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-welke-pakketten\">Which BioProfile packages measure the De Ritis ratio<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The De Ritis ratio is included in BioProfile 77, 87, 121 and 150.<sup>[2]<\/sup><\/p>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-3e41869c wp-block-buttons-is-layout-flex\">\n\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/bioprofile.com\/en\/blood-testing\/\">View the packages<\/a><\/div>\n\n<\/div>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-waarden-die-erbij-horen\">Values that go with it<\/h2>\n\n\n\n<ul class=\"wp-block-list bp-bm-related\">\n\n<li><a href=\"https:\/\/bioprofile.com\/en\/biomarkers\/alkaline-phosphatase\/\">ALP<\/a>: another enzyme linked to the liver, which adds to the picture alongside AST and ALT.<\/li>\n\n\n<li><a href=\"https:\/\/bioprofile.com\/en\/biomarkers\/alt\/\">ALT<\/a>: the bottom number of the ratio. When ALT is abnormal, the lab should ideally calculate the ratio as well.<sup>[1]<\/sup><\/li>\n\n\n<li><a href=\"https:\/\/bioprofile.com\/en\/biomarkers\/total-bilirubin\/\">Bilirubin, total<\/a>: shows how your liver processes waste products, so it adds to what the enzymes tell you.<\/li>\n\n\n<li><a href=\"https:\/\/bioprofile.com\/en\/biomarkers\/ggt\/\">GGT<\/a>: another enzyme linked to the liver, and a good one to look at alongside the ratio.<\/li>\n\n\n<li><a href=\"https:\/\/bioprofile.com\/en\/biomarkers\/ast\/\">AST<\/a>: the top number of the ratio. This enzyme leaves your blood faster than ALT.<sup>[1]<\/sup><\/li>\n\n<\/ul>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec bp-adv-sec--wash is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-hoe-gemaakt\">How this page was made<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The BioProfile editorial team wrote this page on 27 October 2026 from the sources below, which we read on 27 October 2026. Every number on this page comes from one of those sources, with that source's number next to it. An expert will still review this page; after that review, the expert's name and the date of the review will appear at the top. This page explains and does not diagnose. Discuss an abnormal value with your GP.<\/p>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group bp-adv-sec bp-adv-sec--disclosure is-layout-flow wp-block-group-is-layout-flow\">\n\n<h2 class=\"wp-block-heading\" id=\"bp-bronnen\">Sources<\/h2>\n\n\n\n<ol class=\"wp-block-list bp-adv-srclist bp-bm-src\">\n\n<li>Botros M, Sikaris KA. The de ritis ratio: the test of time. Clin Biochem Rev. 2013;34(3):117-30. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24353357\/\" target=\"_blank\" rel=\"noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/24353357\/<\/a><\/li>\n\n\n<li>BioProfile, the blood test packages and the values in each package. <a href=\"https:\/\/bioprofile.com\/en\/blood-testing\/\" target=\"_blank\" rel=\"noopener\">https:\/\/bioprofile.com\/en\/blood-testing\/<\/a><\/li>\n\n<\/ol>\n\n<\/div>\n\n<\/section>\n\n","protected":false},"excerpt":{"rendered":"<p>Home \u203a Biomarkers \u203a De Ritis ratio De Ritis ratio The De Ritis ratio is the balance between two enzymes in your blood: AST divided by ALT. If ALT is higher than AST, this can point to an acute inflammation of the liver caused by a virus. If AST is higher than ALT, this is [&hellip;]<\/p>\n","protected":false},"author":18,"featured_media":0,"parent":6592,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_yoast_wpseo_title":"De Ritis ratio explained | BioProfile","_yoast_wpseo_metadesc":"What is the De Ritis ratio, the balance between AST and ALT? 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