Aspartate aminotransferase

Method

Serum aspartate aminotransferase catalytic activity by clinical enzymatic assay.

The method is part of the endpoint identity. Studies measuring the same quantity by a different method are held as separate endpoints.

Notes

Alanine aminotransferase is the counterpart — see that entry for the dissociation. This enzyme is expressed in skeletal muscle and erythrocytes as well as liver, so it rises after a hard exercise bout or after haemolysis with no liver event at all, which makes it the wrong marker in every exercise trial in this vocabulary. That is also why it near-misses CAT:outcome/creatine-kinase: both rise with muscle damage, but CK is the muscle-damage marker and this is a liver-panel enzyme, and reading a post-exercise AST rise as hepatotoxicity is the specific error to avoid. SIGN INVERSION against serum albumin on the same panel.

Findings

4 findings from 2 compounds, strongest first.

• curcumin — decreases

  BLikelyGrade B, Likely. Human evidence, limited replication or design limits.Findingreplicated ×2

  “The results showed that curcumin reduced AST compared with placebo [SMD = -0.48, 95% CI (-0.76, -0.20), P = 0.0007].”

  Study

  meta-analysis

  Participants

  681

  Population

  adults with non-alcoholic fatty liver disease

  Effect -0.48 standardised mean difference, 95% CI -0.76 to -0.2

  Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic fatty liver disease: A systematic review and meta-analysis.2022PMID:36159792

• curcumin — decreases

  BLikelyGrade B, Likely. Human evidence, limited replication or design limits.Findingreplicated ×2

  “Similarly, the mean AST reduction was − 15.03 ± 16.31 U/L in the nanocurcumin group and − 0.92 ± 11.64 U/L in the placebo group, with a significant between-group difference ( P = 0.004).”

  Study

  RCT

  Dose

  Oral nanomicellar curcumin (nano-curcumin, Exir Nano Sina), one 40 mg capsule twice daily with a main meal (80 mg/day) for 16 weeks

  Population

  Adults aged 30-70 y with NAFLD-associated liver fibrosis of METAVIR stage F2 or higher, Tehran, Iran; 55 randomised and all 55 analysed with no withdrawals (27 nano-curcumin, 28 placebo); secondary endpoint (declared primary outcomes: liver fibrosis and steatosis by FibroScan and the FIB-4 index); unadjusted between-group comparison of change from baseline; baseline AST was higher in the nano-curcumin arm than in the placebo arm (38.44 vs 27.21 U/L, P = 0.05); serum AST by enzyme colorimetric method on a Cobas c 311 analyser

  Effect of nano-curcumin supplementation on liver fibrosis in patients with NAFLD-associated fibrosis: a double-blind randomized controlled trial.2025PMID:41168313Industry funded

• curcumin — decreases

  BLikelyGrade B, Likely. Human evidence, limited replication or design limits.Findingreplicated ×2

  “The overall pooling of data indicated that curcumin supplementation was significantly associated with reduced AST with MD (95% CI) of −3.90 (−5.97, −1.82) units/L, although high heterogeneity was observed (I2 = 73.9%).”

  Study

  meta-analysis

  Dose

  80–3000 mg/day pooled across bioavailability-enhanced forms (80–1000 mg/day), curcumin extracts (1500 mg/day) and turmeric powder (2000–3000 mg/day)

  Population

  Adults with MAFLD (NAFLD/NASH); overall pooling of 15 RCTs, all curcumin forms; liver enzymes were a primary outcome of interest

  Effect -3.9 mean difference, 95% CI -5.97 to -1.82

  An updated meta-analysis of effects of curcumin on metabolic dysfunction-associated fatty liver disease based on available evidence from Iran and Thailand.2023PMID:37037891

• berberine — decreases

  DPreliminaryGrade D, Preliminary. Non-human or in vitro only.Finding

  “However, oral administration of BBR not only reversed hepatocyte necrosis, but also decreased the elevated levels of TBA, ALP, TBIL, DBIL, ALT, and AST ( Supplementary Fig. 1A, 1B).”

  Study

  animal · not in humans

  Duration

  7 days

  Population

  C57BL/6J mice with bile duct ligation-induced cholestatic liver injury; serum AST by automated biochemical analyser

  Gut microbiota-mediated berberine metabolism ameliorates cholestatic liver disease by suppressing 5-hydroxytryptamine production.2026PMID:41087029