Which liver enzyme pattern is typically elevated in alcohol-related liver injury?

• A. AST, ALT, GGT, Alk Phos
• B. ALT and AST only
• C. GGT only
• D. CK and LDH

Answer: (A)

Alcohol-related liver injury usually affects multiple liver enzyme pathways, reflecting both hepatocellular damage and cholestatic effects, and it often shows a marker tied specifically to alcohol exposure. Transaminases (AST and ALT) indicate hepatocellular injury, with AST commonly higher than ALT in alcohol-related cases. GGT is frequently elevated and is particularly associated with chronic alcohol use. Alkaline phosphatase can also rise when there’s a cholestatic component or biliary involvement. So the pattern that best fits this scenario is elevations across AST, ALT, GGT, and alkaline phosphatase. In contrast, CK and LDH are not specific to the liver and are less informative for alcohol-related liver injury, and limiting to just ALT and AST or to a single marker would miss the broader, alcohol-associated pattern.