An Epic Research analysis of 11,469 adults ages 18–44 found that very low liver enzyme levels were associated with a higher likelihood of colorectal cancer diagnosed around the time of first screening. Compared with AST and ALT levels of 14–29 U/L, AST below 14 U/L was associated with a 65% higher likelihood of early-onset CRC, while ALT below 14 U/L was associated with a 68% higher likelihood. In contrast, AST ≥30 U/L and ALT ≥30 U/L were associated with 22% and 29% lower likelihoods, respectively.
A rising AST or ALT over the preceding three years was also associated with a lower likelihood of CRC, while triglycerides, HDL, triglyceride-to-HDL ratio and potassium showed no significant associations.