In alcoholic hepatitis, elevated levels of AST and ALT are primarily due to a deficiency of which vitamin?

In alcoholic hepatitis, elevated levels of AST and ALT are primarily associated with the metabolism of alcohol and the resulting liver damage, which can impair various biochemical processes. The correct answer is related to the role of pyridoxine (B6) in the metabolism of amino acids and fatty acids, as well as in the synthesis of neurotransmitters.

Pyridoxine is crucial for the enzyme transaminases, which facilitate the transfer of amino groups. In the context of alcoholic liver disease, insufficient levels of pyridoxine can lead to impaired transamination reactions, resulting in increased levels of AST and ALT in the serum. This is due to the liver's inability to properly handle the elevated levels of amino acids during liver injury or inflammation. Therefore, a deficiency in pyridoxine contributes to the abnormal enzyme levels seen in alcoholic hepatitis.

Other vitamins listed, though essential in various metabolic pathways, do not directly correlate with the increase in AST and ALT seen specifically in the context of alcoholic liver injury. This is why focusing on pyridoxine provides insight into the metabolic dysfunction that leads to the observed elevated enzyme levels in this condition.