High serum alanine aminotransferase measurement of 46 U/L may be associated with fatty liver, viral hepatitis, bile duct tumor and other diseases. 1. Fatty liver: lesions caused by excessive accumulation of fat in liver cells due to various reasons, which can affect the normal function of the liver and also cause high serum alanine aminotransferase. 2. Viral hepatitis: when viral hepatitis is in severe active stage, liver cells will be seriously damaged, and high serum alanine aminotransferase can occur, even up to 2000U/L. 3. Bile duct tumor: bile duct tumor will damage liver function, serum alanine aminotransferase can be high, tumor invasion or compression of portal vein may cause portal hypertension, advanced patients may be complicated with hepatorenal syndrome. There are many other reasons for abnormal serum alanine aminotransferase test results, it is recommended to go to regular hospitals in time, after clarifying the cause of the disease, under the guidance of the doctor for targeted treatment or therapy.