GPT and familial hypercholesterolemia: However, such elevations in the mean levels of serum AST, ALT, ALP, and LDH enzymes appear to have been prevented in hypercholesterolemic rats that had been treated with the Piper betle extract or with eugenol, since the mean levels were significantly lower than those in hypercholesterolemic, saline-treated rats (Table 2); these observations suggest that the Piper betle extract and eugenol were able to protect the hepatic tissue from hypercholesterolemia-induced oxidative stress-mediated cellular damage.