string: The mechanism underlying the relationship of AST and RCC is related to the vital role of AST in glycolysis by relocation of NADH into the mitochondria through the malate-aspartate shuttle pathway, in which clear cell RCC with VHL loss was known to induce the expression of hypoxia factors known to be connected to extensively increased glycolysis in the mitochondria, which is well-known as the Warburg effect [26, 27].