The gamma-glutamyl transpeptidase to platelet ratio for non-invasive assessment of liver fibrosis in patients with chronic hepatitis B and non-alcoholic fatty liver disease
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Qiang Li1,2, Chuan Lu1, Weixia Li1, Yuxian Huang1,2, Liang Chen1
1Department of Hepatitis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
2Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China
Liang Chen , email: email@example.com
Qiang Li, email: firstname.lastname@example.org
Keywords: chronic hepatitis B, non-alcoholic fatty liver disease, gamma-glutamyl transpeptidase-to-platelet ratio, liver fibrosis, non-invasive marker
Received: February 10, 2017 Accepted: March 04, 2017 Published: March 13, 2017
Background/Aim: The gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a novel serum model, which was reported more accurate than aspartate transaminase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) for diagnosing significant fibrosis and cirrhosis in HBV mono-infection in West Africa. We aimed to evaluate the diagnostic performance of GPR for liver fibrosis in patients with chronic hepatitis B (CHB) and non-alcoholic fatty liver disease (NAFLD).
Results: Of 131 patients, 41 (31.3%), 20 (15.3%), and 10 (7.6%) were classified as having significant fibrosis, severe fibrosis and cirrhosis, respectively. To predict significant fibrosis, the AUROC of GPR was higher than that of APRI (0.86 vs 0.75, p = 0.001) and FIB-4 (0.86 vs 0.66, p < 0.001). To predict severe fibrosis, the AUROC of GPR was also higher than that of APRI (0.89 vs 0.77, p = 0.002) and FIB-4 (0.89 vs 0.72, p = 0.001). To predict cirrhosis, no difference was found between the AUROC of GPR and that of APRI (0.92 vs 0.86, p = 0.104).
Materials and Methods: 131 patients with CHB-NAFLD were included, and the diagnostic performances of GPR, APRI and FIB-4 were compared by receiver operating characteristic (ROC) curves and the area under ROC curves (AUROCs).
Conclusions: The GPR could be used as a non-invasive marker to predict liver fibrosis and cirrhosis in CHB-NAFLD individuals.
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