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

Oncotarget. 2017 Apr 25;8(17):28641-28649. doi: 10.18632/oncotarget.16162.

Abstract

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.

Keywords: chronic hepatitis B; gamma-glutamyl transpeptidase-to-platelet ratio; liver fibrosis; non-alcoholic fatty liver disease; non-invasive marker.

MeSH terms

  • Adult
  • Biomarkers
  • Female
  • Hepatitis B, Chronic / blood*
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / diagnosis
  • Humans
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / etiology
  • Liver Function Tests
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / blood*
  • Non-alcoholic Fatty Liver Disease / complications
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Platelet Count*
  • ROC Curve
  • Reproducibility of Results
  • Severity of Illness Index
  • gamma-Glutamyltransferase / blood*

Substances

  • Biomarkers
  • gamma-Glutamyltransferase