Comparison of thrombocytopenia between patients with non-alcoholic fatty liver disease and those with hepatitis C virus-related chronic liver disease

Naohiko Kinoshita; Toshihide Shima; Kei Terasaki; Hirohisa Oya; Takayuki Katayama; Junko Matsumoto; Yasuhide Mitsumoto; Masayuki Mizuno; Chiemi Mizuno; Rina Hirohashi; Kyoko Sakai; Takeshi Okanoue

doi:10.1111/hepr.13791

Comparison of thrombocytopenia between patients with non-alcoholic fatty liver disease and those with hepatitis C virus-related chronic liver disease

Hepatol Res. 2022 Aug;52(8):677-686. doi: 10.1111/hepr.13791. Epub 2022 May 24.

Authors

Affiliations

¹ Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan.
² Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
³ Radiology, Saiseikai Suita Hospital, Suita, Japan.
⁴ Clinical Laboratory, Saiseikai Suita Hospital, Suita, Japan.
⁵ Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.

PMID: 35543116
DOI: 10.1111/hepr.13791

Abstract

Aim: Thrombocytopenia is widely recognized as a simple surrogate marker of liver fibrosis in non-alcoholic fatty liver disease (NAFLD). Thrombocytopenia of NAFLD has not been compared with that of hepatitis C virus-related chronic liver disease (CLD-C). Here, we examined whether there is any difference in the platelet counts between patients with NAFLD and CLD-C and investigated the underlying mechanisms.

Methods: A total of 760 biopsy-confirmed NAFLD and 1171 CLD-C patients were enrolled. After stratification according to the liver fibrosis stage, platelet counts between NAFLD and CLD-C patients were compared. The platelet count, spleen size, serum albumin level, serum thrombopoietin level, and immature platelet fraction (IPF) value were also compared after covariate adjustment using propensity score (PS) matching.

Results: The median platelet counts (×10⁴ /μL) of NAFLD and CLD-C patients were 20.2 and 18.7 (p = 2.4 × 10^-5 ) in F1; 20.0 and 14.5 (p = 2.1 × 10^-12 ) in F2; 16.9 and 12.3 (p = 8.1 × 10^-10 ) in F3; and 11.1 and 8.1 (p = 0.02) in F4, respectively. In the F3 group, NAFLD patients had a significantly higher platelet count and significantly smaller spleen volume than CLD-C patients. Although the serum thrombopoietin levels were comparable between NAFLD and CLD-C patients, the IPF value of NAFLD patients was significantly higher than that of CLD-C patients.

Conclusions: NAFLD patients had a significantly higher platelet count than CLD-C patients following stratification according to the liver fibrosis stage. The milder hypersplenism and higher platelet production in NAFLD than CLD-C may have contributed to this difference.

Keywords: hepatitis C virus; immature platelet fraction; non-alcoholic fatty liver disease; platelet count; spleen volume; thrombopoietin.