The gamma-glutamyl transferase to platelet ratio and the FIB-4 score are noninvasive markers to determine the severity of liver fibrosis in chronic hepatitis B infection

J. Lee, M. Y. Kim, S. H. Kang, J. Kim, Y. Uh, K. J. Yoon, Hyonsuk Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: Noninvasive liver fibrosis evaluation is an important issue in chronic hepatitis B infection, and may be assessed using transient elastography (Fibroscan) or with blood markers. We compared the value of Fibroscan with that of a panel of routine serum markers. Materials and methods: We recruited 278 chronic hepatitis B patients who underwent Fibroscan and HBV DNA testing. Fibroscan assessments were made, and blood taken for the measurement of the gamma-glutamyl transferase (GGT) to platelet ratio (GPR), platelet count, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), international normalised ratio (INR), total cholesterol, trigylcerides, bilirubin, mean platelet volume (MPV), AST to platelet ratio index (APRI) and neutrophil to lymphocyte ratio. Results: A fibrosis index based on four factors (FIB-4) and GPR were higher and platelets were lower in mild liver fibrosis than in non-liver fibrosis. GGT, AST, ALT, INR, MPV, APRI, FIB-4, GPR, and NLR were higher, and platelet and cholesterol were lower in severe liver fibrosis than in mild liver fibrosis. Elevated GPR (Odds ratio 95% CI 9.1 [1.66–50.0] p = 0.011) and FIB-4 (2.3 [1.2–4.2], p = 0.01) were associated with greater risk of liver fibrosis. The areas under the curve (AUC) were for GPR 0.84 at a cut-off of 0.299 and for FIB-4 0.82 at cut-off 1.571. Conclusions: FIB-4 and GPR may be useful blood markers for evaluating the severity of liver fibrosis in chronic hepatitis B patients. Further prospective study is required to validate these noninvasive blood markers in a clinical practice.

Original languageEnglish
Pages (from-to)128-132
Number of pages5
JournalBritish Journal of Biomedical Science
Volume75
Issue number3
DOIs
Publication statusPublished - 2018 Jul 3

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Chronic Hepatitis B
Transferases
Platelets
Liver Cirrhosis
Liver
Blood Platelets
Infection
Aspartic Acid
Mean Platelet Volume
Blood
International Normalized Ratio
Alanine
Fibrosis
Cholesterol
Elasticity Imaging Techniques
Platelet Count
Bilirubin
Area Under Curve
Lymphocytes
Neutrophils

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Microbiology
  • Immunology
  • Clinical Biochemistry
  • Microbiology (medical)
  • Biochemistry, medical
  • Infectious Diseases

Cite this

@article{ff557a82cdb14598a86892414580c509,
title = "The gamma-glutamyl transferase to platelet ratio and the FIB-4 score are noninvasive markers to determine the severity of liver fibrosis in chronic hepatitis B infection",
abstract = "Objective: Noninvasive liver fibrosis evaluation is an important issue in chronic hepatitis B infection, and may be assessed using transient elastography (Fibroscan) or with blood markers. We compared the value of Fibroscan with that of a panel of routine serum markers. Materials and methods: We recruited 278 chronic hepatitis B patients who underwent Fibroscan and HBV DNA testing. Fibroscan assessments were made, and blood taken for the measurement of the gamma-glutamyl transferase (GGT) to platelet ratio (GPR), platelet count, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), international normalised ratio (INR), total cholesterol, trigylcerides, bilirubin, mean platelet volume (MPV), AST to platelet ratio index (APRI) and neutrophil to lymphocyte ratio. Results: A fibrosis index based on four factors (FIB-4) and GPR were higher and platelets were lower in mild liver fibrosis than in non-liver fibrosis. GGT, AST, ALT, INR, MPV, APRI, FIB-4, GPR, and NLR were higher, and platelet and cholesterol were lower in severe liver fibrosis than in mild liver fibrosis. Elevated GPR (Odds ratio 95{\%} CI 9.1 [1.66–50.0] p = 0.011) and FIB-4 (2.3 [1.2–4.2], p = 0.01) were associated with greater risk of liver fibrosis. The areas under the curve (AUC) were for GPR 0.84 at a cut-off of 0.299 and for FIB-4 0.82 at cut-off 1.571. Conclusions: FIB-4 and GPR may be useful blood markers for evaluating the severity of liver fibrosis in chronic hepatitis B patients. Further prospective study is required to validate these noninvasive blood markers in a clinical practice.",
author = "J. Lee and Kim, {M. Y.} and Kang, {S. H.} and J. Kim and Y. Uh and Yoon, {K. J.} and Hyonsuk Kim",
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The gamma-glutamyl transferase to platelet ratio and the FIB-4 score are noninvasive markers to determine the severity of liver fibrosis in chronic hepatitis B infection. / Lee, J.; Kim, M. Y.; Kang, S. H.; Kim, J.; Uh, Y.; Yoon, K. J.; Kim, Hyonsuk.

In: British Journal of Biomedical Science, Vol. 75, No. 3, 03.07.2018, p. 128-132.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The gamma-glutamyl transferase to platelet ratio and the FIB-4 score are noninvasive markers to determine the severity of liver fibrosis in chronic hepatitis B infection

AU - Lee, J.

AU - Kim, M. Y.

AU - Kang, S. H.

AU - Kim, J.

AU - Uh, Y.

AU - Yoon, K. J.

AU - Kim, Hyonsuk

PY - 2018/7/3

Y1 - 2018/7/3

N2 - Objective: Noninvasive liver fibrosis evaluation is an important issue in chronic hepatitis B infection, and may be assessed using transient elastography (Fibroscan) or with blood markers. We compared the value of Fibroscan with that of a panel of routine serum markers. Materials and methods: We recruited 278 chronic hepatitis B patients who underwent Fibroscan and HBV DNA testing. Fibroscan assessments were made, and blood taken for the measurement of the gamma-glutamyl transferase (GGT) to platelet ratio (GPR), platelet count, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), international normalised ratio (INR), total cholesterol, trigylcerides, bilirubin, mean platelet volume (MPV), AST to platelet ratio index (APRI) and neutrophil to lymphocyte ratio. Results: A fibrosis index based on four factors (FIB-4) and GPR were higher and platelets were lower in mild liver fibrosis than in non-liver fibrosis. GGT, AST, ALT, INR, MPV, APRI, FIB-4, GPR, and NLR were higher, and platelet and cholesterol were lower in severe liver fibrosis than in mild liver fibrosis. Elevated GPR (Odds ratio 95% CI 9.1 [1.66–50.0] p = 0.011) and FIB-4 (2.3 [1.2–4.2], p = 0.01) were associated with greater risk of liver fibrosis. The areas under the curve (AUC) were for GPR 0.84 at a cut-off of 0.299 and for FIB-4 0.82 at cut-off 1.571. Conclusions: FIB-4 and GPR may be useful blood markers for evaluating the severity of liver fibrosis in chronic hepatitis B patients. Further prospective study is required to validate these noninvasive blood markers in a clinical practice.

AB - Objective: Noninvasive liver fibrosis evaluation is an important issue in chronic hepatitis B infection, and may be assessed using transient elastography (Fibroscan) or with blood markers. We compared the value of Fibroscan with that of a panel of routine serum markers. Materials and methods: We recruited 278 chronic hepatitis B patients who underwent Fibroscan and HBV DNA testing. Fibroscan assessments were made, and blood taken for the measurement of the gamma-glutamyl transferase (GGT) to platelet ratio (GPR), platelet count, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), international normalised ratio (INR), total cholesterol, trigylcerides, bilirubin, mean platelet volume (MPV), AST to platelet ratio index (APRI) and neutrophil to lymphocyte ratio. Results: A fibrosis index based on four factors (FIB-4) and GPR were higher and platelets were lower in mild liver fibrosis than in non-liver fibrosis. GGT, AST, ALT, INR, MPV, APRI, FIB-4, GPR, and NLR were higher, and platelet and cholesterol were lower in severe liver fibrosis than in mild liver fibrosis. Elevated GPR (Odds ratio 95% CI 9.1 [1.66–50.0] p = 0.011) and FIB-4 (2.3 [1.2–4.2], p = 0.01) were associated with greater risk of liver fibrosis. The areas under the curve (AUC) were for GPR 0.84 at a cut-off of 0.299 and for FIB-4 0.82 at cut-off 1.571. Conclusions: FIB-4 and GPR may be useful blood markers for evaluating the severity of liver fibrosis in chronic hepatitis B patients. Further prospective study is required to validate these noninvasive blood markers in a clinical practice.

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