Noninvasive assessment of liver fibrosis with the aspartate transaminase to platelet ratio index (APRI): Usefulness in patients with chronic liver disease
Yusuf Yilmaz
1
, *
,
Oya Yonal
2
,
Ramazan Kurt
2
,
Muharrem Bayrak
3
,
Bilge Aktas
2
and
Osman Ozdogan
2
1 Department of Gastroenterology, Marmara University, School of Medicine, yusufyilmaz@uludag.edu.tr, Turkey
2 Department of Gastroenterology, Marmara University, School of Medicine, Turkey
3 Department of Internal Medicine, Marmara University, School of Medicine, Turkey
*
Department of Gastroenterology, Marmara University, School of Medicine, yusufyilmaz@uludag.edu.tr, Turkey. Tel: +90-5334403995. Fax: +90-2166886681. Email:
yusufyilmaz@uludag.edu.tr
Hepatitis Monthly: 11 (2) ; 103-106 Article Type: Research Article
Received:
June 19, 2010
Accepted:
November 20, 2010
To Cite:
Yilmaz
Y, Yonal
O, Kurt
R, Bayrak
M, Aktas
B, et al. Noninvasive assessment of liver fibrosis with the aspartate transaminase to platelet ratio index (APRI): Usefulness in patients with chronic liver disease,
Hepat Mon.
Online ahead of Print
; 11(2):103-106.
Abstract
Background: The aspartate aminotransferases (AST) to platelet ratio index (APRI) may serve as a noninvasive marker to assess liver fibrosis.Objectives: To assess the diagnostic ability of the APRI for prediction of fibrosis in patients with chronic hepatitis B (CHB), chronic hepatitis C (CHC), and non-alcoholic fatty liver disease (NAFLD).Patients and Methods: This retrospective study included 207 patients with CHB, 108 with CHC, and 140 patients with NAFLD. The APRI was calculated as (AST level/upper normal limit for AST)/platelet counts (109/L) × 100. The stage of liver fibrosis in patients with chronic viral hepatitis was graded using the METAVIR scale. The Kleiner system for grading fibrosis was used in patients with NAFLD. Results: Bivariate correlation analyses showed that the APRI was significantly associated with fibrosis scores in patients with CHC (p = 0.2634, p = 0.0059) and NAFLD (p = 0.2273, p = 0.0069), but not in those with CHB (p = 0.1005, p = 0.1495). Receiver operating characteristic (ROC) curves were used for assessing the ability of the APRI as a predictor of the absence or presence of liver fibrosis (fibrosis score of 0 vs fibrosis scores of 1-4). In patients with CHC, the APRI showed a sensitivity of 72.7% and a specificity of 62.4% for detection of fibrosis (p<0.01). In the NAFLD group, the APRI showed a sensitivity of 60.0% and specificity of 73.3% for detection of fibrosis (p<0.01). In patients with CHB, the APRI showed a sensitivity of 55.0% and a specificity of 75.4% for fibrosis (p=NS).
Keywords:
Chronic hepatitis C; Chronic hepatitis B; Fatty liver; Fibrosis; Aspartate aminotransferases
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