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Noninvasive assessment of liver fibrosis with the aspartate transaminase to platelet ratio index (APRI): Usefulness in patients with chronic liver disease

AUTHORS

Yusuf Yilmaz 1 , * , Oya Yonal 2 , Ramazan Kurt 2 , Muharrem Bayrak 3 , Bilge Aktas 2 , Osman Ozdogan 2

AUTHORS INFORMATION

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

How 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.

ARTICLE INFORMATION

Hepatitis Monthly: 11 (2); 103-106
Article Type: Research Article
Received: June 19, 2010
Accepted: November 20, 2010

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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).
Conclusions: The APRI shows an acceptable accuracy for the assessment of liver fibrosis in patients with CHC and NAFLD, but not in those with CHB.

Keywords

Chronic hepatitis C Chronic hepatitis B Fatty liver Fibrosis Aspartate aminotransferases

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