Increased mean platelet volume is related to histologic severity of primary biliary cirrhosis

Abstract

AimTo evaluate the main platelet volume (MPV) as a severity marker in patients with primary biliary cirrhosis (PBC).Materials and methodsThirty-nine patients with biopsy-proven and as yet untreated PBC followed between January 2008 and January 2015 were included in this study. Liver biopsies were categorized as early stage (stage 1 and 2 according to Scheuer’s histological stage) and late stage (Scheuer’s stage 3 and 4). As part of the routine evaluation, all PBC patients had their full blood count and biochemistry profile determined, where MPV, white blood cell count, hemoglobin, platelet count, red cell distribution width (RDW), alanine aminotransferase, aspartate aminotransferase (AST), gamma glutamyl transferase, alkaline phosphatase, and total bilirubin values were evaluated. Both groups were compared in terms of the RDW/platelet ratio, the AST platelet ratio index, and the neutrophil lymphocyte ratio.ResultsEighteen patients had early-stage disease (46.2%), whereas 21 PBC patients had late-stage disease (53.8%). There were no differences between groups in terms of routine hematological parameters (white blood cell count, platelet count, hemoglobin, RDW) or biochemical parameters (alanine aminotransferase, AST, gamma glutamyl transferase, alkaline phosphatase, total bilirubin, albumin) (P>0.05). Similarly, there were no differences in AST platelet ratio index, RDW/platelet ratio, or neutrophil lymphocyte ratio values between groups (P values 0.08, 0.19, and 0.14, respectively). The MPV and direct bilirubin were significantly higher in the advanced stage group compared with the early-stage group (11.08 vs. 9.73 fl, respectively, P=0.01 and 0.44 vs. 0.28 mg/dl, respectively, P=0.03). The area under the curve, cut-off value, sensitivity, and specificity of MPV and direct bilirubin for detecting advanced stage were 0.721, 10.3, 71%, and 66%, respectively, and 0.698, 0.23, 71%, and 66%, respectively.ConclusionMPV can be used as a noninvasive, simple, and effective parameter in patients with PBC to predict histological severity of the disease.

Increased red cell width distribution to lymphocyte ratio is a predictor of histologic severity in primary biliary cholangitis

“…RLR showed the highest AUROC among all the noninvasive markers (0.744). The results pertaining to APRI in this study contradict those reported from a study conducted in Turkey, [41] in which APRI value decreased with increase in the severity of PBC. Of note, there were no significant differences pertaining to baseline data between patients with early-stage and late-stage disease in the Turkish study; this may have contributed to the contradictory results.…”

Increased red cell width distribution to lymphocyte ratio is a predictor of histologic severity in primary biliary cholangitis

“…RLR showed the highest AUROC among all the noninvasive markers (0.744). The results pertaining to APRI in this study contradict those reported from a study conducted in Turkey, [41] in which APRI value decreased with increase in the severity of PBC. Of note, there were no significant differences pertaining to baseline data between patients with early-stage and late-stage disease in the Turkish study; this may have contributed to the contradictory results.…”

The Predictive Value of Mean Platelet Volume for Liver Fibrosis in Children With Chronic Liver Diseases

“…8 The most common clinical symptom in our patients was jaundice which was in accordance to the previous study in Shiraz. 9,10 In this study, a significant difference was observed in MPV values regarding different fibrosis severities which was in parallel to the report of Tahtaci et al on PBC patients, 11 Karagoz et al on patients with chronic hepatitis B, 5 Purnak et al on patients with chronic hepatitis C, 6 and Abdel-Razik et al on AIH patients. 12 Furthermore, in our study only, MPV significantly differed in patients with neonatal hepatitis as well.…”

“…In this study, there was no significant statistical difference for AAR in various degrees of fibrosis which was in line with the study of Yang et al in China 14 and Yang et al in South Korea. 15 In this study, there was a statistically significant difference in APRI among different degrees of liver fibrosis which was supported by the reports of Tahtaci et al in Turkey, 11 Kim et al in Japan, 16 Yang et al in South Korea, 15 Yang et al in China, 14 and Shokouhi et al in Iran. 17 FIB-4 index also showed a significant relationship with the degree of fibrosis in our study which was similar to the studies of Purnak et al in Turkey, 6 Yang et al in South Korea, 15 and Yang et al in China.…”

“…13 According to the results of ROC curve analysis, an appropriate cut off did not obtained for MPV to differentiate various degrees of fibrosis. On the other hand, Tahtaci et al, 11 Karagoz et al 5 and Purnak et al 6 reported threshold values with better predictability.…”

Red Blood Cell Distribution Width to Platelet Ratio is Related to Histologic Severity of Primary Biliary Cirrhosis

“…Further, studies investigating the relationship between biochemical markers and histological stages of fibrosis are limited in PBC. Recently, Tahtaci et al 27 found that increased MPV is related to the histologic severity of PBC, but their sample size of 39 patients was small. Hence, the need to identify a noninvasive diagnostic marker that is indicative of the histological severity observed in PBC in a large population is urgent.…”

Increased red cell width distribution to lymphocyte ratio is a predictor of histologic severity in primary biliary cholangitis

“…RLR showed the highest AUROC among all the noninvasive markers (0.744). The results pertaining to APRI in this study contradict those reported from a study conducted in Turkey, [41] in which APRI value decreased with increase in the severity of PBC. Of note, there were no significant differences pertaining to baseline data between patients with early-stage and late-stage disease in the Turkish study; this may have contributed to the contradictory results.…”

The Predictive Value of Mean Platelet Volume for Liver Fibrosis in Children With Chronic Liver Diseases

“…8 The most common clinical symptom in our patients was jaundice which was in accordance to the previous study in Shiraz. 9,10 In this study, a significant difference was observed in MPV values regarding different fibrosis severities which was in parallel to the report of Tahtaci et al on PBC patients, 11 Karagoz et al on patients with chronic hepatitis B, 5 Purnak et al on patients with chronic hepatitis C, 6 and Abdel-Razik et al on AIH patients. 12 Furthermore, in our study only, MPV significantly differed in patients with neonatal hepatitis as well.…”

“…In this study, there was no significant statistical difference for AAR in various degrees of fibrosis which was in line with the study of Yang et al in China 14 and Yang et al in South Korea. 15 In this study, there was a statistically significant difference in APRI among different degrees of liver fibrosis which was supported by the reports of Tahtaci et al in Turkey, 11 Kim et al in Japan, 16 Yang et al in South Korea, 15 Yang et al in China, 14 and Shokouhi et al in Iran. 17 FIB-4 index also showed a significant relationship with the degree of fibrosis in our study which was similar to the studies of Purnak et al in Turkey, 6 Yang et al in South Korea, 15 and Yang et al in China.…”

“…13 According to the results of ROC curve analysis, an appropriate cut off did not obtained for MPV to differentiate various degrees of fibrosis. On the other hand, Tahtaci et al, 11 Karagoz et al 5 and Purnak et al 6 reported threshold values with better predictability.…”

Red Blood Cell Distribution Width to Platelet Ratio is Related to Histologic Severity of Primary Biliary Cirrhosis

“…Further, studies investigating the relationship between biochemical markers and histological stages of fibrosis are limited in PBC. Recently, Tahtaci et al 27 found that increased MPV is related to the histologic severity of PBC, but their sample size of 39 patients was small. Hence, the need to identify a noninvasive diagnostic marker that is indicative of the histological severity observed in PBC in a large population is urgent.…”

Increased red cell width distribution to lymphocyte ratio is a predictor of histologic severity in primary biliary cholangitis

“…RLR showed the highest AUROC among all the noninvasive markers (0.744). The results pertaining to APRI in this study contradict those reported from a study conducted in Turkey, [41] in which APRI value decreased with increase in the severity of PBC. Of note, there were no significant differences pertaining to baseline data between patients with early-stage and late-stage disease in the Turkish study; this may have contributed to the contradictory results.…”

The Predictive Value of Mean Platelet Volume for Liver Fibrosis in Children With Chronic Liver Diseases

“…8 The most common clinical symptom in our patients was jaundice which was in accordance to the previous study in Shiraz. 9,10 In this study, a significant difference was observed in MPV values regarding different fibrosis severities which was in parallel to the report of Tahtaci et al on PBC patients, 11 Karagoz et al on patients with chronic hepatitis B, 5 Purnak et al on patients with chronic hepatitis C, 6 and Abdel-Razik et al on AIH patients. 12 Furthermore, in our study only, MPV significantly differed in patients with neonatal hepatitis as well.…”

“…In this study, there was no significant statistical difference for AAR in various degrees of fibrosis which was in line with the study of Yang et al in China 14 and Yang et al in South Korea. 15 In this study, there was a statistically significant difference in APRI among different degrees of liver fibrosis which was supported by the reports of Tahtaci et al in Turkey, 11 Kim et al in Japan, 16 Yang et al in South Korea, 15 Yang et al in China, 14 and Shokouhi et al in Iran. 17 FIB-4 index also showed a significant relationship with the degree of fibrosis in our study which was similar to the studies of Purnak et al in Turkey, 6 Yang et al in South Korea, 15 and Yang et al in China.…”

“…13 According to the results of ROC curve analysis, an appropriate cut off did not obtained for MPV to differentiate various degrees of fibrosis. On the other hand, Tahtaci et al, 11 Karagoz et al 5 and Purnak et al 6 reported threshold values with better predictability.…”

Red Blood Cell Distribution Width to Platelet Ratio is Related to Histologic Severity of Primary Biliary Cirrhosis

“…Further, studies investigating the relationship between biochemical markers and histological stages of fibrosis are limited in PBC. Recently, Tahtaci et al 27 found that increased MPV is related to the histologic severity of PBC, but their sample size of 39 patients was small. Hence, the need to identify a noninvasive diagnostic marker that is indicative of the histological severity observed in PBC in a large population is urgent.…”