Application of alkaline phosphatase‑to‑platelet ratio as a novel noninvasive index predicts liver fibrosis in patients with chronic hepatitis B

Abstract

Assessment of the extent of liver fibrosis is a crucial requirement for the design of antiviral treatments for patients with chronic hepatitis B (CHB). Several non-invasive predictive indices have been developed as potential alternatives to liver biopsy for fibrosis assessment. The present study aimed to establish a novel non-invasive method for predicting liver fibrosis in patients with CHB. A total of 382 patients with CHB who underwent liver biopsy and pathological examination at The Second Hospital of Anhui Medical University (Hefei, China) were enrolled into the present study. Liver fibrosis was assessed according to the meta-analysis of histological data in viral hepatitis scoring system. Logistic regression analyses were performed to explore possibly significant characteristics associated with liver fibrosis. In addition, potential correlations between the alkaline phosphatase (AKP)-to-platelet count (PLT) ratio (APPR) and the aspartate transaminase-to-platelet ratio index (APRI), fibrosis index based on four factors (FIB-4) and γ-glutamyl transpeptidase-to-platelet ratio (GPR) were assessed using Spearman's correlation analysis. Subsequently, the performance of APPR was compared with APRI, FIB-4 and GPR using receiver operating characteristic (ROC) analysis. Logistic regression analysis identified AKP and PLT to be significant independent predictors of fibrosis. Therefore, an index was then constructed for predicting the degree of fibrosis, which was expressed using the formula APPR=AKP (IU/ml)/PLT (1x10 9 /l). APPR was found to be positively associated with the fibrotic stage of the liver in addition to being positively correlated with APRI, FIB-4 and GPR. The area under the ROC curve (AUROC) values of APPR were also significantly higher compared with those of APRI and FIB-4 in predicting significant fibrosis but were equal to those of GPR. However, for advanced fibrosis and cirrhosis, the AUROC value of APPR was shown to be higher compared with that of APRI, FIB-4 and GPR. In conclusion, these observations suggest that APPR is a viable marker that can be used to assess liver fibrosis in patients with CHB.

The clinical value of the monocyte to high-density lipoprotein cholesterol ratio and alkaline phosphatase-to-platelet ratio in primary biliary cholangitis

“…[ 21 ] In this study, APPR was found to be significantly positively correlated with APRI and FIB-4. Analogous to our research results, Pan et al [ 15 ] found that APPR was positively correlated with APRI and FIB-4, as well as with the stage of hepatic fibrosis. It was a significant independent predictor of hepatic fibrosis and could be used to evaluate hepatic fibrosis in patients with CHB.…”

“…[14] APPR was utilized to evaluate the prognosis of patients with HCC and CHB. [15,16] In the current study, our results revealed that increased MHR and APPR were strongly associated with the deterioration of PBC patients, and suggested that the combination of MHR with APPR might hold a significant diagnostic value in distinguishing PBC from AIH and CHB. In addition, we found that APPR may be a noninvasive indicator of hepatic fibrosis in PBC.…”

“…[14] In recent years, a novel prognostic marker, APPR, has emerged as a feasible tool for estimating the development and prognostic analysis of patients with chronic hepatitis B (CHB) and hepatocellular carcinoma (HCC). [15,16] Although MHR and APPR have been studied in a large number of diseases, there are few studies on the correlation between MHR and APPR in PBC. Consequently, this retrospective study of 92 PBC patients aimed to assess the prognostic significance of MHR and APPR in PBC and investigate their potential as novel noninvasive markers for diagnosing and detecting the disease.…”

“…[ 14 ] In recent years, a novel prognostic marker, APPR, has emerged as a feasible tool for estimating the development and prognostic analysis of patients with chronic hepatitis B (CHB) and hepatocellular carcinoma (HCC). [ 15 , 16 ]…”

Informative value of laboratory markers in assessing the stage of liver fibrosis in children with type 1 autoimmune hepatitis

“…Концентрация аминотрансфераз (АЛТ, АСТ) во время лечения коррелирует с долгосрочной выживаемостью пациентов с АИГ I типа [6]. Описано применение отношения щелочной фосфатазы (ЩФ) к тром-боцитам в качестве неинвазивного показателя для прогнозирования стадии ФП у пациентов с хроническим гепатитом В [7]. Обсуждается применения новых биомаркеров, которые могут быть клинически значимыми в отношении дифференцировки различных стадий ФП, активности процесса и эффективности лечения заболевания [8].…”