Aspartate aminotransferase to platelet ratio index and severity of hepatic fibrosis in children

Imanieh, Mohammad Hadi; Hakimzadeh, Mehran; Dehghani, Seyed Mohsen; Geramizadeh, Bita; Safarpour, Ali Reza; Sepehrimanesh, Masood; Haghighat, Mahmood

doi:10.1007/s00580-015-2124-x

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…[8,9] APRI has been shown to be useful as a predictor of histological severity as well as for follow-up of liver cirrhosis. [10] In a study conducted in United Kingdom, elevated APRI was shown to be associated with future risk of adverse events, independently and additively of the response to ursodeoxycholic acid (UDCA) therapy. [11] To the best of our knowledge, few studies have investigated noninvasive markers specifically for PBC.…”

Section: Introductionmentioning

confidence: 99%

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

Meng

Liu

et al. 2018

Medicine

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Primary biliary cholangitis (PBC) is a chronic disease that is increasingly being recognized in recent years. In this study, we sought to identify noninvasive markers of the severity of cirrhosis in patients with PBC based on routinely investigated laboratory parameters.Ninety-four patients with histologically-confirmed PBC based on liver biopsy performed between January 2013 and December 2017 at the First Hospital of Jilin University were divided into 2 groups: early-stage cirrhosis (fibrosis stage F1 and F2; n = 74) and advanced-stage cirrhosis (fibrosis stage F3 and F4; n = 20).Patients with advanced-stage had significantly higher red blood cell distribution width (RDW) (15.2 vs 13.7; P = .003) and significantly lower platelet (163.35 vs 202.73; P = .032) and lymphocyte counts (1.47 vs 1.79; P = .018) as compared with patients with early-stage cirrhosis. Advanced-stage cirrhosis was associated with significantly higher RDW to platelet ratio (RPR), RDW to lymphocyte ratio (RLR), aspartate aminotransferase to platelet ratio index (APRI), and fibrosis index based on the 4 factors (FIB-4) as compared with early-stage cirrhosis. RLR showed the highest area under receiver operating characteristic curve (AUROC) (0.744). The sensitivity and specificity of RLR were 65% and 78.3%, respectively. RLR had higher AUROC than the other 3 noninvasive markers.The noninvasive markers RPR, RLR, APRI, and FIB-4 showed good diagnostic accuracy for advanced-stage cirrhosis. These markers are easily acquired by routine laboratory tests and are reproducible predictors of the severity of PBC. RLR is a novel marker that may serve as a valuable supplement to APRI and FIB-4 for predicting the severity of cirrhosis.

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Section: Introductionmentioning

confidence: 99%

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

Meng

Liu

et al. 2018

Medicine

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Aspartate aminotransferase to platelet ratio can reduce the need for transient elastography in Chinese patients with chronic hepatitis B

Yue

Geng

et al. 2019

Medicine

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In the absence of liver biopsy and transient elastography (TE), aspartate aminotransferase to platelet ratio (APRI), fibrosis-4 score (FIB-4), and gammaglutamyl transpeptidase to platelet ratio (GPR) are simple and inexpensive methods for the detection of liver fibrosis. Aims: We compared the performance of APRI, FIB-4, and GPR scores against TE in predicting the presence of liver fibrosis and cirrhosis, determined the optimal cut-off values for fibrosis and cirrhosis prediction, and reviewed the need for further TE assessment in resource-limited areas in China. Methods: TE and basic laboratory tests were performed in 2014 consecutive patients with chronic hepatitis B (CHB), and then compared to APRI, FIB-4, and GPR. Results: For the detection of significant fibrosis, the areas under the receiver operating characteristic (AUROC) curves for APRI, FIB-4, and GPR were 0.83, 0.75, and 0.77, respectively. For the detection of cirrhosis, the AUROC curves for APRI, FIB-4, and GPR were 0.90, 0.84, and 0.84, respectively. The cutoff of APRI was 0.35, with 78% sensitivity and 63% negative predictive value (NPV), to exclude significant fibrosis (F ≥ 2). At an APRI of 0.6, results showed a 94% specificity, 100% positive predictive value (PPV) and 7.9 positive likelihood ratio (PLR) in detecting significant fibrosis. Thus, patients with an APRI of <0.35 or >0.6 demonstrated correct prediction of liver fibrosis. These results translated to 1250 out of the 2014 patients avoiding the need for TE with a diagnostic accuracy of >80%. Conclusions: The APRI score accurately assessed fibrosis and reduced the need for TE in almost two-thirds of Chinese patients with CHB.

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Aspartate aminotransferase to platelet ratio index and severity of hepatic fibrosis in children

Cited by 2 publications

References 24 publications

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

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

Aspartate aminotransferase to platelet ratio can reduce the need for transient elastography in Chinese patients with chronic hepatitis B

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