Can simple non-invasive fibrosis models determine prognostic indicators (fibrosis and treatment response) of primary biliary cholangitis?

Abstract

Objective: The fibrosis stage during diagnosis and the response to ursodeoxycholic acid in the 1 st year of treatment are considered to be prognostic indicators in primary biliary cholangitis (PBC). Determining these indicators with non-invasive models can enable the risk of liver failure to be monitored with continuous variables from the moment of diagnosis. The aim of this study was to evaluate the diagnostic performance of non-invasive models for determining the prognostic indicators in patients with PBC. Materials and Methods: Data from patients with PBC were screened retrospectively. Patients were divided into early (≤2) and advanced (≥3) fibrosis groups. In addition, treatment response status according to the Paris-II criteria and liver failure risk (LFR) according to the UK-PBC score were determined. The S-Index consisting of gamma-glutamyltransferase (GGT), platelets (PLT), and albumin, (S-index: 1000×GGT÷[PLT×Albumın 2 ]), other non-invasive models were calculated. The diagnostic effectiveness of non-invasive indicators to determine the fibrosis stage, response to treatment, and low LFR was analyzed. Results: Fifty-three patients were included in the study. The overall mean age at diagnosis was 49.6±13.6 years and 86.8% of the patients ( n =46) were female. The S-Index was able to determine fibrosis stage, treatment responded, and patients with low LFR (AUC: 0.747, 0.823, and 0.752; p =0.006, <0.001, and 0.0007, respectively). Furthermore, S-Index found to superior to other non-invasive indicators in terms diagnosis of prognostic indicators of PBC. Conclusion: S-index is a practical and inexpensive non-invasive model that can identify liver fibrosis and treatment response in patients with PBC. It can be used as a continuous variable prognostic model in PBC.

The gamma-glutamyl transferase to platelet ratio for noninvasive evaluation of liver fibrosis in patients with primary biliary cholangitis

“…Among these, APRI, FIB-4, and elastography are widely used methods. [ 7 , 18 , 19 ] The relationship between PBC and many fibrosis markers has been evaluated. [ 7 , 20 , 21 ] In a study involving 107 patients diagnosed with PBC, erythrocyte distribution width, FIB-4, albumin, and platelet values were found to be associated with fibrosis, among which FIB-4 had the highest sensitivity and specificity for distinguishing histological severity.…”

“…[ 10 ] In a recent study, the S-index calculated with a special formula consisting of GGT, platelets, and albumin was found to be significantly higher in patients with PBC in the advanced fibrosis group (F3-4) according to the Scheuer system. [ 19 ] Based on this information, we hypothesized that GPR, which can be calculated more easily using GGT and platelets among the parameters used in the S-index in patients with PBC, could be an effective marker for determining fibrosis and cirrhosis. In our study, FIB-4 and GPR levels were found to be statistically significantly higher in the advanced fibrosis group.…”