Gamma-glutamyl transpeptidase to platelet ratio index is a good noninvasive biomarker for predicting liver fibrosis in Chinese chronic hepatitis B patients

Abstract

ObjectiveTo evaluate whether gamma-glutamyl transpeptidase to platelet ratio index (GPRI) can diagnose the extent of liver fibrosis in Chinese patients with chronic hepatitis B (CHB) infection.MethodsThis prospective observational study used liver biopsy results as the gold standard to evaluate the ability of GPRI to predict hepatic fibrosis compared with two other markers, the aspartate aminotransferase (AST) to platelet ratio index (APRI) and fibrosis-4 score (FIB-4). The clinical and demographic factors that affected GPRI, independent of liver fibrosis, were assessed using multivariate linear regression analyses.ResultsThis study enrolled 312 patients with CHB. GPRI had a significantly positive correlation with liver fibrosis stage and the correlation coefficient was higher than that for APRI and FIB-4. The areas under the receiver operating curves for GPRI for significant fibrosis, bridging fibrosis, and cirrhosis were 0.728, 0.836, and 0.842, respectively. Of the three indices, GPRI had the highest diagnostic accuracy for bridging fibrosis and cirrhosis. Age, elevated AST and elevated total bilirubin levels were independent determinants of increased GPRI.ConclusionGPRI was a more reliable laboratory marker than APRI and FIB-4 for predicting the stage of liver fibrosis in Chinese patients with CHB.

Gamma-Glutamyl Transpeptidase-to-Platelet Ratio Predicts Significant Liver Fibrosis of Chronic Hepatitis B Patients in China

“…The giant differences in HBV genotypes may be one reason why the results were so variant. Secondly, in Lemoine et al's cohorts [ 5 ], most patients are HBeAg seronegative and had low HBV DNA levels, while the three retrospective studies (Li et al's [ 7 ], Wang et al's [ 8 ], and ours) in China mostly covered patients being HBeAg seropositive and having high HBV DNA levels. This may also lead us to different conclusions.…”

“…They compared GPR with APRI and Fib-4 in three cohorts (Africa and Europe) [ 5 ]. In 2016, two Chinese research groups independently performed studies to evaluate the diagnostic accuracy of GPR both in Shanghai, China, and in Hebei, China [ 7 , 8 ]. However, the results of these 3 research teams were conflicting, and all of them expected further data for the future [ 5 , 7 , 8 ].…”

“…In 2016, two Chinese research groups independently performed studies to evaluate the diagnostic accuracy of GPR both in Shanghai, China, and in Hebei, China [ 7 , 8 ]. However, the results of these 3 research teams were conflicting, and all of them expected further data for the future [ 5 , 7 , 8 ]. In our retrospective study, we found that GPR showed advantages than APRI in diagnosing fibrosis, significant fibrosis, and extensive fibrosis and it was comparable with Fib-4 in diagnostic performances.…”

“…Meanwhile, researchers from Hebei Province, China, carried out a prospective observational study to evaluate the diagnostic ability of this novel biomarker too. Their results showed that GPR was more reliable to predict fibrosis stage [ 8 ]. All 3 groups of scientists have done great works but their results differ.…”

“…All 3 groups of scientists have done great works but their results differ. According to authors' conclusions, there needs to be more data to access this model's accuracy and to verify whether GPR deserves utilization in China or not [ 5 , 7 , 8 ]. So, using liver biopsy as the standard, we compared the diagnosing performance of GPR with that of APRI and Fib-4 in 160 CHB patients.…”