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

Abstract

We aimed to investigate whether red blood cell distribution width (RDW) and RDW to platelet ratio (RPR) were related to the histologic severity of primary biliary cirrhosis (PBC).Seventy-three treatment-naïve PBC patients who had undergone a liver biopsy between January 2010 and January 2015 were enrolled in our study. The patients’ histological stages were based on the classifications of Ludwig and Scheuer. The patients were divided into early stage (Stage I) and advanced stage (Stage II, III, and IV) hepatic fibrosis according to their histological stage. All common patient demographics, clinical characteristics, hematological parameters, liver biochemistry, and antimitochondrial M2 antibody levels (AMA-M2) were retrospectively analyzed, and RDW, RPR, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis index based on the 4 factors (FIB-4) were calculated.A total of 28 (38.4%) patients had early stage PBC, whereas 45 (62.6%) were classified as advanced stage. Regarding age, no significant differences between the early and advanced stages were observed. Patients with advanced stage PBC had significantly higher RDW (13.6 vs 14.4; P = 0.019), conjugated bilirubin (10.1 vs 23.4; P = 0.029), and significantly lower cholinesterase (7901.1 vs 6060.8; P = 0.001) and platelets (212.6 vs 167.0; P = 0.006). However, no significant differences (P > 0.05) in other routine parameters previously evaluated in PBC, including aspartate aminotransferase (AST) and mean platelet volume, were found between the groups. The sensitivity and specificity of RDW were 33.3% and 92.9%, respectively, and the area under the receiver-operating characteristic curve (AUROC) was 0.66. However, the sensitivity and specificity of RPR were 46.7% and 96.4%, respectively, and the corresponding AUROC was 0.74 (P < 0.001). Hence, compared with preexisting indicators, RPR showed a higher AUROC than APRI (0.648; P = 0.035) and FIB-4 (0.682; P = 0.009).RDW and RPR may be a new noninvasive marker for predicting histologic severity of PBC.

A promising, novel index in the diagnosis and follow‐up of patent ductus arteriosus: Red cell distribution width‐to‐platelet ratio

“…A new index, namely RPR, which possesses a good predictive property for inflammatory liver and cardiac diseases in adults, was put forth . General sterile inflammation was thought to have a part in PDA pathogenesis .…”

“…A new index, namely RPR, which possesses a good predictive property for inflammatory liver and cardiac diseases in adults, was put forth. [20][21][22] General sterile inflammation was thought to have a part in PDA pathogenesis. 26 This systemic inflammation was overt during the first 3 days of life independent of sepsis, probably due to intensive care.…”

“…Red cell distribution width-to-platelet ratio (RPR) is a quite new, easily calculated parameter that was demonstrated to have a high predictive value in inflammatory diseases of adults. [20][21][22] We hypothesized that this index may be supportive in the diagnosis of hemodynamically significant PDA (hsPDA) and prediction of ductal closure with pharmacotherapy, in addition to echocardiography. Therefore, the aim of this study was to assess whether RPR would be useful in the diagnosis and follow-up of the response to treatment.…”

The Relationship between Inflammatory Marker Levels and Hepatitis C Virus Severity

“…Recently, markers obtained from or calculated using CBC indices, including RDW and/or RPR, were also considered as independent risk factors for studying liver diseases such as HBV-related diseases [8, 10, 15–17], PBC [11], and NAFLD [18]. However, only a few studies in the literature have investigated the relationship between RDW, RPR, and PLR and hepatitis C.…”

Association Between Red Cell Distribution Width (RDW)/Platelet Ratio and Degree of Fibrosis in Patient with Chronic Hepatitis B

“…9,10,11,12 Study in primary biliary cirrhosis patients, the RDW/platelet ratio can predict liver fibrosis with 46.7% sensitivity and 96.4% specificity. 13 Another study also showed an increase in RDW was associated with the incidence of cardiovascular complications and increased mortality. 14 …”