Assessment of Hepatic Fibrosis Using Non-Invasive Aspartate Aminotransferase to Platelets Ratio Index Compared to Hepatic Stiffness Measurements Using Transient Elastography FibroScan®

Abstract

Background: Transient Elastography FibroScan® and aspartate aminotransferase to platelets ratio index have frequently been evaluated in comparison to liver biopsy for the assessment of liver fibrosis.
 Methods: Cross-sectional study to correlate between Aspartate transaminase to platelets ratio index and liver Transient Elastography FibroScan® among patients with liver diseases. Aspartate transaminase to platelets ratio index (in IU/L) and platelet count (expressed as K/ul) were calculated. Transient Elastography FibroScan® scores were obtained and then the patients were categorized into four stages of fibrosis. Baseline characteristic data were obtained for each patient. IBM SPSS V.20 was used to perform a correlation analysis of stiff ness score and Aspartate transaminase to platelets ratio index. Moreover, one-way ANOVA was performed to test for differences in Aspartate transaminase to platelets ratio index, Platelets, and Aspartate Aminotransferase among different stages of fibrosis.
 Results: 235 patients were included: 141 (60%) males and 94 (40%) females. Th e most common cause of liver disease was chronic viral hepatitis C (38.3%). The majority of patients had mild fibrosis (F0-F1, n = 117 (49.8%)). Eighteen (7.6%) patients had F3, and 62 (26.4%) had cirrhosis (F4). Age > 40 years was associated with higher liver stiff ness compared with age ≤ 40 years. There was a profound relationship between stiffness score and Aspartate transaminase to platelets ratio index.
 Conclusion: Aspartate transaminase to platelets ratio index is strongly correlated with Transient Elastography FibroScan® in patients with advanced fibrosis and cirrhosis and can effectively categorize mild from advanced fibrosis or cirrhosis.