Fibroscan Compared to Aspartate Aminotransferase to Platelet Ratio Index (APRI) and Aspartate Aminotransferase to Alanine Aminotransferase Ratio (AST to ALT) in the Assessment of Liver Fibrosis in Patients with Non Alcoholic Fatty Liver Disease in a Terti

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Objectives: To compare the extent of liver fibrosis using fibroscan and subsequently compare it with AST/ALT ratio and AST to platelet ratio index (APRI).
 Study Design: Comparative cross-sectional study.
 Place and Duration of Study: Chemical Pathology Department, Military Hospital Rawalpindi in collaboration with Armed forces institute of Radiology & Imaging and Gastroenterology Department, Military Hospital Rawalpindi from Jan to Apr 2021.
 Methodology: A total of 50 patients in group-1 and 24 healthy subject participants in group-2 as controls were studied. Serum AST, ALT, platelet count, APRI and AST to ALT ratio were assessed along with fibroscan results to determine stages of liver fibrosis and results were compared for the association.
 Results: There were 49 (66%) males and 25 (34%) females included in the study with the mean age of 49.77 ± 8.3 years. 11 (14.9%) patients had advanced fibrosis. There was a significant negative relationship (p-value <0.001 and r = -0.637) between platelet count and increasing fibroscan score (F1, F2) and a significant positive correlation between fibroscan score and AST (pvalue <0.001 and r=0.623), ALT (p-value <0.001 and r=0.596), fibroscan result and APRI (p-value < 0.001 and r=0.771) and fibroscan scores and AST/ALT ratio (p-value= 0.037 and r=0.243). One third of the study subjects had fibrosis in early and relatively advanced stages (F1, F2 respectively) correlating with serum and blood markers.
 Conclusion: Early fibro scan testing and serum markers can help in early diagnosis and timely initiation of treatment.