Abstract
The aim of this study was to evaluate the diagnostic values of noninvasive indirect markers of liver fibrosis: APRI, GAPRI, Forns, FIB-4, Age-Platelet, and Hepascore in alcoholics. Blood samples were collected from a randomized group of 142 alcohol-dependent patients. The diagnosis of dependency was made according to the ICD-10 WHO criteria. The values of noninvasive markers were calculated with specific algorithms. The fibrosis stage was evaluated on the basis of FibroTest. The values of APRI, Forns, FIB-4, GAPRI, AP, and Hepascore differ between various stages of liver fibrosis. Patients with fibrosis stage F0 present lower values of APRI, Forns, FIB-4, GAPRI, and Hepascore in comparison to the patients with stages F1 and F0-F1. Patients with fibrosis stages < F2 have lower values of all noninvasive markers than patients with stages ≥F2. Patients with fibrosis stages ≥F2 but <F4 have lower values of APRI, Forns, FIB-4, GAPRI, and Hepascore than patients with stage F4. The values of noninvasive markers tested here differ in various stages of liver fibrosis. To our surprise, the patented marker, Hepascore, achieves a lower diagnostic value in alcoholics than simple markers involving only liver enzymes, platelet count, and cholesterol. The best marker of liver fibrosis in alcoholic patients seems to be the Forns index.
Highlights
Liver diseases induced by excessive alcohol consumption are an important cause of morbidity and mortality worldwide
The patients did not undergo the liver biopsy, and fibrosis stage was established in FibroTest which was used as the reference standard
The values of APRI, Forns, FIB-4, GAPRI, AP, and Hepascore differed between the stages of liver fibrosis (ANOVA rank Kruskal-Wallis test: H=30.902, P
Summary
Liver diseases induced by excessive alcohol consumption are an important cause of morbidity and mortality worldwide. We will follow the work of Thiele et al who compared the accuracy of 10 liver fibrosis markers (patented or not) in patients with alcoholic liver diseases [9]. According to these results, the receiver operating characteristic curve (AUROC) of two tests—ELF and FibroTest—for advanced fibrosis (≥F3) reached and exceeded the value of 0.9. Taking into account the fact that, among others, these two tests exhibited the highest diagnostic power for identification of alcoholic patients with advanced liver fibrosis, we have treated the FibroTest as a matrix for comparing the diagnostic values of five nonpatented, noninvasive indirect markers of liver fibrosis: APRI, GAPRI, Forns, FIB-4, Age-Platelet (AP), and one patented algorithm, Hepascore, in alcoholics. According to our previous published work, BioMed Research International the relative values of CDT are affected by liver diseases and reflected the severity of liver dysfunction [11]
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