Serum Gamma-Glutamyl Transpeptidase-to-Platelet Ratio as a Noninvasive Marker of Liver Fibrosis in Chronic Hepatitis B.

Abstract

Background The gamma-glutamyl transpeptidase (GGT)-to-platelet ratio (GPR) is identified as a new model for the assessment of liver fibrosis in patients with chronic hepatitis B (CHB). We aimed to determine the diagnostic performance of GPR for the prediction of liver fibrosis in patients with CHB. Methods In an observational cohort study, patients with CHB were enrolled. The diagnostic performance of GPR was compared with transient elastography (TE), aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) scores for the prediction of liver fibrosisusing liver histology as a gold standard. Results Forty-eight patients with CHB with a mean age of 33.42 ± 15.72years were enrolled. Liver histology showed meta-analysis of histological data in viral hepatitis (METAVIR) stage F0, F1, F2, F3, and F4 fibrosis in 11, 12, 11, seven, and seven patients, respectively. The Spearman correlation of METAVIR fibrosis stage with APRI, FIB-4, GPR, and TE were 0.354, 0.402, 0.551, and 0.726, respectively (P value < 0.05). TE had the highest sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) (80%, 83%, 83%, and 79%, respectively), followed by GPR (76%, 65%, 70%, and 71%, respectively) for predicting significant fibrosis (≥F2). However, TE had comparable sensitivity, specificity, PPV, and NPV with GPR (86%, 82%, 42%, and 93%, and 86%, 71%, 42%, and 92%, respectively) for predicting extensive fibrosis (≥F3). Conclusion The performance of GPR is comparable to TE in predicting significant and extensive liver fibrosis. GPR may be an acceptable, low-cost alternative for predicting compensated advanced chronic liver disease (cACLD) (F3-F4) in CHB patients.