Open AccessRed cell distribution width to platelet ratio predicts liver fibrosis in patients with autoimmune hepatitis
Author(s) -
Huali Wang,
Jian Wang,
Juan Xia,
Xiaomin Yan,
Yu Feng,
Lin Li,
Jun Chen,
Duxian Liu,
Weimao Ding,
Yue Yang,
Rui Huang,
Chao Wu
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000021408
Subject(s) - medicine , interquartile range , gastroenterology , receiver operating characteristic , fibrosis , autoimmune hepatitis , cirrhosis , liver biopsy , red blood cell distribution width , confidence interval , aspartate transaminase , liver fibrosis , biopsy , hepatitis , alkaline phosphatase , biochemistry , chemistry , enzyme
Noninvasive tests for the assessment of liver fibrosis are highly needed for the management of patients with autoimmune hepatitis (AIH). We aimed to investigate the accuracy of red cell distribution width to platelet ratio (RPR) in predicting liver fibrosis in AIH patients. One hundred nineteen AIH patients who underwent liver biopsy were enrolled. Liver fibrosis stage was diagnosed using the Scheuer scoring system. The diagnostic accuracy was evaluated by the area under the receiver operating characteristic curve (AUROC). RPR values in AIH patients with S2-S4 (0.10, interquartile range [IQR] 0.08–0.15), S3-S4 (0.10, IQR 0.09–0.14), and S4 (0.14, IQR 0.09–0.19) were significantly higher than patients with S0-S1 (0.07, IQR 0.06–0.08, P < .001), S0-S2 (0.08, IQR 0.06–0.12, P = .025) and S0-S3 (0.09, IQR 0.07–0.13, P = .014), respectively. The RPR was positively correlated with fibrosis stages ( r = 0.412, P < .001), while aspartate transaminase to platelet ratio index (APRI) and fibrosis-4 score (FIB-4) were not significantly associated with fibrosis stages in AIH patients. The AUROCs of RPR in identifying significant fibrosis (S2-S4), advanced fibrosis (S3-S4), and cirrhosis (S4) were 0.780 (95% confidence interval [CI] 0.696–0.865), 0.639 (95% CI 0.530–0.748), and 0.724 (95% CI 0.570–0.878), respectively. The AUROCs of RPR were significantly higher than APRI and FIB-4 in diagnosing significant fibrosis, advanced fibrosis, and cirrhosis. Our study demonstrates that the RPR is a simple predictor of liver fibrosis and is superior to APRI and FIB-4 in identifying liver fibrosis in AIH patients.