The Gama-Glutamyl Transpeptidase to Platelet Ratio for Noninvasive Assessment of Liver Fibrosis in Patients With Chronic Liver Disease

Background & Aims: Chronic liver disease (CLD) progression is marked by liver brosis, traditionally assessed via invasive biopsy. This study evaluated the diagnostic accuracy of the non-invasive gammaglutamyl transpeptidase-to-platelet ratio (GPR) compared to established indices (APRI, FIB-4) for brosis staging in CLD patients. Methods: A prospective observational study of 100 CLD patients (viral hepatitis, NAFLD, alcohol-related) was conducted. GPR, APRI, and FIB-4 were calculated using laboratory data. Diagnostic performance was assessed via ROC curve analysis (AUROC), sensitivity, specicity, and predictive values, with liver biopsy as the reference standard. Results: GPR outperformed APRI and FIB-4, with AUROCs of 0.88 (signicant brosis, F2-F3) and 0.91 (advanced brosis, F4). Optimal cutoffs: >0.32 (F2-F3; sensitivity 87%, specicity 83%), >0.55 (F4; sensitivity 90%, specicity 88%). Strong correlations: Platelet count inversely (r=−0.69) and GGT positively (r=0.66) linked to brosis stage (p<0.01). Subgroup analyses conrmed consistency across etiologies (HBV, HCV, NAFLD) and demographics (age, gender). Conclusions: GPR is a superior noninvasive biomarker for liver brosis staging, offering high accuracy, accessibility, and cost-effectiveness. Its integration into clinical practice could reduce biopsy dependence, enabling early intervention and improved CLD management. Further validation in larger cohorts is warranted.