The gamma-glutamyl transpeptidase to platelet ratio for non-invasive assessment of liver fibrosis in patients with chronic hepatitis B and non-alcoholic fatty liver disease

// Qiang Li 1, 2 , Chuan Lu 1 , Weixia Li 1 , Yuxian Huang 1, 2 , Liang Chen 1 1 Department of Hepatitis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China 2 Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China Correspondence to: Liang Chen , email: chenliang@shaphc.org Qiang Li, email: liqiang66601@163.com Keywords: chronic hepatitis B, non-alcoholic fatty liver disease, gamma-glutamyl transpeptidase-to-platelet ratio, liver fibrosis, non-invasive marker Received: February 10, 2017 Accepted: March 04, 2017 Published: March 13, 2017 ABSTRACT Background/Aim: The gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a novel serum model, which was reported more accurate than aspartate transaminase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) for diagnosing significant fibrosis and cirrhosis in HBV mono-infection in West Africa. We aimed to evaluate the diagnostic performance of GPR for liver fibrosis in patients with chronic hepatitis B (CHB) and non-alcoholic fatty liver disease (NAFLD). Results: Of 131 patients, 41 (31.3%), 20 (15.3%), and 10 (7.6%) were classified as having significant fibrosis, severe fibrosis and cirrhosis, respectively. To predict significant fibrosis, the AUROC of GPR was higher than that of APRI (0.86 vs 0.75, p = 0.001) and FIB-4 (0.86 vs 0.66, p < 0.001). To predict severe fibrosis, the AUROC of GPR was also higher than that of APRI (0.89 vs 0.77, p = 0.002) and FIB-4 (0.89 vs 0.72, p = 0.001). To predict cirrhosis, no difference was found between the AUROC of GPR and that of APRI (0.92 vs 0.86, p = 0.104). Materials and Methods: 131 patients with CHB-NAFLD were included, and the diagnostic performances of GPR, APRI and FIB-4 were compared by receiver operating characteristic (ROC) curves and the area under ROC curves (AUROCs). Conclusions: The GPR could be used as a non-invasive marker to predict liver fibrosis and cirrhosis in CHB-NAFLD individuals.