The gamma-glutamyl transpeptidase to platelet ratio (GPR) shows poor correlation with transient elastography measurements of liver fibrosis in HIV-positive patients with chronic hepatitis B in West Africa. Response to: ‘The gamma-glutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa’ by Lemoineet al

Background & Aims: The gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR), the gamma-glutamyl transpeptidase to albumin (GAR) and S-index are novel biomarkers suggested to assess liver fibrosis. The aim of the work was to assess the correlation between GGT and other related markers as GAR and GPR among other previous documented markers and the degree of fibrosis and steatosis in chronic HBV Egyptian patients as measured by fibroscan. Materials And Methods: After ethical approval of the protocol, a total of 170 chronic HBV patients were recruited from tropical medicine department, Tanta University. They underwent fibroscan examination for fibrosis and steatosis measurement with concomitant testing of liver functions and complete blood picture. Proposed serum markers were calculated. The relation between these ratios with the fibrosis and steatosis measured by fibroscan were tested using Pearson rank correlation. Results: There was a highly significant positive correlation between gamma-glutamyl transpeptidase and platelet ratio (GPR), GAR, GGT, Fib4, APRI and fibrosis (p=<0.001, <0.001,<0.001,<0.001,0.011 and <0.001 respectively), while there was no correlation with the degree of steatosis (p=0.922,0.66,0.936,0.214,0.591 and 0.760 respectively). Also these markers were significantly higher in patients with higher grades of fibrosis (f2-4) (p= 0.007,0.013,<0.001,0.018,0.029,and 0.002 respectively), they also showed high sensitivity and low specificity in detecting higher grades of fibrosis with no statistically significant difference between the AUC of GPR and GAR (p=0.89). Conclusion: Noninvasive serum markers including GGT, GPR, GAR, Fib4, APRI, and S-index are positively correlated to the degree of fibrosis in CHB patients with high sensitivity and low specificity. They were good negative tests for diagnosis of significant fibrosis.

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Gamma-Glutamyl Transpeptidase-to-Platelet Ratio Predicts Significant Liver Fibrosis of Chronic Hepatitis B Patients in China

Gastroenterology Research and Practice ◽

10.1155/2017/7089702 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Tianyi Ren ◽

Huan Wang ◽

Ruihong Wu ◽

Junqi Niu

Keyword(s):

Liver Fibrosis ◽

Operating Characteristic ◽

Routine Laboratory ◽

Gamma Glutamyl Transpeptidase ◽

Laboratory Marker ◽

Significant Fibrosis ◽

Receiver Operating Characteristic Curves ◽

Treatment Naïve ◽

Glutamyl Transpeptidase ◽

Significant Liver Fibrosis

Background and Aims. We want to investigate whether a novel noninvasive marker is suitable for Chinese CHB patients. Methods. A total of 160 treatment-naïve CHB patients who underwent liver biopsy were enrolled in our study, and we assessed the diagnostic accuracies of GPR, aspartate transaminase-to-platelet ratio index (APRI), and the fibrosis index based on 4 factors (FIB-4) in them. Results. Of these 160 CHB patients, the numbers of F0, F1, F2, F3, and F4 are 34 (21.3%), 62 (38.8%), 18 (11.3%), 24 (15%), and 22 (13.8%), respectively. The area under the receiver operating characteristic curves (AUROC) of GPR for fibrosis (0.77 versus 0.70, P=0.03), significant fibrosis (0.70 versus 0.63, P=0.02), and extensive fibrosis (0.71 versus 0.64, P=0.02) were significantly higher than those of APRI. The AUROCs of GPR and Fib-4 for fibrosis (0.77 versus 0.75, P=0.14), significant fibrosis (0.70 versus 0.70, P=0.22), extensive fibrosis (0.71 versus 0.68, P=0.13), and cirrhosis (0.64 versus 0.67, P=0.24) were comparable. Conclusions. The GPR can be a routine laboratory marker to stage liver fibrosis in patients with CHB in China.

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