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Is mean platelet volume better than other long-used non-invasive parameters in assessing severe fibrosis in patients with chronic hepatitis B?

Year 2021, Volume: 4 Issue: 1, 96 - 102, 21.01.2021
https://doi.org/10.32322/jhsm.840794

Abstract

Background & Aims: This study was aimed to investigating the correlation between the severity of hepatic fibrosis and mean platelet volume (MPV) and comparing the accuracy rate of MPV with that of other long-used non-invasive parameters in predicting severe hepatic fibrosis in patients with chronic hepatitis B (CHB).
Materials and Methods: Ninety-nine patients with CHB were enrolled. The patients were assigned to two groups, based on their hepatic fibrosis scores. Those with scores ranging from 0 to 3 (mild to moderate fibrosis) were assigned to Group 1, and those with scores ranging from 4 to 6 (severe fibrosis) were included in Group 2.
Results: The mean age of the patients was 4213, and 69 (70%) of them were male. Twenty two patients (22%) were in Group 2. Patients in Group 2 displayed significantly lower albumin and platelet count (p<0.001), and significantly higher aspartate aminotransferase-to-platelet ratio index (APRI) and MPV (p<0.001). While the most sensitive (90%) test to show severe fibrosis was MPV at a cut-off value of ≥10 fl, the most specific (95%) test was platelet count at a cut-off value of ≤150x103/mm3. The accuracy rates of albumin, platelet count, MPV, and APRI were 79%, 91%, 90%, and 77%, respectively.
Conclusions: Among the parameters for the detection of severe fibrosis in patients with CHB, the most sensitive test was MPV and the most specific test was platelet count. When assessed for their accuracy rates, it was determined that platelet count was superior to the other parameters.

References

  • Global Hepatitis Report 2017. Geneva: World Health Organization; 2017. Available at: http: //apps.who.int/iris /handle/10665/255016. Accessed October 01, 2020.
  • Karagoz E, Tanoglu A. Clinical usefulness of HBsAg quantification in patients with chronic hepatitis B infection. Hepat Mon 2017; 17(4): e12293.
  • Hyun Kim B, Ray Kim W. Epidemiology of Hepatitis B Virus Infection in the United States. Clin Liver Dis (Hoboken) 2018; 12: 1-4.
  • Konerman MA & Lok AS: Epidemiology, diagnosis, and natural history of hepatitis B. In Sanyal AJ, Boyer TD, Lindor KD & Terrault NA (Eds.), Zakim and Boyer's Hepatology: A textbook of liver disease, 7th edition, Philadelphia; Saunders/Elsevier; 2018: pp. 474-84.
  • Bedossa P, Dargere D, Paradis V: Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology. 2003; 38: 1449-57.
  • Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection. Geneva: World Health Organization; 2015 Mar. PMID: 26225396.
  • Xiao G, Yang J, Yan L. Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: a systemic review and meta-analysis. Hepatology 2015; 61: 292-302.
  • Leroy V, Sturm N, Faure P, et al. Prospective evaluation of FibroTest®, FibroMeter®, and HepaScore® for staging liver fibrosis in chronic hepatitis B: comparison with hepatitis C. J Hepatol 2014; 61: 28-34.
  • Astegiano M, Sapone N, Demarchi B, Rossetti S, Bonardi R, Rizzetto M. Laboratory evaluation of the patient with liver disease. Eur Rev Med Pharmacol Sci 2004; 8: 3-9.
  • Krier M, Ahmed A. The asymptomatic outpatient with abnormal liver function tests. Clin Liver Dis 2009; 13: 167-77.
  • Peck-Radosavljevic M. Thrombocytopenia in chronic liver disease. Liver Int 2017; 37: 778-93.
  • Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators Inflamm 2019; 2019: 9213074.
  • Madan SA, John F, Nonalcholic fatty liver disease and mean platelet volüme: A systemic review and meta-anaysis. J Clin Gastroenterol 2016; 50: 69-74.
  • Abdel-Razik A, Mousa N, Shabana W, et al. A novel model using mean platelet volume and neutrophil to lymphocyte ratio as a marker of nonalcoholic steatohepatitis in NAFLD patients: multicentric study. Eur J Gastroenterol Hepatol 2016; 28: e1-9.
  • Wai CT, Greenson JK, Fontana RJ, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003; 38: 518–26.
  • Ishak KG, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol. 1995, 22: 696-99.
  • Lurie Y, Webb M, Cytter-Kuint R, Shteingart S, Lederkremer GZ. Non-invasive diagnosis of liver fibrosis and cirrhosis. World J Gastroenterol 2015; 21: 11567-83.
  • Lin ZH, Xin YN, Dong QJ, et al. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. Hepatology 2011; 53: 726–36.
  • Shin WG, Park SH, Jang MK, et al. Aspartate aminotransferase to platelet ratio index (APRI) can predict liver fibrosis in chronic hepatitis B. Dig Liver Dis 2008; 40: 267-74.
  • Shoaei SD, Sali S, Karamipour M, Riahi E. Non-invasive histologic markers of liver disease in patients with chronic hepatitis B. Hepat Mon 2014; 14: e14228.
  • Margraf A, Zarbock A. Platelets in Inflammation and Resolution. J Immunol 2019; 203: 2357-67.
  • Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost 2015; 114: 449-58.
  • Milovanovic M, Nilsson E, Järemo P. Relationships between platelets and inflammatory markers in rheumatoid arthritis. Clin Chim Acta 2004; 343: 237-40.
  • Yazici S, Yazici M, Erer B, et al. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets 2010; 21: 122-5.
  • Kisacik B, Tufan A, Kalyoncu U, et al. Mean platelet volüme (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008; 75: 291–94.
  • Yüksel O, Helvaci K, Basar O, et al. An overlooked indicator of disease activity in ulcerative colitis: Mean platelet volume. Platelets 2009; 20: 277–81.
  • Liu S, Ren J, Han G, et al. Mean platelet volume: a controversial marker of disease activity in Crohn'sdisease. Eur J Med Res 2012; 17: 27.
  • Mimidis K, Papadopoulos V, Kotsianidis J, et al. Alterations of platelet function, number and indexes during acute pancreatitis. Pancreatology 2004; 4: 22-7.
  • Turhan O, Coban E, Inan D, Yalcin AN. Increased mean platelet volume in chronic hepatitis B patients with inactive disease. Med Sci Monit 2010; 16: 202–05.
  • Hu Y, Lou Y, Chen Y, Mao W. Evaluation of mean platelet volume in patients with hepatitis B virus infection. Int J Clin Exp Med 2014; 7: 4207-13.
  • Eminler AT, Uslan MI, Ayyildiz T, et al. Mean platelet volume is an important predictor of hepatitis C but not hepatitis B liver damage. J Res Med Sci 2015; 20: 865-70.
  • Hamidi AA, Oncul A, Ozguven BY, et al. Diagnostic accuracy of different noninvasive scores for detecting advanced fibrosis in chronic hepatitis B. Eur J Gastroenterol Hepatol 2019; 31: 1439-43.
  • Ekiz F, Yüksel O, Koçak E, et al. Mean Platelet Volume as a Fibrosis Marker in Patients With Chronic Hepatitis B. Journal of Clinical Laboratory Analysis 2011, 25: 162–65.
  • Karagoz E, Ulcay A, Tanoglu A, et al. Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis B virus patients. Eur J Gastroenterol Hepatol 2014; 26: 1320-4.
  • Ceylan B, Fincancı M, Yardımcı C, et al. Can mean platelet volume determine the severity of liver fibrosis or inflammation in patients with chronic hepatitis B? Eur J Gastroenterol Hepatol 2013, 25: 606–12.
Year 2021, Volume: 4 Issue: 1, 96 - 102, 21.01.2021
https://doi.org/10.32322/jhsm.840794

Abstract

References

  • Global Hepatitis Report 2017. Geneva: World Health Organization; 2017. Available at: http: //apps.who.int/iris /handle/10665/255016. Accessed October 01, 2020.
  • Karagoz E, Tanoglu A. Clinical usefulness of HBsAg quantification in patients with chronic hepatitis B infection. Hepat Mon 2017; 17(4): e12293.
  • Hyun Kim B, Ray Kim W. Epidemiology of Hepatitis B Virus Infection in the United States. Clin Liver Dis (Hoboken) 2018; 12: 1-4.
  • Konerman MA & Lok AS: Epidemiology, diagnosis, and natural history of hepatitis B. In Sanyal AJ, Boyer TD, Lindor KD & Terrault NA (Eds.), Zakim and Boyer's Hepatology: A textbook of liver disease, 7th edition, Philadelphia; Saunders/Elsevier; 2018: pp. 474-84.
  • Bedossa P, Dargere D, Paradis V: Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology. 2003; 38: 1449-57.
  • Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection. Geneva: World Health Organization; 2015 Mar. PMID: 26225396.
  • Xiao G, Yang J, Yan L. Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: a systemic review and meta-analysis. Hepatology 2015; 61: 292-302.
  • Leroy V, Sturm N, Faure P, et al. Prospective evaluation of FibroTest®, FibroMeter®, and HepaScore® for staging liver fibrosis in chronic hepatitis B: comparison with hepatitis C. J Hepatol 2014; 61: 28-34.
  • Astegiano M, Sapone N, Demarchi B, Rossetti S, Bonardi R, Rizzetto M. Laboratory evaluation of the patient with liver disease. Eur Rev Med Pharmacol Sci 2004; 8: 3-9.
  • Krier M, Ahmed A. The asymptomatic outpatient with abnormal liver function tests. Clin Liver Dis 2009; 13: 167-77.
  • Peck-Radosavljevic M. Thrombocytopenia in chronic liver disease. Liver Int 2017; 37: 778-93.
  • Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators Inflamm 2019; 2019: 9213074.
  • Madan SA, John F, Nonalcholic fatty liver disease and mean platelet volüme: A systemic review and meta-anaysis. J Clin Gastroenterol 2016; 50: 69-74.
  • Abdel-Razik A, Mousa N, Shabana W, et al. A novel model using mean platelet volume and neutrophil to lymphocyte ratio as a marker of nonalcoholic steatohepatitis in NAFLD patients: multicentric study. Eur J Gastroenterol Hepatol 2016; 28: e1-9.
  • Wai CT, Greenson JK, Fontana RJ, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003; 38: 518–26.
  • Ishak KG, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol. 1995, 22: 696-99.
  • Lurie Y, Webb M, Cytter-Kuint R, Shteingart S, Lederkremer GZ. Non-invasive diagnosis of liver fibrosis and cirrhosis. World J Gastroenterol 2015; 21: 11567-83.
  • Lin ZH, Xin YN, Dong QJ, et al. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. Hepatology 2011; 53: 726–36.
  • Shin WG, Park SH, Jang MK, et al. Aspartate aminotransferase to platelet ratio index (APRI) can predict liver fibrosis in chronic hepatitis B. Dig Liver Dis 2008; 40: 267-74.
  • Shoaei SD, Sali S, Karamipour M, Riahi E. Non-invasive histologic markers of liver disease in patients with chronic hepatitis B. Hepat Mon 2014; 14: e14228.
  • Margraf A, Zarbock A. Platelets in Inflammation and Resolution. J Immunol 2019; 203: 2357-67.
  • Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost 2015; 114: 449-58.
  • Milovanovic M, Nilsson E, Järemo P. Relationships between platelets and inflammatory markers in rheumatoid arthritis. Clin Chim Acta 2004; 343: 237-40.
  • Yazici S, Yazici M, Erer B, et al. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets 2010; 21: 122-5.
  • Kisacik B, Tufan A, Kalyoncu U, et al. Mean platelet volüme (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008; 75: 291–94.
  • Yüksel O, Helvaci K, Basar O, et al. An overlooked indicator of disease activity in ulcerative colitis: Mean platelet volume. Platelets 2009; 20: 277–81.
  • Liu S, Ren J, Han G, et al. Mean platelet volume: a controversial marker of disease activity in Crohn'sdisease. Eur J Med Res 2012; 17: 27.
  • Mimidis K, Papadopoulos V, Kotsianidis J, et al. Alterations of platelet function, number and indexes during acute pancreatitis. Pancreatology 2004; 4: 22-7.
  • Turhan O, Coban E, Inan D, Yalcin AN. Increased mean platelet volume in chronic hepatitis B patients with inactive disease. Med Sci Monit 2010; 16: 202–05.
  • Hu Y, Lou Y, Chen Y, Mao W. Evaluation of mean platelet volume in patients with hepatitis B virus infection. Int J Clin Exp Med 2014; 7: 4207-13.
  • Eminler AT, Uslan MI, Ayyildiz T, et al. Mean platelet volume is an important predictor of hepatitis C but not hepatitis B liver damage. J Res Med Sci 2015; 20: 865-70.
  • Hamidi AA, Oncul A, Ozguven BY, et al. Diagnostic accuracy of different noninvasive scores for detecting advanced fibrosis in chronic hepatitis B. Eur J Gastroenterol Hepatol 2019; 31: 1439-43.
  • Ekiz F, Yüksel O, Koçak E, et al. Mean Platelet Volume as a Fibrosis Marker in Patients With Chronic Hepatitis B. Journal of Clinical Laboratory Analysis 2011, 25: 162–65.
  • Karagoz E, Ulcay A, Tanoglu A, et al. Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis B virus patients. Eur J Gastroenterol Hepatol 2014; 26: 1320-4.
  • Ceylan B, Fincancı M, Yardımcı C, et al. Can mean platelet volume determine the severity of liver fibrosis or inflammation in patients with chronic hepatitis B? Eur J Gastroenterol Hepatol 2013, 25: 606–12.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Mustafa Akar 0000-0002-5589-2849

Publication Date January 21, 2021
Published in Issue Year 2021 Volume: 4 Issue: 1

Cite

AMA Akar M. Is mean platelet volume better than other long-used non-invasive parameters in assessing severe fibrosis in patients with chronic hepatitis B?. J Health Sci Med / JHSM. January 2021;4(1):96-102. doi:10.32322/jhsm.840794

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