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Correlation Between Liver Fibrosis and Mean Platelet Volume in Autoimmune Hepatitis Patients

Year 2020, Volume: 10 Issue: 4, 615 - 622, 15.12.2020
https://doi.org/10.31832/smj.752361

Abstract

Objective: This study was carried out in order to assess the usability of platelet parameters and other biochemical values as predictive parameters in the evaluation of hepatic damage in autoimmune hepatitis (AIH) patients.
Materials and Methods: We devised a retrospective descriptive and methodological study of cross-sectional type over the histological findings, laboratory and clinical parameters of AIH patients at our gastroenterology clinic. As per the analysis carried out using the scoring classification, the patients with a histological activity index (HAI) of 0-12 were identified as low activity, and the patients with a HAI of 13-18 as high activity. The patients with a fibrosis score of 0-2 were identified as early fibrosis, while those having a fibrosis score of 3-6 were identified as advanced fibrosis, and comparisons were made accordingly.
Results: In patients with AIH, the levels of mean platelet volume (MPV) in the group showing high HAI scores were found to be higher compared to the group showing low activity (p=0.013). There was a statistically significant difference in terms of MPV levels between the fibrosis classes in patients with AIH (p=0.034). When the values of the areas below the ROC curve as well as the sensitivity and specificity of the MPV measurements were analyzed with regard to distinguishing the patients with AIH that were at high activity levels in the HAI classification and the patients at the advanced fibrosis level as per the fibrosis classification, they were found to be statistically significant.
Discussion: A positive correlation was found when the MPV values of the patients with AIH were compared to the group showing a high activity as per the HAI classification. A positive correlation was found when the MPV values in the patients with AIH were compared to the group showing advanced fibrosis as per the fibrosis classification.

References

  • 1. Akbayır N. Autoimmun Hepatitis. Maltepe Medical J 2019;12:55-67.
  • 2. Werner M, Prytz H, Ohlsson B, Almer S, Björnsson E, Bergquist A, et al. Epidemiology and the initial presentation of autoimmune hepatitis in Sweden: a nationwide study. Scand J Gastroenterol 2008;43:1232-40.
  • 3. Mieli-Vergani G, Vergani D, Czaja AJ, Manns MP, Krawitt EL, Vierling JM, et al. Autoimmune hepatitis. Nat Rev Dis Primers 2018;4:18017.
  • 4. Sebode M, Hartl J, Vergani D, Lohse AW. International Autoimmune Hepatitis Group (IAIHG). Autoimmune hepatitis: From current knowledge and clinical practice to future research agenda. Liver Int 2018;38:15-22.
  • 5. Adiga A, Nugent K. Lupus Hepatitis and Autoimmune Hepatitis (Lupoid Hepatitis). Am J Med Sci 2017;353:329-335.
  • 6. Zeremski M, Dimova RB, Benjamin S. FibroSURE as a noninvasive marker of liver fibrosis and inflammation in chronic hepatitis B. BMC Gastroenterol 2014;14:118-119.
  • 7. Zorlu Ç. Mean Platelet Volume and Coronary Artery Ectasia. Sakarya Med J 2020;10(2):225-230.
  • 8. Eğilmez OK, Güven M, Yılmaz MS, Demir D, Çelik B. NRL, PLR, ELR, MPV ve Efüzyonlu Otitis Media. Sakarya Tıp Dergisi 2019;9(2):297-301.
  • 9. Czaja AJ. Evolving paradigm of treatment for autoimmune hepatitis. Expert Rev Clin Immunol 2017;13:781-798.
  • 10. Pape S, Schramm C, Gevers TJ. Clinical Management of Autoimmune Hepatitis. United European Gastroenterol J 2019;7:1156-1163.
  • 11. Şahpaz F, Ulutaş FT. Assessment of mean platelet volume in type 2 diabetics receiving insulin or oral antidiabetic agents. Dicle Medical J 2015;42:399-403.
  • 12. Kowara M, Grodecki K, Huczek Z, Puchta D, Paczwa K. Platelet distribution width predicts left ventricular dysfunction in patients with acute coronary syndromes treated with percutaneous coronary intervention. Kardiol Pol 2017;75:42–47.
  • 13. Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. The significance of the platelet distribution width as a severity marker for the development of preeclampsia. Eur J Obstet Gynecol Reprod Biol 2014;175:107–11.
  • 14. Dinc B, Oskay A, Dinc SE, Bas B, Tekin S. New parameter in the diagnosis of acute appendicitis: platelet distribution width. World J Gastroenterol 2015;21:1821–26.
  • 15. Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75:291–294.
  • 16. Kapsoritakis AN, Koukourakis MI, Sfiridaki A, Potamianos SP, Kosmadaki MG. Mean platelet volume: A useful marker of inflammatory bowel disease activity. Am J Gastroenterol 2001;96:776–781.
  • 17. Jaremo P, Sandberg-Gertzen H. Platelet density and size in inflammatory bowel disease. Thromb Haemost 1996;75:560–561.
  • 18. Celikbilek M, Baskol M, Taheri S, Deniz K, Dogan S, Zararsiz G, et al. Circulating microRNAs in patients with non-alcoholic fatty liver disease. World J Hepatol 2014;6:613-620.
  • 19. Eminler AT, Uslan Mİ, Ayyildiz T, Irak K, Kiyici M, Gurel S, et al. Mean platelet volume is an important predictor of hepatitis C but not hepatitis B liver damage. J Res Med Sci 2015;20:865-870.
  • 20. Beyazit Y, Sayilir A, Torun S, Suvak B, Yesil Y, Purnak T, et al. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol 2012;36:162-8.
  • 21. Purnak T, Ölmez Ş, Torun S, Efe C, Sayilir A, Ozaslan E, et al. Mean platelet volume is increased in chronic hepatitis C patients with advanced fibrosis Clinics and Research in Hepatology and Gastroenterology 2013;37:41-46.
  • 22. Alvarez F, Berg PA, Bianchi FB, L Bianchi, Burroughs AK, Cancado EL, et al. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol 1999;31:929–938.
  • 23. Hennes EM, Zeniya M, Czaja AJ, Parés A, Dalekos GN, Krawitt EL, et al. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology 2008;48:169–176.
  • 24. Helmreich-Becker I, Lohse AW. Minilaparoskopie in der Leberdiagnostik Ein Vorteil? Z Gastroenterol 2001;39:7–9.
  • 25. Anastasiou J, Alisa A, Virtue S, Portmann B, Murray-Lyon I, Williams R. Noninvasive markers of fibrosis and inflammation in clinical practice: prospective comparison with liver biopsy. Eur J Gastroenterol Hepatol 2010;22:474–480.
  • 26. Gutkowski K, Hartleb M, Kacperek-Hartleb T, Kajor M, Mazur W, Zych W, et al. Laboratory-based scoring system for prediction of hepatic inflammatory activity in patients with autoimmune hepatitis. Liver Int 2013;33:1370–1377.
  • 27. Abdel-Razik A, Mousa N, Zakaria S, Elhelaly R, Elzehery R, Zalata K, et al. New predictive factors of poor response to therapy in autoimmune hepatitis: role of mean platelet volüme. Eur J Gastroenterol Hepatol 2017;29:1373-1379.

Otoimmün Hepatit Hastalarında Karaciğer Fibrozisi ile Ortalama Trombosit Hacmi Arasındaki Korelasyon

Year 2020, Volume: 10 Issue: 4, 615 - 622, 15.12.2020
https://doi.org/10.31832/smj.752361

Abstract

Giriş: Bu çalışma trombosit parametreleri ve diğer biyokimyasal değerlerin otoimmün hepatit (OH) hastalarında karaciğer hasarının değerlendirilmesinde prediktif bir parametre olarak kullanılabilirliğini değerlendirmek amacıyla yapıldı.
Gereç ve Yöntemler: Gastroenteroloji kliniğimizde OH hastalarının histolojik bulguları laboratuvar ve klinik parametreleri üzerinden retrospektif kesitsel tipte tanımlayıcı ve metodolojik bir çalışma planladık. Skorlama sınıflamasıyla yapılan değerlendirmeye göre, 0 ile 12 arasında histolojik aktivite indeksi (HAI) olan hastalar düşük aktivite, 13 ile 18 arasında HAI olan hastalar yüksek aktivite olarak tanımlandı. Fibrozis skoru 0-2 olan hastalar erken fibrozis, fibrozis skoru 3 ile 6 arasında olanlar ileri fibrozis olarak tanımlanmış ve buna göre karşılaştırmalar yapılmıştır.
Bulgular: Otoimmün hepatitli hastalarda HAI skoru yüksek aktivite gösteren grupta ortalama trombosit hacmi (MPV) düzeyleri düşük aktivite gösteren gruba göre daha yüksek saptanmıştır (p=0,013). Otoimmün hepatitli hastalarda fibrozis sınıfları arasında MPV düzeyleri açısından istatistiksel olarak anlamlı bir fark saptanmıştır (p=0,034). Otoimmün hepatitli hastalarda HAI sınıflamasında yüksek aktivite ve fibrozis sınıflamasına göre ileri fibrozis düzeyinde olan hastaları ayırt etmede MPV ölçümlerinin ROC eğrisi altında kalan alan değerleri, sensitivite ve spesifitesi incelendiğinde istatistiksel olarak anlamlı olduğu saptanmıştır.
Tartışma: Otoimmün hepatitli hastalarda MPV değerlerinin HAI sınıflamasına göre yüksek aktivite gösteren grup ile karşılaştırıldığında pozitif korelasyon saptanmıştır. Otoimmün hepatitli hastalarda MPV değerlerinin fibrozis sınıflamasına göre ileri fibrozis gösteren grup ile karşılaştırıldığında pozitif korelasyon saptanmıştır.

References

  • 1. Akbayır N. Autoimmun Hepatitis. Maltepe Medical J 2019;12:55-67.
  • 2. Werner M, Prytz H, Ohlsson B, Almer S, Björnsson E, Bergquist A, et al. Epidemiology and the initial presentation of autoimmune hepatitis in Sweden: a nationwide study. Scand J Gastroenterol 2008;43:1232-40.
  • 3. Mieli-Vergani G, Vergani D, Czaja AJ, Manns MP, Krawitt EL, Vierling JM, et al. Autoimmune hepatitis. Nat Rev Dis Primers 2018;4:18017.
  • 4. Sebode M, Hartl J, Vergani D, Lohse AW. International Autoimmune Hepatitis Group (IAIHG). Autoimmune hepatitis: From current knowledge and clinical practice to future research agenda. Liver Int 2018;38:15-22.
  • 5. Adiga A, Nugent K. Lupus Hepatitis and Autoimmune Hepatitis (Lupoid Hepatitis). Am J Med Sci 2017;353:329-335.
  • 6. Zeremski M, Dimova RB, Benjamin S. FibroSURE as a noninvasive marker of liver fibrosis and inflammation in chronic hepatitis B. BMC Gastroenterol 2014;14:118-119.
  • 7. Zorlu Ç. Mean Platelet Volume and Coronary Artery Ectasia. Sakarya Med J 2020;10(2):225-230.
  • 8. Eğilmez OK, Güven M, Yılmaz MS, Demir D, Çelik B. NRL, PLR, ELR, MPV ve Efüzyonlu Otitis Media. Sakarya Tıp Dergisi 2019;9(2):297-301.
  • 9. Czaja AJ. Evolving paradigm of treatment for autoimmune hepatitis. Expert Rev Clin Immunol 2017;13:781-798.
  • 10. Pape S, Schramm C, Gevers TJ. Clinical Management of Autoimmune Hepatitis. United European Gastroenterol J 2019;7:1156-1163.
  • 11. Şahpaz F, Ulutaş FT. Assessment of mean platelet volume in type 2 diabetics receiving insulin or oral antidiabetic agents. Dicle Medical J 2015;42:399-403.
  • 12. Kowara M, Grodecki K, Huczek Z, Puchta D, Paczwa K. Platelet distribution width predicts left ventricular dysfunction in patients with acute coronary syndromes treated with percutaneous coronary intervention. Kardiol Pol 2017;75:42–47.
  • 13. Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. The significance of the platelet distribution width as a severity marker for the development of preeclampsia. Eur J Obstet Gynecol Reprod Biol 2014;175:107–11.
  • 14. Dinc B, Oskay A, Dinc SE, Bas B, Tekin S. New parameter in the diagnosis of acute appendicitis: platelet distribution width. World J Gastroenterol 2015;21:1821–26.
  • 15. Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75:291–294.
  • 16. Kapsoritakis AN, Koukourakis MI, Sfiridaki A, Potamianos SP, Kosmadaki MG. Mean platelet volume: A useful marker of inflammatory bowel disease activity. Am J Gastroenterol 2001;96:776–781.
  • 17. Jaremo P, Sandberg-Gertzen H. Platelet density and size in inflammatory bowel disease. Thromb Haemost 1996;75:560–561.
  • 18. Celikbilek M, Baskol M, Taheri S, Deniz K, Dogan S, Zararsiz G, et al. Circulating microRNAs in patients with non-alcoholic fatty liver disease. World J Hepatol 2014;6:613-620.
  • 19. Eminler AT, Uslan Mİ, Ayyildiz T, Irak K, Kiyici M, Gurel S, et al. Mean platelet volume is an important predictor of hepatitis C but not hepatitis B liver damage. J Res Med Sci 2015;20:865-870.
  • 20. Beyazit Y, Sayilir A, Torun S, Suvak B, Yesil Y, Purnak T, et al. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol 2012;36:162-8.
  • 21. Purnak T, Ölmez Ş, Torun S, Efe C, Sayilir A, Ozaslan E, et al. Mean platelet volume is increased in chronic hepatitis C patients with advanced fibrosis Clinics and Research in Hepatology and Gastroenterology 2013;37:41-46.
  • 22. Alvarez F, Berg PA, Bianchi FB, L Bianchi, Burroughs AK, Cancado EL, et al. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol 1999;31:929–938.
  • 23. Hennes EM, Zeniya M, Czaja AJ, Parés A, Dalekos GN, Krawitt EL, et al. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology 2008;48:169–176.
  • 24. Helmreich-Becker I, Lohse AW. Minilaparoskopie in der Leberdiagnostik Ein Vorteil? Z Gastroenterol 2001;39:7–9.
  • 25. Anastasiou J, Alisa A, Virtue S, Portmann B, Murray-Lyon I, Williams R. Noninvasive markers of fibrosis and inflammation in clinical practice: prospective comparison with liver biopsy. Eur J Gastroenterol Hepatol 2010;22:474–480.
  • 26. Gutkowski K, Hartleb M, Kacperek-Hartleb T, Kajor M, Mazur W, Zych W, et al. Laboratory-based scoring system for prediction of hepatic inflammatory activity in patients with autoimmune hepatitis. Liver Int 2013;33:1370–1377.
  • 27. Abdel-Razik A, Mousa N, Zakaria S, Elhelaly R, Elzehery R, Zalata K, et al. New predictive factors of poor response to therapy in autoimmune hepatitis: role of mean platelet volüme. Eur J Gastroenterol Hepatol 2017;29:1373-1379.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Mehmet Nur Kaya 0000-0003-4368-3078

Ali Kırık 0000-0002-7968-1229

Mehmet İçli 0000-0002-7857-6902

Ayla Yıldız 0000-0002-7968-1229

Ömer Toprak 0000-0002-2865-1687

Publication Date December 15, 2020
Submission Date June 13, 2020
Published in Issue Year 2020 Volume: 10 Issue: 4

Cite

AMA Kaya MN, Kırık A, İçli M, Yıldız A, Toprak Ö. Otoimmün Hepatit Hastalarında Karaciğer Fibrozisi ile Ortalama Trombosit Hacmi Arasındaki Korelasyon. Sakarya Tıp Dergisi. December 2020;10(4):615-622. doi:10.31832/smj.752361

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