Are There any Associations Between RDW and MPV and Noninvasive Fibrosis Scores in Primary Biliary Cirrhosis?

Öz

Background: Primary Biliary Cholangitis (PBC) is a progressive autoimmune disease of unclear etiology that causes destructi-ve inflammation in the intrahepatic bile ducts. Predicting liver fibrosis in these patients is important for the early identification of those who may require transplantation. Our aim is to investigate the role of routinely measured complete blood count parameters—specifically red cell distribution width (RDW) and mean platelet volume (MPV) in predicting liver fibrosis. Materials and Methods: Data from 39 patients diagnosed with PBC, including demographic, hematological, biochemical, and imaging parameters, were retrospectively analyzed. The presence of anti-mitochondrial antibodies was recorded for diag-nostic purposes. To assess the severity of fibrosis, Fibrosis 4 score (FIB-4) and Aspartate Aminotransferase to Platelet Ratio Index (APRI) scores were calculated. Patients were divided into three groups based on FIB-4 (<1.45, 1.45-3.25, and >3.25) and APRI (<0.5, 0.5-1.5, and >1.5) scores, and laboratory parameters were compared. Results: Of the patients included in the study, 37 (94.9%) were female. The mean age was 51.6± 15.5 years. The average FIB-4 score was 1.7 ± 1.3 (range: 0.4–6.2), and the APRI score was 1.0 ± 0.5 (range: 0.1–8.8). Six patients (15.3%) had a FIB-4 score above 3.25 and 5 patients (12.8%) had an APRI score above 1.5. In the comparison based on FIB-4 score, significant differences were found between the groups in age (p=0.041), aspartate transferase (AST) (p=0.005), alanine transferase (ALT) (p=0.004), bilirubin level (p=0.002), and platelet count (p<0.001). However, no significant differences were found in MPV (p=0.159) and RDW (p=0.357). In the comparison based on APRI score, significant differences were found between the groups in AST (p<0.001), ALT (p<0.001), ALP (p=0.009), GGT (p=0.030), and total bilirubin (p<0.001). Similarly, no significant differences were found between the groups in MPV (0.195) and RDW (p=0.369). Conclusions: As a result of our study, we determined that MPV and RDW values are not useful parameters for predicting fibrosis or progression to cirrhosis in patients with PBC.

Anahtar Kelimeler

• Primary Biliary Cirrhosis
• Mean Platelet Volume
• Red Cell Distribution Width
• FIB-4 Score

Primer Biliyer Sirozda RDW ve MPV’nin Noninvaziv Fibrozis Skorları ile İlişkisi Var mıdır?

Öz

Amaç: Primer Biliyer kolanjit (PBK), intrahepatik safra yollarında destrüktif tipte bir inflamasyona neden olan, progresif ve etiyolojisi tam olarak aydınlatılamamış bir otoimmün hastalıktır. Bu hastalarda karaciğerde fibrozisi önceden tahmin etmek transplantasyon ihtiyacı olan hastaları erken belirlemek adına önemlidir. Amacımız tam kan parametrelerinde rutin olarak bakılan Eritrosit dağılım indeksi (RDW) ve ortalama trombosit hacmi (MPV) değerlerinin fibrozisi tahmin etmedeki rolünü araştırmaktır. Materyal ve Metod: PBK tanısı olan 39 hastanın demografik, hematolojik, biyokimyasal ve görüntüleme parametrelerini içeren verileri retrospektif olarak analiz edilmiştir. Anti-mitokondriyal antikorların varlığı tanısal açıdan kaydedilmiştir. Fibrozis şiddetini değerlendirmek için Fibrozis 4 indeksi (FIB-4) ve AST Trombosit oranı indeksi (APRI) skorları kullanıldı. Hastalar FIB-4 (<1.45 olanlar, 1.45-3.25 arası olanlar ve >3.25 olanlar) ve APRI (<0.5 olanlar, 0.5-1.5 arasında olanlar ve >1.5 olalar) skorlarına göre 3 gruba ayrılarak laboratuvar parametreleri açısından karşılaştırmalar yapıldı. Bulgular: Çalışmaya alınan hastaların 37’si (%94.9) kadındı. Hastaların yaş ortalaması 51.6± 15.5 idi. Hastaların ortalama FIB-4 skoru 1.7 ± 1.3 (0.4-6.2 arası), APRI skoru ise 1.0 ± 0.5 (0.1-8.8 arası) idi. Hastaların 6’sının (%15.3) FIB-4 skoru 3.25’in üzerinde, 5’inin de (%12.8) APRI skoru 1.5’in üzerinde idi.FIB-4 skoruna göre yapılan karşılaştırmada yaş (p=0.041), Aspartat Transferaz (AST) (p=0.005), Alanin Transferaz (ALT) (p=0.004), Bilirubin seviyesi (p=0.002) ve Trombosit sayısı (p<0.001) gruplar arasında anlamlı farklılık gösteriyordu. Ancak, MPV (p=0.159) ve RDW (p=0.357) açısından anlamlı bir farklılık saptanmadı. APRI skoruna göre yapılan karşılaştırmada ise; gruplar arasında AST (p<0.001), ALT (p<0.001), ALP (p=0.009), GGT (p=0.030) ve total bilirubin (p<0.001) açısından anlamlı farklılık saptandı. Benzer şekilde, MPV (0.195) ve RDW (p=0.369) açısından gruplar arasında anlamlı farklılık saptanmadı. Sonuç: Araştırmamız sonucunda PBK hastalarında MPV ve RDW değerinin fibrozisi ve siroza gidişi öngörmede faydalı para-metreler olmadığını belirledik.

Anahtar Kelimeler

• Primer Biliyer Siroz
• Ortalama Trombosit Hacmi
• Kırmızı Hücre Dağılımı
• FIB-4 Skoru

Kaynakça

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