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

Yıl 2025, Cilt: 22 Sayı: 3, 567 - 572, 29.09.2025
https://doi.org/10.35440/hutfd.1654188

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.

Etik Beyan

This study received approval from the Clinical Research Ethics Committee of Gazi Yaşargil Training and Research Hospital, decision number 244, dated November 25, 2022.

Proje Numarası

244

Kaynakça

  • 1. Flores A, Mayo MJ. Primary biliary cirrhosis in 2014. Curr Opin Gastroenterol. 2014;30(3):245-52.
  • 2. Tahtaci M, Yurekli OT, Bolat AD, Balci S, Akin FE, Buyukasik NS, et al. Increased mean platelet volume is related to histologic severity of primary biliary cirrhosis. Eur J Gastroenterol Hepatol. 2015 Dec;27(12):1382-5.
  • 3. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med. 2012;44(8):805-16.
  • 4. Celikbilek M, Gursoy S, Deniz K, Karaman A, Zararsiz G, Yurci A. Mean platelet volume in biopsy-proven non-alcoholic fatty liver disease. Platelets. 2013;24(3):194-9.
  • 5. Qi XT, Wan F, Lou Y, Ye B, Wu D. The mean platelet volume is a potential biomarker for cirrhosis in chronic hepatitis B virus-infected patients. Hepatogastroenterology. 2014;61(129):456-9.
  • 6. Hu Z, Sun Y, Wang Q, Han Z, Huang Y, Liu X, et al. Red blood cell distribution width is a potential prognostic index for liver disease. Clin Chem Lab Med. 2013;51(7):1403-8.
  • 7. Aslam H, Oza F, Ahmed K, Kopel J, Aloysius MM, Ali A, et al. The role of red cell distribution width as a prognostic marker in chronic liver disease: a literature review. Int J Mol Sci. 2023 Feb 9;24(4):3487.
  • 8. Sharma S, Khalili K, Nguyen GC. Non-invasive diagnosis of advanced fibrosis and cirrhosis. World J Gastroenterol. 2014;20(45):16820-30.
  • 9. Poynard T, Ngo Y, Perazzo H, Munteanu M, Lebray P, Moussalli J, et al. Prognostic value of liver fibrosis biomarkers: a meta-analysis. Gastroenterol Hepatol (N Y). 2011 Jul;7(7):445-54.
  • 10. Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006;43(6):1317-25.
  • 11. Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003 Aug;38(2):518-26.
  • 12. Mitchison HC, Bassendine MF, Hendrick A, Bennett MK, Bird G, Watson A, et al. Positive antimitochondrial antibody but normal alkaline phosphatase: is this primary biliary cirrhosis? Hepatology. 1986;6(6):1279-84.
  • 13. Smith SH. Using albumin and prealbumin to assess nutritional status. Nursing. 2017;47(4):65-6. doi: 10.1097/01.NURSE.0000482276.77845.44.
  • 14. Kim BK, Kim DY, Park JY, Ahn SH, Chon CY, Han KH, et al. Validation of FIB-4 and comparison with other simple non-invasive indices for predicting liver fibrosis and cirrhosis in hepatitis B virus-infected patients. Liver Int. 2010;30(4):546-53. doi: 10.1111/j.1478-3231.2009.02192.x.
  • 15. Rinella ME, Sanyal AJ. Management of NAFLD: a stage-based approach. Nat Rev Gastroenterol Hepatol. 2016;13(4):196-205.
  • 16. Dulai PS, Singh S, Patel J, Soni M, Prokop LJ, Younossi Z, et al. Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis. Hepatology. 2017;65(5):1557-65.
  • 17. Chrostek L, Przekop D, Gruszewska E, Gudowska-Sawczuk M, Cylwik B. Noninvasive indirect markers of liver fibrosis in alcoholics. Biomed Res Int. 2019;2019:3646975. doi: 10.1155/2019/3646975.18. Guller BY, Gulumsek E, Sumbul HE, Avci BS, Tas A. RDW Predicts Fibrosis in Patients with Chronic Hepatitis B Having Persistently Normal ALT Levels. Ethiop J Health Sci. 2023;33(4):591-600.
  • 18. 18. Guller BY, Gulumsek E, Sumbul HE, Avci BS, Tas A. RDW predicts fibrosis in patients with chronic hepatitis B having persistently normal ALT levels. Ethiop J Health Sci. 2023;33(4):591-600.
  • 19. Chen B, Ye B, Zhang J, Ying L, Chen Y. RDW to platelet ratio: a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B. PLoS One. 2013;8(7):e68780.
  • 20. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. J Hepatol. 2017;67(1):145-72.
  • 21. Chen B, Ye B, Zhang J, Ying L, Chen Y. RDW to platelet ratio: a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B. PLoS One. 2013;8(7):e68780.
  • 22. Wang D, Zhang P, Zhang M, Wang L. Red cell distribution width to platelet ratio predicts liver fibrosis in autoimmune hepatitis. Medicine (Baltimore). 2020;99(35):e21999.

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

Yıl 2025, Cilt: 22 Sayı: 3, 567 - 572, 29.09.2025
https://doi.org/10.35440/hutfd.1654188

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.

Proje Numarası

244

Kaynakça

  • 1. Flores A, Mayo MJ. Primary biliary cirrhosis in 2014. Curr Opin Gastroenterol. 2014;30(3):245-52.
  • 2. Tahtaci M, Yurekli OT, Bolat AD, Balci S, Akin FE, Buyukasik NS, et al. Increased mean platelet volume is related to histologic severity of primary biliary cirrhosis. Eur J Gastroenterol Hepatol. 2015 Dec;27(12):1382-5.
  • 3. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med. 2012;44(8):805-16.
  • 4. Celikbilek M, Gursoy S, Deniz K, Karaman A, Zararsiz G, Yurci A. Mean platelet volume in biopsy-proven non-alcoholic fatty liver disease. Platelets. 2013;24(3):194-9.
  • 5. Qi XT, Wan F, Lou Y, Ye B, Wu D. The mean platelet volume is a potential biomarker for cirrhosis in chronic hepatitis B virus-infected patients. Hepatogastroenterology. 2014;61(129):456-9.
  • 6. Hu Z, Sun Y, Wang Q, Han Z, Huang Y, Liu X, et al. Red blood cell distribution width is a potential prognostic index for liver disease. Clin Chem Lab Med. 2013;51(7):1403-8.
  • 7. Aslam H, Oza F, Ahmed K, Kopel J, Aloysius MM, Ali A, et al. The role of red cell distribution width as a prognostic marker in chronic liver disease: a literature review. Int J Mol Sci. 2023 Feb 9;24(4):3487.
  • 8. Sharma S, Khalili K, Nguyen GC. Non-invasive diagnosis of advanced fibrosis and cirrhosis. World J Gastroenterol. 2014;20(45):16820-30.
  • 9. Poynard T, Ngo Y, Perazzo H, Munteanu M, Lebray P, Moussalli J, et al. Prognostic value of liver fibrosis biomarkers: a meta-analysis. Gastroenterol Hepatol (N Y). 2011 Jul;7(7):445-54.
  • 10. Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006;43(6):1317-25.
  • 11. Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003 Aug;38(2):518-26.
  • 12. Mitchison HC, Bassendine MF, Hendrick A, Bennett MK, Bird G, Watson A, et al. Positive antimitochondrial antibody but normal alkaline phosphatase: is this primary biliary cirrhosis? Hepatology. 1986;6(6):1279-84.
  • 13. Smith SH. Using albumin and prealbumin to assess nutritional status. Nursing. 2017;47(4):65-6. doi: 10.1097/01.NURSE.0000482276.77845.44.
  • 14. Kim BK, Kim DY, Park JY, Ahn SH, Chon CY, Han KH, et al. Validation of FIB-4 and comparison with other simple non-invasive indices for predicting liver fibrosis and cirrhosis in hepatitis B virus-infected patients. Liver Int. 2010;30(4):546-53. doi: 10.1111/j.1478-3231.2009.02192.x.
  • 15. Rinella ME, Sanyal AJ. Management of NAFLD: a stage-based approach. Nat Rev Gastroenterol Hepatol. 2016;13(4):196-205.
  • 16. Dulai PS, Singh S, Patel J, Soni M, Prokop LJ, Younossi Z, et al. Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis. Hepatology. 2017;65(5):1557-65.
  • 17. Chrostek L, Przekop D, Gruszewska E, Gudowska-Sawczuk M, Cylwik B. Noninvasive indirect markers of liver fibrosis in alcoholics. Biomed Res Int. 2019;2019:3646975. doi: 10.1155/2019/3646975.18. Guller BY, Gulumsek E, Sumbul HE, Avci BS, Tas A. RDW Predicts Fibrosis in Patients with Chronic Hepatitis B Having Persistently Normal ALT Levels. Ethiop J Health Sci. 2023;33(4):591-600.
  • 18. 18. Guller BY, Gulumsek E, Sumbul HE, Avci BS, Tas A. RDW predicts fibrosis in patients with chronic hepatitis B having persistently normal ALT levels. Ethiop J Health Sci. 2023;33(4):591-600.
  • 19. Chen B, Ye B, Zhang J, Ying L, Chen Y. RDW to platelet ratio: a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B. PLoS One. 2013;8(7):e68780.
  • 20. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. J Hepatol. 2017;67(1):145-72.
  • 21. Chen B, Ye B, Zhang J, Ying L, Chen Y. RDW to platelet ratio: a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B. PLoS One. 2013;8(7):e68780.
  • 22. Wang D, Zhang P, Zhang M, Wang L. Red cell distribution width to platelet ratio predicts liver fibrosis in autoimmune hepatitis. Medicine (Baltimore). 2020;99(35):e21999.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Gastroenteroloji ve Hepatoloji
Bölüm Araştırma Makalesi
Yazarlar

Jehat Kılıç 0000-0003-3722-350X

Mustafa Zanyar Akkuzu 0000-0002-9908-6881

Berat Ebik 0000-0002-0012-2505

Proje Numarası 244
Erken Görünüm Tarihi 12 Eylül 2025
Yayımlanma Tarihi 29 Eylül 2025
Gönderilme Tarihi 9 Mart 2025
Kabul Tarihi 1 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 22 Sayı: 3

Kaynak Göster

Vancouver Kılıç J, Akkuzu MZ, Ebik B. Are There any Associations Between RDW and MPV and Noninvasive Fibrosis Scores in Primary Biliary Cirrhosis? Harran Üniversitesi Tıp Fakültesi Dergisi. 2025;22(3):567-72.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty