Abstract
Background Accurately evaluate the stages of liver fibrosis are critical for the management of patients with autoimmune hepatitis (AIH). We evaluated the accuracy of red cell distribution width (RDW) to platelet (PLT) ratio (RPR) in predicting liver fibrosis in AIH patients.Methods One hundred and nineteen AIH patients with liver biopsy was retrospectively enrolled. Scheuer scoring system was used to stage liver fibrosis. Receiver operating characteristic curve (AUROC) was performed to evaluate the diagnostic accuracy of RPR.Results The median RPR values were 0.10, 0.10 and 0.14 for AIH patients with S2-S4, S3-S4 and S4, which were significantly higher than patients with S0-S1 (0.07, P<0.001), S0-S2 (0.08, P=0.025) and S0-S3 (0.09, P=0.014), respectively. The RPR levels were positively associated with the fibrosis stages (r=0.412, P<0.001), whereas there were no associations between liver fibrosis stages and aspartate transaminase to platelet ratio index (APRI) and fibrosis-4 score (FIB-4). The AUROCs of RPR were 0.780 (95%CI 0.696 to 0.865), 0.639 (95%CI 0.530 to 0.748) and 0.724 (95%CI 0.570 to 0.878) in diagnosing significant fibrosis (S2-S4), advanced fibrosis (S3-S4) and cirrhosis (S4) for AIH patients, respectively. The AUROCs of RPR were significantly higher than those of APRI and FIB-4 in staging liver fibrosis for AIH patients.Conclusion RPR is a simple predictor of liver fibrosis and is superior to APRI and FIB-4 in identifying liver fibrosis in AIH patients.
Red Cell Distribution Width to Platelet Ratio: in a Search of Non-Invasive Liver Fibrosis Biomarker