Diagnostic and Prognostic Value of Aspartate Transaminase-to-platelet Ratio Index, Gamma-glutamyl Transpeptidase-to-platelet Ratio, and Fibrosis-4 for Compensated Hepatitis B-related Liver Cirrhosis

The aim of this study was to investigate a serodiagnostic model as a substitute for liver stiffness measurement (LSM) for diagnosing compensated liver cirrhosis (LC). This retrospective study included 150 patients with compensated hepatitis B-related LC and 153 with chronic Hepatitis B virus (HBV) infection. It was conducted from May 2017 to June 2022 at Qinghai University Affiliated Hospital, China. The values of LSM, aspartate transaminase-to-platelet ratio index (APRI), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), and fibrosis-4 (FIB-4) were evaluated in all admitted patients. The diagnostic value of APRI, GPR, FIB-4, and LSM was assessed using the receiver operating characteristic (ROC) curve. FIB-4 score (AUC=0.842; specificity=77.8%; sensitivity=80.7%; cut-off=2.824) was the best substitute for LSM from the three serum scoring models. The Cox regression model indicated that a FIB-4 score & GE;2.824 was an independent predictor of prognosis for compensated hepatitis B-related LC (HR=1.15, 95%CI: 1.07-1.23, p<0.001). This study's findings suggested that FIB-4 could be the best substitute for LSM and may help to assess LC prognosis.