Value of red blood cell distribution width-to-platelet ratio in evaluating metabolic-associated fatty liver disease and liver cirrhosis / 临床肝胆病杂志

ABSTRACT

Objective To investigate the clinical significance of red blood cell distribution width-to-platelet ratio (RPR index) in evaluating the severity of metabolic-associated fatty liver disease and predicting fatty liver-associated cirrhosis. Methods A total of 192 patients with metabolic-associated fatty liver disease and 210 patients with fatty liver-associated cirrhosis who were admitted to Shengjing Hospital of China Medical University from January 2019 to June 2020 were enrolled as group A and group B, respectively, and 206 individuals who underwent physical examination in our hospital during the same period of time were enrolled as control group (group C). All subjects underwent general measurement, blood cell analysis, blood biochemical test, and abdominal CT examination, and related formulas were used to calculate RPR, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) index. A one-way analysis of variance was used for comparison of continuous data with homogeneity of variance between groups, and the SNK method was used for comparison between two groups; the Kruskal-Wallis H test was used for comparison of continuous data with heterogeneity of variance between groups, and the Mann-Whitney U test was used for comparison between two groups; the chi-square test was used for comparison of categorical data between groups; the receiver operating characteristic (ROC) curve was used to analyze the accuracy of the prediction of liver cirrhosis. Results There were significant differences in red blood cell distribution width-standard deviation, albumin, creatinine, body mass index, RPR, and APRI between any two groups (all P < 0.001), and there were significant differences in white blood cell count, platelet count, alanine aminotransferase, aspartate aminotransferase, direct bilirubin, blood urea nitrogen, and FIB-4 between group A and group B (all P < 0.05). There were significant differences in waist circumference and fasting blood glucose between groups A and B and between groups A and C (all P < 0.001). There was a significant difference in RPR between any two groups of the mild, moderate, and severe metabolic-associated fatty liver disease groups (all P < 0.05). In terms of diagnostic efficiency, the three noninvasive models RPR, APRI, and FIB-4 had an area under the ROC curve of 0.932, 0.815, and 0.877, respectively, in predicting fatty liver-associated cirrhosis. Conclusion There is a difference in RPR index between different stages of liver disease, and RPR index gradually increases with the aggravation of metabolic-associated fatty liver disease. RPR index has a higher value than APRI and FIB-4 in the warning of fatty liver-associated cirrhosis.