Zheng MH, Lonardo A. Red cell distribution width/platelet ratio predicts decompensation of metabolic dysfunction-associated steatotic liver disease-related compensated advanced chronic liver disease. World J Gastroenterol 2025; 31(3): 100393 [DOI: 10.3748/wjg.v31.i3.100393]
Corresponding Author of This Article
Ming-Hua Zheng, PhD, Doctor, Professor, Teacher, Department of Hepatology, MAFLD Research Center, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Street, Ouhai District, Wenzhou 325000, Zhejiang Province, China. zhengmh@wmu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 21, 2025; 31(3): 100393 Published online Jan 21, 2025. doi: 10.3748/wjg.v31.i3.100393
Red cell distribution width/platelet ratio predicts decompensation of metabolic dysfunction-associated steatotic liver disease-related compensated advanced chronic liver disease
Ming-Hua Zheng, Amedeo Lonardo
Ming-Hua Zheng, Department of Hepatology, MAFLD Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Amedeo Lonardo, Department of Internal Medicine, Azienda Ospedaliero-Universitaria of Modena (2023), Modena 41126, Italy
Author contributions: Both authors equally contributed to the conception of the study, and manuscript preparation and revision; both authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: There is no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming-Hua Zheng, PhD, Doctor, Professor, Teacher, Department of Hepatology, MAFLD Research Center, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Street, Ouhai District, Wenzhou 325000, Zhejiang Province, China. zhengmh@wmu.edu.cn
Received: August 15, 2024 Revised: November 12, 2024 Accepted: December 2, 2024 Published online: January 21, 2025 Processing time: 127 Days and 2 Hours
Abstract
Prognostication of compensated advanced chronic liver disease (cACLD) is of paramount importance for the physician-and-patient communication and for rational clinical decisions. The paper published by Dallio et al reports on red cell distribution width (RDW)/platelet ratio (RPR) as a non-invasive biomarker in predicting decompensation of metabolic dysfunction-associated steatotic liver disease (MASLD)-related cACLD. Differently from other biomarkers and algorithms, RPR is inexpensive and widely available, based on parameters which are included in a complete blood count. RPR is computed on the grounds of two different items, one of which, RDW, mirrors the host’s response to a variety of disease stimuli and is non-specific. The second parameter involved in RPR, platelet count, is more specific and has been used in the hepatological clinic to discriminate cirrhotic from non-cirrhotic chronic liver disease for decades. Cardiovascular disease is the primary cause of mortality among MASLD subjects, followed by extra-hepatic cancers and liver-related mortality. Therefore, MASLD biomarkers should be validated not only in terms of liver-related events but also in the prediction of major adverse cardiovascular events and cardiovascular mortality and extra-hepatic cancers. Adequately sized multi-ethnic confirmatory investigation is required to define the role and significance of RPR in the stratification of MASLD-cACLD.
Core Tip: A recent paper published in World Journal of Gastroenterology reports on the utility of red cell distribution width (RDW)/platelet ratio, a non-expensive and universally available biomarker based on RDW and platelet count, in predicting decompensation of metabolic dysfunction-associated steatotic liver disease (MASLD)-related compensated advanced chronic liver disease (cACLD) (MASLD-cACLD). We discuss these novel findings in the context of MASLD natural history and of a foreseeable research agenda pertaining to the stratification of MASLD-cACLD.
