Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2024; 30(7): 685-704
Published online Feb 21, 2024. doi: 10.3748/wjg.v30.i7.685
Red cell distribution width/platelet ratio estimates the 3-year risk of decompensation in Metabolic Dysfunction-Associated Steatotic Liver Disease-induced cirrhosis
Marcello Dallio, Mario Romeo, Paolo Vaia, Salvatore Auletta, Simone Mammone, Marina Cipullo, Luigi Sapio, Angela Ragone, Marco Niosi, Silvio Naviglio, Alessandro Federico
Marcello Dallio, Mario Romeo, Paolo Vaia, Salvatore Auletta, Simone Mammone, Marina Cipullo, Marco Niosi, Alessandro Federico, Department of Precision Medicine, Hepatogastroenterology Division, University of Campania Luigi Vanvitelli, Naples 80138, Italy
Luigi Sapio, Angela Ragone, Silvio Naviglio, Department of Precision Medicine, Clinical Biochemistry Division, University of Campania Luigi Vanvitelli, Naples 80138, Italy
Co-first authors: Marcello Dallio and Mario Romeo.
Author contributions: Romeo M is responsible for guarantor of the article, conceptualization, methodology, investigation, and writing the original draft; Vaia P, Auletta S, Mammone S, Dallio M are responsible for conceptualization, methodology, formal analysis, investigation, and writing the original draft; Cipullo M, Niosi M are responsible for investigation, resources, data curation, and visualization; Naviglio S, Sapio L are responsible for reviewing the original draft; Ragone A is responsible for visualization; Federico A is responsible for conceptualization, data curation, supervision; all authors approved the final version of the manuscript. In light of the shared collaborative effort, as well as the distribution of responsibilities and burdens to complete the study, Dallio M and Romeo M were designated as co-first authors.
Institutional review board statement: The study was reviewed and approved by the Comitato Etico Università degli Studi della Campania "Luigi Vanvitelli" -Azienda Ospedaliera Universitaria “Luigi Vanvitelli”- AORN “Ospedali dei Colli" Institutional Review Board (Approval No. 417).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no competing interests.
Data sharing statement: The data presented in this study are available on request from the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: Silvio Naviglio, MD, PhD, Full Professor, Department of Precision Medicine, Clinical Biochemistry Division, University of Campania Luigi Vanvitelli, Via L. De Crecchio 7, Naples 80138, Italy. silvio.naviglio@unicampania.it
Received: December 11, 2023
Peer-review started: December 11, 2023
First decision: December 14, 2023
Revised: December 19, 2023
Accepted: January 17, 2024
Article in press: January 17, 2024
Published online: February 21, 2024
ARTICLE HIGHLIGHTS
Research background

In clinical practice, the availability of non-invasive tools predicting the first decompensation event (DE) in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)-related compensated advanced chronic liver disease (cACLD) context is still an unmet need.

Research motivation

Red cell distribution width to platelet ratio (RPR) has been recently shown to predict fibrosis in MASLD patients; however, its role in predicting DE has never been explored.

Research objectives

Herein, we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.

Research methods

MASLD-cACLD patients were consecutively enrolled and followed up for 3 years. Biochemical, clinical, and Liver Stiffness Measurement were collected.

Research results

RPR accurately predicts [area under the curve (AUC): 0.94; best cut-off 0.472) the first DE in MASLD-cACLD. RPR accurately predicts acute decompensation (AD; AUC: 0.94; best cut-off 0.894) as the first DE in these patients. Patients presenting baseline clinically significant portal hypertension and RPR 0.472 show higher risk (hazard ratio: 3.10) of 3-year decompensation occurrence.

Research conclusions

Altogether these findings suggest RPR as a valid and potentially applicable non-invasive tool in the prediction of decompensation in MASLD-related cACLD patients.

Research perspectives

The potential availability of RPR as non-invasive, not expensive, and routinely assessable tool in the prediction of timing and modalities of decompensation in MASLD-cACLD patients could remodel the management of these patients.