Globulin-platelet model predicts minimal fibrosis and cirrhosis in chronic hepatitis B virus infected patients

Table 1 Characteristics of the study population

Features	mean ± SD	Minimum	Maximum
Gender (male/female)	91/23
HBV DNA (copies/mL)
(< 1000/≥ 1000)	44/70
(< 103/103-105/≥ 105)	44/32/38
E antigen (+/-)	52/62
Age (yr)	38.32 ± 11.36	15	67
PLT( × 109/L)	174.44 ± 62.68	50.6	334
T.Bil (g/dL)	0.88 ± 0.49	0.27	3.14
D.Bil (g/dL)	0.29 ± 0.23	0.08	1.39
ALT (IU/L)	69.32 ± 116.40	10.00	983
AST (IU/L)	48.60 ± 64.56	13	594
ALB (g/dL)	4.15 ± 0.43	2.85	5.26
GLOB (g/dL)	2.98 ± 0.52	1.75	4.47
ALP (IU/L)	80.10 ± 27.38	24	154
GGT (IU/L)	59.46 ± 66.92	5	430
PT (s)	12.01 ± 1.58	9.3	18.1

HBV: Hepatitis B virus; GLOB: Globulin; PLT: Platelet count; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; T.bil: Total bilirubin; D.bil: Direct bilirubin; ALB: Albumin; GGT: Glutamyltransferase; ALP: Alkaline phosphatase; PT: Prothrombin time.

Table 2 Noninvasive simple fibrosis models composed of routine clinical and laboratory parameters

Fibrosis test	Calculation
FI	8.0-0.01 × PLT (× 109/L)-ALB (g/dL)
APRI	AST (IU/L) × 100/PLT (× 109/L)
FIB-4	Age (yr) × AST (IU/L)/PLT (× 109/L) × ALT (IU/L) 1/2
FCI	ALP (IU/L) × T.bil (g/dL)/ALB (g/dL)/ PLT (× 109/L)
Age-AST model	Age (yr)/AST (IU/L)
AP index	Age (yr)/PLT (× 109/L)

PLT: Platelet count ; ALB: Albumin; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; T.bil: Total bilirubin; AP index: Age-PLT ratio; AST: Aspartate aminotransferase; APRI: AST-platelet ratio; FI: Fibrosis index; FCI: Fibrosis-cirrhosis index.

Table 3 Correlation analysis of seven models and different fibrosis stages (F0-F1, F2-F3 and F4)

F0-F1, F2-F3 and F4 fibrosis stages	Bivariate Spearman’s rank correlation coefficient	P value
FI	0.231	0.06
APRI	0.146	0.237
FIB-4	0.307	0.012
FCI	0.159	0.20
Age-AST model	0.132	0.286
AP index	0.246	0.045
GP model	0.441	0.000

AP index: Age-platelet count ratio; AST: Aspartate aminotransferase; APRI: AST-platelet ratio; FI: Fibrosis index; GP: Globulin/platelet; FCI: Fibrosis-cirrhosis index.

Table 4 Validity of age-platelet count ratio, aspartate aminotransferase-platelet ratio, age-aspartate aminotransferase model, fibrosis index, FIB-4 and fibrosis-cirrhosis index for prediction of minimal fibrosis (F0-F1) and comparison with globulin/platelet model

Fibrosis test	Cutoff value	Specificity %	Sensitivity %	PPV %	NPV %	AUC (95% CI)	Standard error	P value(vs GP model)
FI	1.58	41.1	89.7	61.2	79.4	0.695 (0.600-0.791)	0.049	> 0.05
APRI	0.85	87.5	41.4	77.4	59.0	0.635 (0.533-0.738)	0.052	< 0.05
FIB-4	1.7	85.7	51.7	78.9	63.1	0.720 (0.627-0.813)	0.047	> 0.05
FCI	0.17	80.4	55.2	74.5	63.4	0.692 (0.594-0.790)	0.050	> 0.05
Age-AST model	-	19.6	94.8	55.0	78.4	0.524 (0.417-0.632)	0.055	< 0.001
AP index	0.17	46.4	89.7	63.4	81.3	0.726 (0.634-0.818)	0.047	> 0.0
GP model	1.68	69.6	72.4	71.2	70.8	0.762 (0.676-0.848)	0.044

AP index: Age-platelet count ratio; AST: Aspartate aminotransferase; APRI: AST-platelet ratio; FI: Fibrosis index; GP: Globulin/platelet; FCI: Fibrosis-cirrhosis index; PPV: Positive predictive values; NPV: Negative predictive values; AUC: Area under the curve; CI: Confidence interval.

Table 5 Validity of age-platelet count ratio, aspartate aminotransferase-platelet ratio, age-aspartate aminotransferase model, fibrosis index, FIB-4, and fibrosis-cirrhosis index for prediction of cirrhosis (F4) and comparison with globulin/platelet model

Fibrosis test	Cutoff value	Specificity %	Sensitivity %	PPV %	NPV %	AUC (95% CI)	Standard error	P value(vs GP model)
FI	2.16	53.4	81.8	15.8	96.4	0.717 (0.569-0.865)	0.075	> 0.05
APRI	0.77	72.8	72.7	22.2	96.1	0.703 (0.584-0.822)	0.061	> 0.05
FIB-4	2.29	89.3	72.7	42.0	96.8	0.768 (0.050-0.931)	0.083	> 0.05
FCI	0.10	68.0	81.8	21.4	97.2	0.738 (0.612-0.864)	0.064	> 0.05
Age-AST model	-	-	-		-	0.486 (0.365-0.608)	0.062	-
AP index	0.32	74.8	72.7	23.6	96.2	0.735 (0.575-0.895)	0.082	> 0.05
GP model	2.53	84.5	72.7	33.4	96.7	0.781 (0.638-0.924)	0.073

AP index: Age-platelet count ratio; AST: Aspartate aminotransferase; APRI: AST-platelet ratio; FI: Fibrosis index; GP: Globulin/platelet; FCI: Fibrosis-cirrhosis index; PPV: Positive predictive values; NPV: Negative predictive values; AUC: Area under the curve; CI: Confidence interval.