Diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index and liver stiffness measurement in hepatitis B virus-infected patients with persistently normal alanine aminotransferase

Table 1 Demographic and clinical characteristics of chronic hepatitis B patients n (%)

Characteristic	PNALT (n = 95)	PIALT1 (n = 86)	PIALT2 (n = 64)	Statistic	P value
Age (yr)	34.5 ± 11.2	34.2 ± 12.5	36.5 ± 13.5	5.423	0.0211
Sex
Male	70 (73.7)	58 (67.4)	46 (71.9)	0.885	0.6422
Female	25 (26.3)	28 (32.6)	18 (28.1)
BMI	23.4 ± 2.65	24.0 ± 3.6	24.25 ± 3.37	1.231	0.5431
PLT (× 109/L)	200.1 ± 60.3	196.8 ± 65.4	186.5 ± 74.5	6.364	0.0181
PTA (%)	99.6 ± 6.7	99.6 ± 8.7	102.3 ± 10.3	0.674	0.7741
ALB (g/L)	41.3 ± 3.4	41.6 ± 3.7	42.4 ± 4.1	1.536	0.5431
ALT (U/L)	21.4 ± 4.3	56.2 ± 19.4	113.6 ± 55.3	25.754	< 0.0011
AST (U/L)	22.6 ±6.8	55.4 ± 16.6	124.5 ± 57.6	31.644	< 0.0011
APRI	0.32 ± 0.14	0.61 ± 0.44	1.25 ± 0.62	284.92	< 0.0011
FIB-4	0.72 ± 0.36	1.12 ± 0.53	1.67 ± 0.84	56.37	< 0.0011
FibroScan (kPa)	5.33± 2.45	7.36 ± 3.14	10.22 ± 5.53	46.34	< 0.0011
HBsAg [lg (IU/L)]	4.41 ± 0.73	4.53 ± 0.88	4.38 ± 0.64	0.743	0.437
HBV DNA [lg (IU/mL)]	6.78 ± 2.13	6.53 ± 2.43	6.42 ± 2.54	0.864	0.2541
≥ 3, < 5	15 (15.8)	11 (12.8)	10 (15.6)	0.384	0.8252
≥ 5	80 (84.2)	75 (87.2)	54 (84.4)
E antigen
Positive	42 (44.2)	31 (36)	29 (45.3)	1.78	0.4112
Negative	53 (55.8)	55 (64)	35 (54.7)
Necroinflammatory score	2.21 ± 2.14	3.47 ± 3.64	4.74 ± 3.65	23.43	0.001
Minimal	35 (32.4)	20 (23.3)	8 (12.5)	18.69	0.005
Mild	44 (38)	38 (44.2)	27 (42.4)
Moderate	15 (15.8)	26 (30.2)	22 (34.4)
Severe	1 (0.9)	2 (2.3)	7 (10.9)
Fibrosis score	1.53 ± 0.46	2.38 ± 1.27	2.85 ± 1.75	15.237	0.0051
Minimal	32 (33.7)	18 (20.9)	13 (20.3)	13.275	0.0352
Mild	40 (42.1)	40 (51.2)	23 (35.9)
Moderate	21 (22.1)	24 (27.9)	21 (32.8)
Severe	2 (2.1)	5 (5.8)	7 (10.9)

¹One-way analysis of variance;

²Pearson χ². APRI = [AST (U/L)/ULN × 100/PLT (10⁹/L)]; FIB-4 = [age (yr) × AST (U/L)]/[PLT (10⁹/L) × (ALT U/L)^1/2].

Table 2 Pairwise comparisons of receiver-operating characteristic curves

	PNALT	PIALT1	PIALT2	All patients
APRI vs FIB-4
Difference between areas	0.0628	0.0169	0.068	0.00904
Standard error	0.0557	0.0699	0.0738	0.0245
95%CI	-0.046 to 0.172	-0.120 to 0.154	-0.077 to 0.213	-0.039 to 0.057
z statistic	1.129	0.242	0.921	0.369
P value	0.2588	0.8087	0.3569	0.712
APRI vs LSM
Difference between areas	0.256	0.124	0.0263	0.111
Standard error	0.104	0.0896	0.0882	0.0518
95%CI	0.0525-0.459	-0.0511 to 0.30	-0.147 to 0.19	0.00909-0.212
z statistic	2.465	1.389	0.298	2.135
P value	0.0137	0.1649	0.7655	0.0327
FIB 4 vs LSM
Difference between areas	0.193	0.141	0.0417	0.102
Standard error	0.106	0.0938	0.0957	0.0531
95%CI	-0.014 to 0.400	-0.0425 to 0.325	-0.146 to 0.229	-0.00246 to 0.206
z statistic	1.829	1.507	0.435	1.914
P value	0.0374	0.1318	0.663	0.0557