Progressive changes in platelet counts and Fib-4 scores precede the diagnosis of advanced fibrosis in NASH patients

Table 1 Characteristics of patients undergoing liver biopsy

	Fibrosis 0		Fibrosis 1		Fibrosis 2		Fibrosis 3		Fibrosis 4
	(% or SD)		(% or SD)		(% or SD)		(% or SD)		(% or SD)
Total (N)	36	(100)	41	(100)	27	(100)	26	(100)	73	(100)
Follow-up > 1 yr	29	(81)	32	(78)	22	(81%)	23	(88%)	59	(81%)
Follow-up (mean, yr)	7.1	(4.32)	7.3	(4.03)	8.6	(3.61)	8.4	(3.36)	8.2	(3.99)
Age (mean, yr)	44.6	(15.7)	47.6	(14.7)	55.9	(10.6)	55.6	(13.2)	58.0	(11.7)
Sex
Male (N)	16	(44)	25	(61)	13	(48)	12	(46)	45	(62)
Female (N)	20	(56)	16	(39)	14	(52)	14	(54)	28	(38)
Ethnicity
White (N)	23	(64)	22	(54)	15	(56)	20	(77)	54	(74)
African American (N)	0	(0)	0	(0)	1	(4)	0	(0)	0	(0)
Hispanic (N)	6	(17)	6	(15)	4	(15)	3	(12)	9	(12)
Asian American (N)	5	(14)	11	(27)	5	(19)	3	(12)	9	(12)
Other (N)	2	(6%)	2	(5)	2	(7)	0	(0)	1	(1)
Smoker
Yes (N)	5	(14)	1	(2)	5	(19)	0	(0)	6	(8)
No (N)	26	(72)	30	(73)	16	(59)	20	(77)	38	(52)
Former (N)	5	(14)	10	(24)	6	(22)	6	(23)	29	(40)
Diabetes mellitus
Yes (N)	8	(22)	14	(34)	12	(44)	10	(38)	42	(58)
No (N)	28	(78)	27	(66)	15	(56)	16	(62)	31	(42)
Hypertension
Yes (N)	14	(39)	20	(49)	16	(59)	15	(58)	49	(67)
No (N)	22	(61)	21	(51)	11	(41)	11	(42)	24	(33)
BMI (last)	30	(7)	32	(7)	31	(7)	31	(7)	33	(7)
Laboratory results
SGOT (last, IU/L)	90	(82)	78	(39)	69	(36)	88	(51)	80	(70)
SGPT (last, IU/L)	126	(86)	124	(57)	89	(52)	113	(87)	79	(68)
Platelets (last, 1000/mL)	259	(87)	242	(64)	229	(75)	206	(73)	167	(65)
Fib-4 score (last)	1.7	(1.8)	1.7	(1.1)	2.4	(2.4)	2.5	(1.1)	3.7	(2.8)
Correlation-plts (mean)	-0.10	(0.48)	-0.22	(0.66)	-0.31	(0.61)	-0.18	(0.52)	-0.56	(0.42)
Correlation-Fib-4 (mean)	0.43	(0.50)	0.36	(0.46)	0.49	(0.45)	0.42	(0.47)	0.43	(0.45)

SGOT: Serum glutamic oxalacetic transaminase; SGPT: Serum glutamic-pyruvic transaminase.

Table 2 Characteristics of patients undergoing magnetic resonance elastography

	MRE 0-2.9		MRE 2.9-3.5		MRE 3.5-4		MRE 4-5		MRE 5+
	(% or SD)		(% or SD)		(% or SD)		(% or SD)		(% or SD)
Total (N)	48	(100%)	15	(100%)	6	(100%)	13	(100%)	24	(100%)
Follow-up > 1 yr (N)	42	(88%)	12	(80%)	6	(100%)	10	(77%)	23	(96%)
Follow-up (mean, yr)	9.8	(4.87)	9.4	(4.87)	12.4	(4.87)	10.7	(4.87)	10.6	(4.87)
Age (mean, yr)	57.8	(15.4)	61.6	(13.5)	63.0	(9.0)	61.5	(8.3)	60.6	(13.4)
Sex
Male (N)	17	(35%)	5	(33%)	5	(83%)	6	(46%)	11	(46%)
Female (N)	31	(65%)	10	(67%)	1	(17%)	7	(54%)	13	(54%)
Ethnicity
White (N)	30	(63%)	8	(53%)	4	(67%)	10	(77%)	15	(63%)
African American (N)	2	(4%)	0	(0%)	0	(0%)	0	(0%)	1	(4%)
Hispanic (N)	6	(13)	3	(20)	1	(17)	1	(8)	5	(21)
Asian American (N)	9	(19)	1	(7)	0	(0)	1	(8)	1	(4)
Other (N)	1	(2)	3	(20)	1	(17)	1	(8)	2	(8)
Smoker
Yes (N)	2	(4)	1	(7)	0	(0)	1	(8)	1	(4)
No (N)	28	(58)	11	(73)	6	(100)	5	(38)	12	(50)
Former (N)	18	(38)	3	(20)	0	(0)	7	(54)	11	(46)
Diabetes mellitus
Yes (N)	14	(29)	9	(60)	4	(67)	9	(69)	15	(63)
No (N)	34	(71)	6	(40)	2	(33)	4	(31)	9	(38)
Hypertension
Yes (N)	29	(60)	12	(80)	5	(83)	8	(62)	16	(67)
No (N)	19	(40)	3	(20)	1	(17)	5	(38)	8	(33)
BMI (mean, last)	33	(7)	32	(8)	38	(7)	35	(6)	33	(6)
Laboratory results
SGOT (last, IU/L)	36	(18)	52	(41)	63	(32)	91	(92)	60	(40)
SGPT (last, IU/L)	48	(29)	57	(48)	79	(34)	101	(88)	59	(43)
Platelets (last, 1000/mL)	244	(60)	231	(62)	205	(39)	201	(74)	182	(75)
Fib-4 score (last)	1.4	(0.9)	1.8	(1.0)	2.6	(1.5)	2.6	(1.1)	3.5	(2.0)
MRE fibrosis score (mean)	2.5	(0.3)	3.2	(0.2)	3.7	(0.1)	4.3	(0.2)	8.2	(3.5)
Correlation-plts (mean)	-0.06	(0.43)	-0.06	(0.43)	-0.28	(0.45)	-0.44	(0.33)	-0.64	(0.35)
Correlation-Fib-4 (mean)	0.44	(0.43)	0.44	(0.43)	0.66	(0.19)	0.61	(0.35)	0.68	(0.32)

BMI: Body mass index; MRE: Magnetic resonance elastography; SGOT: Serum glutamic oxalacetic transaminase; SGPT: Serum glutamic-pyruvic transaminase.

Table 3 Results of least-squares multivariable regression analyses

Predicator variable	Estimate	Std error	t value	Prob >|t|
Outcome: Fibrosis score on biopsy
Fib-4 (last score)	0.214	0.048	4.43	< 0.0001
Correlation-platelets	-0.461	0.227	-2.03	0.044
Diabetes mellitus	-0.436	0.111	-3.94	0.0001
Hypertension	-0.181	0.112	-1.63	0.1062
BMI	0.02	0.016	1.28	0.2016
Smoking	-0.173	0.113	-1.53	0.1275
Sex	-0.028	0.11	-0.26	0.7988
R2 = 0.35, N = 146, P < 0.0001
Outcome: Fibrosis score on MRE
Fib-4 (last score)	0.746	0.239	3.12	0.0025
Correlation-platelets	-1.582	0.747	-2.12	0.0373
Diabetes mellitus	-0.301	0.365	-0.82	0.4133
Hypertension	0.441	0.395	1.12	0.2674
BMI	-0.019	0.039	-0.47	0.6368
Smoking	0.226	0.333	0.68	0.5001
Sex	0.016	0.36	0.04	0.9647
R2 = 0.24, N = 89, P < 0.002

BMI: Body mass index; MRE: Magnetic resonance elastography.