Noninvasive assessment of liver damage in chronic hepatitis B

doi:10.4254/wjh.v5.i8.439

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Hepatol. Aug 27, 2013; 5(8): 439-444
Published online Aug 27, 2013. doi: 10.4254/wjh.v5.i8.439

Table 1 Comparison of clinical and laboratory parameters between control and hepatitis B patients groups

Variable	Control (n = 43)	Hepatitis B patients (n = 89)	P value
Gender (female/male)	31 (72.1)/12 (27.9)	39 (43.8)/50 (56.2)	0.004
Age (yr)	35.4 ± 12.64	41.5 ±1 3.02	0.012
Platelet count (10³μL)	272.0 (242-342)	179.0 (147-231)	< 0.001
Total bilirubin (mg/dL)	0.6 (0.4-0.8)	0.8 (0.6-1)	0.009
AST (IU/L)	17.0 (14-20)	45.0 (30-68)	< 0.001
ALT (IU/L)	16.0 (11-19)	56.0 (36-111)	< 0.001
AP (IU/L)	69.0 (53-79)	72.0 (61-90)	0.086
GGT (IU/L)	17.0 (14-27)	29.0 (21-50)	< 0.001
Neutrophil count	4.3 (3.4-4.9)	3.4 (2.9-4.7)	0.004
Lymphocyte count	2.1 (1.6-2.4)	2.0 (1.6-2.4)	0.355
N/L	2.1 (1.5-2.8)	1.9 (1.4-2.3)	0.123
APRI score	0.1 (0.1-0.1)	0.6 (0.3-1.1)	< 0.001

Values are expressed as n (%), mean ± SD or median (25^th-75^th percentiles). AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; AP: Alkaline phosphatase; GGT: Gamma glutamyl transferase; N/L: Neutrophil-lymphocyte ratio; APRI: Aspartate aminotransferase/platelet ratio index.

Table 2 Between group comparisons and logistic regression results in chronic hepatitis B patients according to fibrosis stage

Variable	Between group comparisons			Logistic regression analysis
Variable	No/mild fibrosis (n = 34)	Significant fibrosis (n = 55)	P value	Univariate OR (95%CI)	Multivariate OR (95%CI)
Gender (female/male)	16 (47.1)/18 (52.9)	23 (41.8) /32 (58.2)	0.792	1.2 (0.5-2.9)	-
Age (yr)	40.2 ± 11.7	42.2 ± 13.7	0.473	1.01 (0.9-1.05)	-
HGB	14.4 ± 2.08	14.6 ± 1.8	0.735	1.04 (0.8-1.3)	-
Platelet Count (10³μL)	203 (176-232)	171 (115-227)	0.010	0.9 (0.9-1)	0.9 (0.9-1)
INR	1.07 ± 0.1	1.13 ± 0.1	0.045	34.5 (1.01-1183.1)	-
Albumine	4.06 ± 0.3	4.01 ± 0.3	0.466	0.6 (0.1-2.3)	-
Total bilirubin (mg/dL)	0.7 (0.5-0.9)	0.8 (0.6-1.1)	0.110	3.05 (0.8-10.8)	-
AST (IU/L)	41.5 (27-73)	47 (32-68)	0.447	1 (0.9-1.01)	-
ALT (IU/L)	57 (33-132)	54 (36-106)	0.866	1 (0.9-1.01)	-
AP (IU/L)	71.5 (62-89)	73 (61-100)	0.630	1.01 (0.9-1.02)	-
GGT (IU/L)	27 (19-48)	36 (23-52)	0.119	1.01 (0.9-1.03)	-
HBV DNA	346 (1.9-1000)	75.7 (1.8-1000)	0.838	1 (0.9-1.01)	-
HBeAg (negative/positive)	30 (88.2)/4 (11.8)	45 (81.8)/10 (18.2)	0.611	1.6 (0.4-5.8)	-
Neutrophil count	3.2 (2.7-4.8)	3.5 (3.04-4.7)	0.569	0.9 (0.6-1.2)	-
Lymphocyte count	1.9 (1.4-2.3)	2 (1.6-2.4)	0.630	0.9 (0.5-1.7)	-
N/L	1.9 (1.3-2.5)	1.8 (1.5-2.2)	0.859	0.8 (0.5-1.3)	-
APRI score	0.5 (0.3-0.9)	0.7 (0.3-1.4)	0.060	1.2 (0.7-2.1)	-

Values are expressed as n (%), mean ± SD or median(25^th-75^th percentiles). HGB: Hemoglobin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; AP: Alkaline phosphatase; GGT: Gamma glutamyl transferase; HBV: Hepatitis B virus; HBeAg: Hepatitis B e antigen; N/L: Neutrophil-lymphocyte ratio; APRI: Aspartate aminotransferase/platelet ratio index.

Table 3 Between group comparisons and logistic regression results in chronic hepatitis B patients according to cirrhosis

Variable	Between group comparisons			Logistic regression analysis
Variable	Non-cirrhotic (n = 76)	Cirrhotic (n = 13)	P value	Univariate OR (95%CI)	Multivariate OR (95%CI)
Gender (female/male)	33 (43.4)/43 (56.6)	6 (46.2)/7 (53.8)	0.999	1.1 (0.3-3.6)	-
Age (yr)	40.2 ± 12.3	49.08 ± 15.04	0.022	1.06 (1.01-1.1)	1.06 (1-1.11)
HGB	14.5 ± 2.03	14.6 ± 1.37	0.891	1.0 (0.7-1.39)	-
Platelet count (10³μL)	190.5 (152-233.5)	152 (117-175)	0.051	0.9 (0.9-1)	-
INR	1.1 ± 0.1	1.1 ± 0.09	0.250	6.3 (0.09-478.1)	-
Albumine	4.04 ± 0.3	3.9 ± 0.4	0.210	0.2 (0.04-2.01)	-
Total bilirubin (mg/dL)	0.8 (0.6-1)	1 (0.6-1.3)	0.389	2.09 (0.5-8.7)	-
AST (IU/L)	41.5 (28-65)	66 (40-79)	0.078	1 (0.9-1.01)	-
ALT (IU/L)	54 (33-124)	69 (51-97)	0.419	1 (0.9-1.01)	-
AP (IU/L)	72 (61-89.5)	82 (62-116)	0.225	1.02 (1-1.03)	1.02 (1-1.04)
GGT (IU/L)	28 (20-50.5)	47 (26-50)	0.189	1.01 (1-1.02)	-
HBV DNA	269.5 (2-1000)	10.1 (0.4-1000)	0.339	1 (0.9-1.01)	-
HbeAg (negative/positive)	65 (85.5)/11 (14.5)	10 (76.9)/3 (23.1)	0.423	1.7 (0.4-7.4)	-
Neutrophil count	3.4 (2.8-4.7)	3.8 (3.04-4.1)	0.468	1.05 (0.7-1.5)	-
Lymphocyte count	2 (1.6-2.4)	2 (1.5-2.2)	0.493	0.6 (0.2-1.5)	-
N/L	1.8 (1.3-2.2)	2.04 (1.6-2.8)	0.160	1.3 (0.8-2.07)	-
APRI score	0.5 (0.3-1.08)	1.1 (0.7-1.7)	0.047	1.2 (0.8-2.05)	-

Table 4 Statistical diagnostic measures and Kappa test results of neutrophil-lymphocyte and aspartate aminotransferase/platelet ratio score in the detection of significant fibrosis and cirrhosis

Variable	Diagnostic measures					Kappa test
Variable	SEN (95%CI)	SPE (95%CI)	PPR (95%CI)	NPR (95%CI)	AR (95%CI)	κ	P value
Significant fibrosis
N/L ( ≤ 2.18)	0.73 (0.59-0.84)	0.41 (0.25-0.59)	0.67 (0.53-0.78)	0.48 (0.29-0.67)	0.61 (0.50-0.71)	0.143	0.174
APRI (> 0.56)	0.65 (0.51-0.78)	0.56 (0.38-0.73)	0.71 (0.56-0.83)	0.50 (0.33-0.67)	0.62 (0.51-0.72)	0.209	0.048
Cirrhosis
N/L (> 2.58)	0.38 (0.14-0.68)	0.87 (0.77-0.64)	0.33 (0.12-0.62)	0.89 (0.80-0.95)	0.80 (0.70-0.88)	0.238	0.024
APRI (> 1.01)	0.62 (0.36-0.86)	0.74 (0.62-0.83)	0.29 (0.13-0.49)	0.92 (0.82-0.97)	0.72 (0.61-0.81)	0.238	0.011

SEN: Sensitivity; SPE: Specifity; PPR: Positive predictive rate; NPR: Negative predictive rate; AR: Accuracy rate; APRI: Aspartate aminotransferase/platelet ratio index; N/L: Neutrophil-lymphocyte ratio.

Citation: Celikbilek M, Dogan S, Gursoy S, Zararsız G, Yurci A, Ozbakır O, Guven K, Yucesoy M. Noninvasive assessment of liver damage in chronic hepatitis B. World J Hepatol 2013; 5(8): 439-444
URL: https://www.wjgnet.com/1948-5182/full/v5/i8/439.htm
DOI: https://dx.doi.org/10.4254/wjh.v5.i8.439