Retrospective study of red blood cell distribution width-platelet ratio in evaluating the severity of liver fibrosis in patients with autoimmune hepatitis

Abstract

Abstract: Objective To compare the clinical data of patients of autoimmune hepatitis (AIH) and drug-induced liver injury (DILI), and then to evaluate the associated factors of liver fibrosis severity and the diagnostic efficiency of AIH patients.Methods From June 2015 to August 2022, 45 patients with AIH (AIH group) were reviewed, including 4 males and 41 females. 86 patients with DILI (DILI group) were also included (23 males and 63 females). Metavir system was used to score the degree of hepatic fibrosis, in which < F2 stage was defined as non-significant hepatic fibrosis, and ≥F2 stage was significant hepatic fibrosis. The clinical data of the two groups were compared, and univariate and multivariate analysis were used to analyze the associated factors of advanced hepatic fibrosis in AIH patients. ROC curve and AUC value were used to evaluate the accuracy of red blood cell distribution width-Platelet (RPR) in the diagnosis of AIH liver fibrosis severity.Results In AIH patietnts, the age, skin pruritus, ALP, globulin, TBA, PT and RDW of AIH patients were 54 (48, 63) years old, 6 cases (13.3%), 154 (119, 278) U/L, 36.1 (31.2, 44.0) g/L, 50.4 (17.8, 140.6) μmol/L, 11.8 (11.2, 13.4) s and 15.1 (13.6, 16.4)%, which was significantly higher than that of DILI [50 (41, 58) years old, 0 (0), 121 (82, 187) U/L, 28.3 (24.6, 31.8) g/L, 25.6 (8.9, 108.4) μmol, 11.2 (10.8, 12.3) s and 14.1(13.0, 15.5) %, respectively, P<0.05]. In AIH patients, PLT was 4 cases (8.9%) and 162 (126, 203) × 10⁹/L, which were significantly lower than those in DILI [23 cases (26.7%) and 204 (173, 352) × 10⁹/L, P<0.05]. Univariate analysis showed that IgA, RDW, FIB-4, GPR and RPR were significant associated with significant hepatic fibrosis in AIH patients. Multivariate analysis showed that increased IgA, GPR and RPR levels, were significant associated with significant hepatic fibrosis, while age, sex, IgG, RDW, APRI and FIB-4 had no significant correlation with significant hepatic fibrosis in AIH patients. The cutoff point, ROC value, sensitivity and specificity of RPR for AIH patients with significant liver fibrosis were -2.3, 0.82, 82.3% (14/17) and 78.6% (22/28), respectively.Conclusion RPR and serum IgA levels were significantly related to .histological liver fibrosis in patients with AIH.

Key words: Autoimmune hepatitis, Drug-induced liver injury, Red blood cell distribution width-platelet ratio, Liver fibrosis

CHEN Li-xia, SHEN Li-lei, ZHENG Yi. Retrospective study of red blood cell distribution width-platelet ratio in evaluating the severity of liver fibrosis in patients with autoimmune hepatitis[J]. Chinese Hepatolgy, 2023, 28(8): 957-960.

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