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Volume 14
Issue 3
10.3390/diagnostics14030265
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Article

Non-Invasive Serum Biomarkers for the Diagnosis of Cirrhosis in Patients with Autoimmune Hepatitis (AIH) and AIH-Primary Biliary Cholangitis Overlap Syndrome (AIH-PBC): Red Cell Distribution Width to Platelet Ratio (RPR) Yielded the Most Promising Result

by
Siwanon Nawalerspanya
1,2,
Jarukit Tantipisit
3,
Suraphon Assawasuwannakit
1,4,
Apichat Kaewdech
1,
Naichaya Chamroonkul
1 and
Pimsiri Sripongpun
1,*
1
Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
2
Department of Internal Medicine, Phaholponpayuhasena Hospital, Kanchanaburi 71000, Thailand
3
Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
4
Department of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi 11120, Thailand
*
Author to whom correspondence should be addressed.
Diagnostics 2024, 14(3), 265; https://doi.org/10.3390/diagnostics14030265
Submission received: 16 November 2023 / Revised: 15 January 2024 / Accepted: 24 January 2024 / Published: 25 January 2024
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Hepatogastroenterology)
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Abstract

Several serum biomarkers for fibrosis assessment have been proposed in various liver diseases, but in autoimmune hepatitis (AIH) or overlap with primary biliary cholangitis (PBC; AIH-PBC) patients, the data are scarce. This retrospective cross-sectional study was conducted to validate six non-invasive biomarkers in the diagnosis of cirrhosis (F4 fibrosis) in such patients. We included adult patients diagnosed with AIH or AIH-PBC overlap syndrome who underwent a liver biopsy between 2011 and 2021. Laboratory data were collected to calculate the following scores: red cell distribution width to platelet ratio (RPR), aspartate aminotransferase/platelet ratio index (APRI), Fibrosis-4 index (FIB-4), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-platelet ratio (LPR). A total of 139 patients were eligible (111 AIH and 28 AIH-PBC). The prevalence of cirrhosis was 35.3% (36% in AIH and 32.1% in AIH-PBC). The AUROCs of the RPR, FIB-4, APRI, AAR, LPR, and NLR in all patients were 0.742, 0.724, 0.650, 0.640, 0.609, and 0.585, respectively. RPR was significantly superior to APRI, NLR, and LPR. Moreover, RPR showed the highest AUROC (0.915) in the overlap AIH-PBC subgroup. In conclusion, RPR yielded the highest diagnostic accuracy to predict cirrhosis in AIH and AIH-PBC overlap syndrome patients, while FIB-4 was considerably optimal.
Keywords: autoimmune hepatitis; primary biliary cholangitis; overlap syndrome; fibrosis; cirrhosis; red cell distribution width to platelet ratio autoimmune hepatitis; primary biliary cholangitis; overlap syndrome; fibrosis; cirrhosis; red cell distribution width to platelet ratio

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MDPI and ACS Style

Nawalerspanya, S.; Tantipisit, J.; Assawasuwannakit, S.; Kaewdech, A.; Chamroonkul, N.; Sripongpun, P. Non-Invasive Serum Biomarkers for the Diagnosis of Cirrhosis in Patients with Autoimmune Hepatitis (AIH) and AIH-Primary Biliary Cholangitis Overlap Syndrome (AIH-PBC): Red Cell Distribution Width to Platelet Ratio (RPR) Yielded the Most Promising Result. Diagnostics 2024, 14, 265. https://doi.org/10.3390/diagnostics14030265

AMA Style

Nawalerspanya S, Tantipisit J, Assawasuwannakit S, Kaewdech A, Chamroonkul N, Sripongpun P. Non-Invasive Serum Biomarkers for the Diagnosis of Cirrhosis in Patients with Autoimmune Hepatitis (AIH) and AIH-Primary Biliary Cholangitis Overlap Syndrome (AIH-PBC): Red Cell Distribution Width to Platelet Ratio (RPR) Yielded the Most Promising Result. Diagnostics. 2024; 14(3):265. https://doi.org/10.3390/diagnostics14030265

Chicago/Turabian Style

Nawalerspanya, Siwanon, Jarukit Tantipisit, Suraphon Assawasuwannakit, Apichat Kaewdech, Naichaya Chamroonkul, and Pimsiri Sripongpun. 2024. "Non-Invasive Serum Biomarkers for the Diagnosis of Cirrhosis in Patients with Autoimmune Hepatitis (AIH) and AIH-Primary Biliary Cholangitis Overlap Syndrome (AIH-PBC): Red Cell Distribution Width to Platelet Ratio (RPR) Yielded the Most Promising Result" Diagnostics 14, no. 3: 265. https://doi.org/10.3390/diagnostics14030265

APA Style

Nawalerspanya, S., Tantipisit, J., Assawasuwannakit, S., Kaewdech, A., Chamroonkul, N., & Sripongpun, P. (2024). Non-Invasive Serum Biomarkers for the Diagnosis of Cirrhosis in Patients with Autoimmune Hepatitis (AIH) and AIH-Primary Biliary Cholangitis Overlap Syndrome (AIH-PBC): Red Cell Distribution Width to Platelet Ratio (RPR) Yielded the Most Promising Result. Diagnostics, 14(3), 265. https://doi.org/10.3390/diagnostics14030265

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