Predictive Role of Non-Invasive Laboratory Markers in Hepatic Fibrosis among Hepatitis B Patients
DOI:
https://doi.org/10.33096/gmj.v7i2.222Keywords:
Chronic hepatitis B, Liver fibrosis, Non-invasive biomarkers, GAR, APPR, AGPRAbstract
Introduction: Chronic hepatitis B (CHB) is a major cause of liver fibrosis, which may progress to cirrhosis if undetected. Non-invasive biomarkers such as Gamma-glutamyl Transferase to Albumin Ratio (GAR), Alkaline Phosphatase to Platelet Ratio (APPR), and Alkaline Phosphatase plus Gamma-glutamyl Transferase to Platelet Ratio (AGPR) have shown promise in predicting fibrosis severity, potentially outperforming traditional markers like APRI.
Methods: We conducted a cross-sectional study involving 34 CHB patients at Dr. Sardjito General Hospital, Yogyakarta (October 2022–February 2023). Liver stiffness was assessed using shear wave elastography (SWE) and staged according to the Metavir system (F0–F4). GAR, APPR, and AGPR were calculated from laboratory data. Spearman correlation and linear regression analyses were used to evaluate their association with fibrosis severity.
Result: AGPR showed the strongest correlation with fibrosis stage (ρ = 0.611, p < 0.001), followed by GAR (ρ = 0.450, p = 0.008) and APPR (ρ = 0.384, p = 0.026). All three indices were significant in univariate regression, while the combined model demonstrated improved predictive performance (R² = 0.389, p = 0.003) despite lack of independent significance in multivariate analysis.
Conclusion: GAR, APPR, and AGPR are promising non-invasive biomarkers for assessing liver fibrosis in CHB patients. Their combined use enhances diagnostic accuracy and offers practical benefits, particularly in settings where biopsy is not available.
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