A High Red Cell Distribution Width-To-Platelet Ratio is a Good Marker of Liver fibrosis in Non-Alcoholic Fatty Liver Disease

Abstract

Background: Most patients with NAFLD are commonly asymptomatic and often identified incidentally, and the patients come to the clinician’s attention usually because of the elevation of liver enzymes. Moreover, the platelet count itself and platelet-related indexes, such as the AP index, APRI index, and FIB4 index have been widely used to evaluate the severity of various liver diseases. Aim of the work: In our study, we have attempted to assess red cell distribution width-to-platelet ratio as a marker of liver fibrosis. Material and methods: This prospective study was carried out on a selected group of 50 patients, 25 of them who have a non-alcoholic fatty liver with liver fibrosis and 25 patients who have non-alcoholic fatty liver without liver fibrosis which Pelvi-abdominal U/S and fibroscan diagnose. All patients had RDW to platelet ratio (RPR) =RDW×100/ PLT (109/L) and Fib 4 score = (Age × AST) / (Platelet count × (square root of ALT). Results: There was a significant increase in RPR% in NAFLD patients with fibrosis in comparison to NAFLD patients without
fibrosis. There was also a positive significant correlation between RPR% and BMI, RDW%, HbA1c, fibrosis, and FIB4, while there was a negative significant correlation between RPR and platelets. Conclusion: RPR has a good sensitivity of 88% so it can be employed as an excellent non-invasive marker for the prediction of fibrosis.