DOI: 10.26453/otjhs.1823481 ISSN: 2459-1467

Predictive Value of Gamma Glutamyl Transferase Platelet Ratio in The Development of Liver Fibrosis and Steatohepatitis in Chronic Hepatitis B Patients

Mine Büşra Bozkürk, Yusuf Coşkun, Gülnur Kul, Funda Güçel, Ramazan Berk Us, Merve Tura Çelik, Alpaslan Öztürk, Emin Ediz Tütüncü
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Objective: Chronic hepatitis B (CHB) represents a major contributor to fibrosis and cirrhosis worldwide. In this study, we aimed to investigate the relationship and predictive value of the gamma-glutamyl transferase (GGT)-to-platelet ratio (GPR) with liver fibrosis and steatohepatitis. Materials and Methods: This retrospective cohort study included 100 patients with CHB and 100 healthy controls. Fibrosis indices were calculated and compared with ultrasound results for fibrosis status and steatohepatitis identified on liver biopsy. The diagnostic performance of these parameters was assessed using receiver operating characteristic (ROC) curve analysis. Results: The body mass index, liver enzyme levels, and fibrosis indices were higher in patients with chronic hepatitis B than in healthy individuals, while platelet counts were lower in these patients (all p<0.05). ROC analysis showed that GPR had the highest discriminative performance in distinguishing CHB patients from healthy controls, with an AUC of 0.960, sensitivity of 96%, and specificity of 80%, and it outperformed both APRI and FIB-4. GGT and FIB-4 exhibited the strongest discriminatory performance. Although GPR showed a strong correlation with APRI and FIB-4, only FIB-4 was independently associated with Ishak fibrosis stages (OR≈1.8, p=0.037). None of the indices significantly predicted hepatic steatosis severity. Conclusion: GPR demonstrates high accuracy in distinguishing CHB patients from healthy individuals. FIB-4 was found to be more valuable than GPR for staging fibrosis progression, indicating that GPR should be interpreted primarily as a disease discrimination index, rather than as a fibrosis staging tool. The combined use of these indices could provide a cost-effective, noninvasive diagnostic tool for the diagnosis and follow-up of patients with CHB and serve as a useful biomarker for clinicians.

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