A STUDY TO COMPARE THE EFFICACY OF ASPARTATE AMINOTRANSFERASE PLATELET RATIO INDEX TO FIBROSCAN AS A MARKER FOR EARLY FIBROSIS IN – NON ALCOHOLIC FATTY LIVER DISEASE

*Dr. G. S. Ramya, Dr. Rajshekar, Dr. Banda Naveen

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ABSTRACT

Introduction: Liver disease represents a rapidly increasing health burden globally. Analyses of liver parameters
are now the third most common type of biochemical test. NAFLD is a spectrum of liver diseases, from fatty
infiltration to steatohepatitis, fibrosis, and cirrhosis. There is immediate need of non-invasive procedure like
aminotransferase platelet ratio index (APRI) and fibroscan in the early diagnosis of liver fibrosis. The present study
was undertaken to assess the efficacy of APRI to fibroscan as a marker for early fibrosis in cases with nonalcoholic
fatty liver diseases. Objectives: Study to assess the relation between Aspartate aminotransferase and platelet count
in patients with pre cirrhosis and compare the efficacy of aspartate aminotransferase platelet ratio index to that of
fibroscan in early fibrosis. Materials and methods: A hospital based prospective study conducted on all
ultrasound defined newly diagnosed 100 NAFLD patients attending outpatient department in RIMS, Raichur
fulfilling inclusion criteria and exclusion criteria during the study period.. Fibroscan was done for all NAFLD
patients. Serum AST level and platelet count was measured is those patients and APRI calculated. Data analysis
was done by using SPSS Ver. 26 software. Chi square test for consolidated data and Pearson correlation for
correlation coefficient to test the significance of difference between variables. A 'p' value less than 0.05 was taken
to denote significant relationship. Results: The mean age was 49.4 years, and most patients were in the age group
45-55 years. High incidence of NAFLD in males (61%) compared to females. The mean APRI score was 1.09. 14
patients having APRI index between 0.7 to 1.0 had a fibro scan score between 7.0 to 8.9 denotes mild to moderate
fibrosis according to the metavir scoring system. The association between APRI score and fibroscan was
statistically significant (p=0.0214) and there was good correlation between fibroscan and APRI. Pearson
correlation coefficient calculated was 0.92 . showed very strong positive correlation. Conclusion: The APRI score
can be a useful non-invasive alternative for the exclusion and inclusion of significant liver fibrosis. The use of
APRI >0.7 would avoid the need for fibroscan.

Keywords: Liver disease; NAFLD; Fibrosis; Fibroscan;APRI;AST.