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Subject Area

Obstetrics and Gynecology

Article Type

Review

Abstract

Objective The aim was to show the relation between glycated albumin (GA) to glycated hemoglobin (HBA1c) ratio alone or combined with aspartate aminotransferase to platelet ratio index (APRI) and the progression of liver fibrosis in correlation with liver biopsy. Background Hepatitis C virus induced-liver fibrosis can result in chronic liver disease, liver cell failure, and the need for liver transplantation. However, liver biopsy still remains the cornerstone for assessment of liver fibrosis; many modalities have been investigated to overcome its complications. Subjects and methods This study was prospectively conducted on 90 patients (47 men, 43 women), with chronic hepatitis C virus infection attended to a tertiary medical center in Egypt. All patients were subjected to routine investigations and percutaneous liver biopsy with histopathological interpretation and classification according to the METAVIR system into five groups F0–F4 and subgroups: F0–F1: no minimal fibrosis, F2–F3: intermediate fibrosis, F3–F4: severe fibrosis, and F4: cirrhosis. GA to HBA1c ratio and APRI were then calculated. Results The mean age of patients was 43.27 ± 11.6. GA/HBA1c and APRI are positively correlated with progression of liver fibrosis with highly statistically significant difference between the groups (P = 0.001 and 0.013, respectively). The sensitivity and specificity of APRI greater than 1.5 or GA/HbA1c ratio greater than 3.0 for the detection of significant liver fibrosis were 39/60 (65%) and 23/30 (76.7%), respectively; but, 34/60 (56.7%) and 26/30 (86.7%) when using APRI greater than 1.5 or GA/HbA1c ratio greater than 3.2. The positive and negative predictive values are highest (89.5 and 52%) when using GA/HBA1c greater than 3.2 or APRI greater than 1.5, respectively. Conclusion We can use GA/HbA1c ratio with or without APRI as a supportive index for assessing liver fibrosis.

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