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AST-to-Platelet Ratio Index (APRI) as Marker in Liver Disease

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Biomarkers in Liver Disease

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Abstract

Liver fibrosis observed in various chronic disorders is a risk factor of unfavorable prognosis and usually leads to cirrhosis. To date, liver biopsy is the gold standard for assessment of fibrosis. Its invasiveness and risk of hemorrhage incline to looking for noninvasive markers of liver fibrosis. The APRI index includes two simple and cheap laboratory tests performed routinely in clinical practice. Usefulness of this marker seems to depend on the etiology of liver damage. The predictive accuracy of APRI for significant fibrosis and cirrhosis was tested by the areas under the receiver operating characteristic curves (AUROC). The APRI score correlates significantly to fibrosis stage in patients with chronic hepatitis C. The APRI in patients with autoimmune hepatitis, chronic hepatitis B, and alcoholic liver disease is controversial and does not seem to have a diagnostic value in significant fibrosis. It showed promising results for predicting the presence of fibrosis in pediatric patients with NAFLD. Transient elastography, a noninvasive and objective but expensive method, showed higher performance in diagnosing significant fibrosis than APRI.

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Abbreviations

AIH:

Autoimmune hepatitis

ALD:

Alcoholic liver disease

ALT:

Alanine aminotransferase

APRI:

Aspartate aminotransferase-to-platelet ratio index

AST:

Aspartate aminotransferase

ATD:

ɑ-1-antitrypsin deficiency

AUROC:

Area under the receiver operating characteristic curve

CHB:

Chronic hepatitis B

CHC:

Chronic hepatitis C

HAART:

Highly active antiretroviral therapy

HCC:

Hepatocellular carcinoma

HIV:

Human immunodeficiency virus

INR:

International normalized ratio

NAFLD:

Nonalcoholic fatty liver disease

NPV:

Negative predictive value

OV:

Esophageal varices

PBC:

Primary biliary cirrhosis

PPV:

Positive predictive value

UDCA:

Ursodeoxycholic acid

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Authors and Affiliations

  1. Department of Gastroenterology, Hepatology, Nutrition Disorders and Paediatrics, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland

    Agnieszka Bakula & Maciej Dadalski

Authors
  1. Agnieszka Bakula
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  2. Maciej Dadalski
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Corresponding author

Correspondence to Agnieszka Bakula .

Editor information

Editors and Affiliations

  1. Department of Biomedical Science, Faculty of Science and Technology, University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Diabetes and Nutritional Sciences Research Division, Faculty of Life Science and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

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Bakula, A., Dadalski, M. (2017). AST-to-Platelet Ratio Index (APRI) as Marker in Liver Disease. In: Patel, V., Preedy, V. (eds) Biomarkers in Liver Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7675-3_2

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