Serum Asparatate Transaminase Platelet Ratio Index (apri) in Patients with Non-alcoholic Fatty Liver Disease in Bangladesh

Objective: To correlate serum Aspartate transaminase (AST) and Platelet Ratio Index (APRI) with the degree of hepatic fibrosis in patients with non alcoholic fatty liver disease (NAFLD). Methodology: This study was conducted on patients with NAFLD presenting at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from July 2007 to June 2008. In all patients, platelet counts and levels of AST were measured in the sera. Percutaneous liver biopsy was done in these patients to assess the levels of hepatic fibrosis (HF). APRI was calculated by using the formula; AST×UNL×100/platelet count×109/L. Results: Out of 30 patients, 28 had HF score of <2, while 2 had HF score of >2. However, high HF score was not associated with high AST. Based on platelet count, patients were divided into 2 groups; patients with platelet counts of <150,000/mm3 and those with platelet counts of >150,000/mm3. Sensitivity of APRI (cut off level 1.5) to diagnose significant fibrosis was 0%, specificity 96.4%, positive predictive value .0%, negative predictive value 93.1% and diagnostic accuracy 90.0%. On the other hand, when we considered APRI level of >1.5 as an indicator of significant fibrosis, one person was supposed to have hepatic fibrosis score of >2 from APRI value. But, liver histology of that person did not support hepatic fibrosis of >2. Conclusion: APRI has no correlation with degree of hepatic fibrosis in patients with NAFLD and hence cannot be used as a non-invasive marker of fibrosis in patients with NAFLD in Bangladesh. However large scale studies are required to confirm these findings.