Original Article—Liver, Pancreas, and Biliary Tract

Journal of Gastroenterology

, Volume 46, Issue 11, pp 1300-1306

Platelet count for predicting fibrosis in nonalcoholic fatty liver disease

  • Masato YonedaAffiliated withDivision of Gastroenterology, Yokohama City University Graduate School of Medicine
  • , Hideki FujiiAffiliated withDepartment of Hepatology, Graduate School of Medicine, Osaka City University
  • , Yoshio SumidaAffiliated withCenter for Digestive and Liver Diseases, Nara City Hospital
  • , Hideyuki HyogoAffiliated withDepartment of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University Email author 
  • , Yoshito ItohAffiliated withDepartment of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine
  • , Masafumi OnoAffiliated withDepartment of Gastroenterology and Hepatology, Kochi Medical School
  • , Yuichiro EguchiAffiliated withDepartment of General Medicine, Saga Medical School
  • , Yasuaki SuzukiAffiliated withDivision of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical College
  • , Noriaki AokiAffiliated withSchool of Biomedical Informatics, University of Texas Health Science Center at Houston
    • , Kazuyuki KanemasaAffiliated withCenter for Digestive and Liver Diseases, Nara City Hospital
    • , Kento ImajoAffiliated withDivision of Gastroenterology, Yokohama City University Graduate School of Medicine
    • , Kazuaki ChayamaAffiliated withDepartment of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University
    • , Toshiji SaibaraAffiliated withDepartment of Gastroenterology and Hepatology, Kochi Medical School
    • , Norifumi KawadaAffiliated withDepartment of Hepatology, Graduate School of Medicine, Osaka City University
    • , Kazuma FujimotoAffiliated withDepartment of General Medicine, Saga Medical School
    • , Yutaka KohgoAffiliated withDivision of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical College
    • , Toshikazu YoshikawaAffiliated withDepartment of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine
    • , Takeshi OkanoueAffiliated withDivision of Gastroenterology, Yokohama City University Graduate School of MedicineHepatology Center, Saiseikai Suita Hospital
    • , Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG-NAFLD)

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Abstract

Background

The severity of liver fibrosis is known to be a good indicator for surveillance, and for determining the prognosis and optimal treatment of nonalcoholic fatty liver disease (NAFLD). However, it is virtually impossible to carry out liver biopsies in all NAFLD patients. The purpose of this study was to investigate the clinical usefulness of measuring the platelet count for predicting the severity of liver fibrosis in a large retrospective cohort of Japanese patients with NAFLD.

Methods

A total of 1,048 patients with liver-biopsy-confirmed NAFLD seen between 2002 and 2008 were enrolled from nine hepatology centers in Japan. Laboratory evaluations were performed for all patients.

Results

A linear decrease of the platelet count with increasing histological severity of hepatic fibrosis was revealed. The area under the receiver operating characteristic curve estimating the diagnostic performance of the platelet count for hepatic fibrosis Stage 3 was 0.774 (optimal cutoff value, 19.2 × 104/μl; sensitivity, 62.7%; specificity, 76.3%), and that for Stage 4 was 0.918 (optimal cutoff value, 15.3 × 104/μl; sensitivity, 80.5%; specificity, 88.8%).

Conclusions

The platelet count may be an ideal biomarker of the severity of fibrosis in NAFLD patients, because it is simple, easy to measure and handle, cost-effective, and accurate for predicting the severity of fibrosis. Furthermore, by using the platelet count cutoff value validated in our multiple large trials, efficient recruitment of NAFLD patients may be facilitated.

Keywords

Nonalcoholic fatty liver disease Platelet Fibrosis