Mean platelet volume as a fibrosis marker in patients with chronic hepatitis C

We designed this study to evaluate the role of mean platelet volume (MPV) as a fibrosis marker in patients with chronic hepatitis C (CHC). Materials and methods: The study was designed at Kayseri Education and Research Hospital. Ninety-five patients with CHC were enrolled retrospectively into the study. The control group comprised 33 age- and sex-matched healthy individuals. Hepatitis C virus-RNA level, alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, prothrombin time (PT), platelet count (PC), serum albumin, histological activity index (HAI), liver fibrosis score (LFS), and MPV were obtained from the patients' files and a computerized database. Results: Statistically significant differences in MPV and PC were seen in patients with CHC compared to healthy controls (MPV: 9.1 ± 1.31 fL vs. 8.58 ± 0.8 fL, P = 0.008; PC (×103/µL): 219.37 ± 74.31 vs. 258.52 ± 48.34, P = 0.001). In multivariate analysis, 4 variables remained as independent risk factors: AST (OR 1.11, 95% CI 1.02 to 1.21), ALT (OR 0.92, 95% CI 0.86 to 0.99), PT (OR 2.11, 95% CI 1.15 to 3.88), and MPV (OR 2.28, 95% CI 1.22 to 4.25). Cut-off values were calculated for diagnostic performance, and the cut-off value for MPV was 8.4 fL. Conclusion: We suggest that high MPV levels (especially those over 8.4 fL) may help to predict advanced fibrosis in patients with CHC. However, it should not be forgotten that MPV is not a specific marker for fibrosis, and the negative predictive rate seems more valuable to exclude a high fibrosis ratio in patients with CHC.

Mean platelet volume as a fibrosis marker in patients with chronic hepatitis C

We designed this study to evaluate the role of mean platelet volume (MPV) as a fibrosis marker in patients with chronic hepatitis C (CHC). Materials and methods: The study was designed at Kayseri Education and Research Hospital. Ninety-five patients with CHC were enrolled retrospectively into the study. The control group comprised 33 age- and sex-matched healthy individuals. Hepatitis C virus-RNA level, alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, prothrombin time (PT), platelet count (PC), serum albumin, histological activity index (HAI), liver fibrosis score (LFS), and MPV were obtained from the patients' files and a computerized database. Results: Statistically significant differences in MPV and PC were seen in patients with CHC compared to healthy controls (MPV: 9.1 ± 1.31 fL vs. 8.58 ± 0.8 fL, P = 0.008; PC (×103/µL): 219.37 ± 74.31 vs. 258.52 ± 48.34, P = 0.001). In multivariate analysis, 4 variables remained as independent risk factors: AST (OR 1.11, 95% CI 1.02 to 1.21), ALT (OR 0.92, 95% CI 0.86 to 0.99), PT (OR 2.11, 95% CI 1.15 to 3.88), and MPV (OR 2.28, 95% CI 1.22 to 4.25). Cut-off values were calculated for diagnostic performance, and the cut-off value for MPV was 8.4 fL. Conclusion: We suggest that high MPV levels (especially those over 8.4 fL) may help to predict advanced fibrosis in patients with CHC. However, it should not be forgotten that MPV is not a specific marker for fibrosis, and the negative predictive rate seems more valuable to exclude a high fibrosis ratio in patients with CHC.

___

  • Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, Houghton M. Isolation of a cDNA clone derived from a bloodborne non-A, non-B viral hepatitis genome. Science 1989; 244: 359–62.
  • Alter HJ, Purcell RH, Shih JW, Melpolder JC, Houghton M, Choo QL et al. Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis. N Engl J Med 1989; 321: 1494–500. van der Poel CL, Reesink HW, Lelie PN, Leentvaar-Kuypers A, Choo QL, Kuo G et al. Anti-hepatitis C antibodies and non-A, non-B post-transfusion hepatitis in the Netherlands. Lancet 1989; 2: 297–8.
  • Öner S, Yapıcı G, Şaşmaz CT, Kurt AÖ, Buğdaycı R. Hepatitis B, hepatitis C, HIV, and VDRL seroprevalence of blood donors in Mersin, Turkey. Turk J Med Sci 2011; 41: 335–41.
  • Barrera JM, Bruguera M, Ercilla MG, Gil C, Celis R, Gil MP et al. Persistent hepatitis C viremia after acute self-limiting posttransfusion hepatitis C. Hepatology 1995; 21: 639–44.
  • Farci P, Shimoda A, Coiana A, Diaz G, Peddis G, Melpolder JC et al. The outcome of acute hepatitis C predicted by the evolution of the viral quasispecies. Science 2000; 288: 339–44.
  • Grebely J, Petoumenos K, Hellard M, Matthews GV, Suppiah V, Applegate T et al. Potential role for interleukin-28B genotype in treatment decision-making in recent hepatitis C virus infection. Hepatology 2010; 52: 1216–24.
  • Seeff LB. Natural history of chronic hepatitis C. Hepatology 2002; 36: S35–46.
  • Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002; 13: 301–6.
  • Bancroft AJ, Abel EW, Mclaren M, Belch JJ. Mean platelet volume is a useful parameter: a reproducible routine method using a modified Coulter thrombocytometer. Platelets 2000; 11: 379–87.
  • Giles H, Smith RE, Martin JF. Platelet glycoprotein IIb-IIIa and size are increased in acute myocardial infarction. Eur J Clin Invest 1994; 24: 69–72.
  • Kiliçli-Camur N, Demirtunç R, Konuralp C, Eskiser A, Başaran Y. Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit 2005: 11: 387–92.
  • Pizzulli L, Yang A, Martin JF, Lüderitz B. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J 1998: 19: 80–4.
  • Bath P, Algert C, Chapman N, Neal B; PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004: 35: 622–6.
  • Yüksel O, Helvaci K, Başar O, Köklü S, Caner S, Helvaci N et al. An overlooked indicator of disease activity in ulcerative colitis: mean platelet volume. Platelets 2009: 20: 277–81.
  • Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008; 75: 291–4.
  • Ekiz F, Yüksel O, Koçak E, Yılmaz B, Altınbaş A, Çoban S et al. Mean platelet volume as a fibrosis marker in patients with chronic hepatitis B. J Clin Lab Anal 2011; 25: 162–5.
  • Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. The French METAVIR Cooperative Study Group. Hepatology 1994; 20: 15–
  • Baldi P, Brunak S, Chauvin Y, Andersen CA, Nielsen H. Assessing the accuracy of prediction algorithms for classification: an overview. Bioinformatics 2000; 16: 412–24.
  • Liang TJ, Rehermann B, Seeff LB, Hoofnagle JH. Pathogenesis, natural history, treatment, and prevention of hepatitis C. Ann Intern Med 2000; 132: 296–305.
  • Rodger AJ, Roberts S, Lanigan A, Bowden S, Brown T, Crofts N. Assessment of long-term outcomes of community-acquired hepatitis C infection in a cohort with sera stored from 1971 to 19 Hepatology 2000; 32: 582–7.
  • Zubcevic N, Mesihovic R, Zubcevic S. Usefulness of laboratory data in estimation of Crohn’s disease activity. Med Arh 2010; 64: 33–6.
  • Jackson SR, Carter JM. Platelet volume: laboratory measurement and clinical application. Blood Rev 1993; 7: 104–
  • Threatte GA. Usefulness of the mean platelet volume. Clin Lab Med 1993; 13: 937–50.
  • Corash L. Platelet sizing: techniques, biological significance, and clinical applications. Curr Top Hematol 1983; 4: 99–122.
  • Beyazit Y, Sayilir A, Torun S, Suvak B, Yesil Y, Purnak T et al. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol 2012; 36: 162–8.
  • Polińska B, Matowicka-Karna J, Kemona H. Assessment of the influence of the inflammatory process on the activation of blood platelets and morphological parameters in patients with ulcerative colitis (colitis ulcerosa). Folia Histochem Cytobiol 2011; 49: 119–24.
  • Korkmaz L, Korkmaz AA, Akyüz AR, Ağaç MT, Acar Z, Kırış A et al. Association between mean platelet volume and coronary artery calcification in patients without overt cardiovascular disease: an observational study. Anadolu Kardiyol Derg 2012; 12: 35–9.
  • Yazici HU, Poyraz F, Sen N, Tavil Y, Turfan M, Tulmaç M et al. Relationship between mean platelet volume and left ventricular systolic function in patients with metabolic syndrome and STelevation myocardial infarction. Clin Invest Med 2011; 34: E3
  • Köşüş N, Köşüş A, Turhan N. Mean platelet volume as a marker of future cardiovascular disease risk in pregnant women with impaired fasting glucose and impaired glucose tolerance. Turk J Med Sci 2012; 42: 245–51.
  • Kandemir O, Polat G, Saraçoğlu G, Taşdelen B. The predictive role of AST level, prothrombin time and platelet count in the detection of liver fibrosis in patients with chronic hepatitis C. Turk J Med Sci 2009; 39: 857–62.
  • Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haematol 2005; 128: 698–702.
  • Hui JM, Sud A, Farrell GC, Bandara P, Byth K, Kench JG et al. Insulin resistance is associated with chronic hepatitis C virus infection and fibrosis progression [corrected]. Gastroenterology 2003; 125: 1695–704.
  • Purnak T, Efe C, Beyazit Y, Ozaslan E, Astan R, Milanloglu A et al. Recent insights into the relationship between inflammatory liver diseases and atherosclerosis. J Investig Med 2011; 59: 904–
  • Wree A, Kahraman A, Gerken G, Canbay A. Obesity affects the liver - the link between adipocytes and hepatocytes. Digestion 2011; 83: 124–33.
  • Goulis J, Chau TN, Jordan S, Mehta AB, Watkinson A, Rolles K et al. Thrombopoietin concentrations are low in patients with cirrhosis and thrombocytopenia and are restored after orthotopic liver transplantation. Gut 1999; 44: 754–8.
  • Kajihara M, Okazaki Y, Kato S, Ishii H, Kawakami Y, Ikeda Y et al. Evaluation of platelet kinetics in patients with liver cirrhosis: similarity to idiopathic thrombocytopenic purpura. J Gastroenterol Hepatol 2007; 22: 112–8.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

The MR imaging features and the analyses of quantitative parameters in cases with surgically repaired tetralogy of Fallot

Bilal BATTAL, Bülent KARAMAN, Veysel AKGÜN, Kemal KARA, Salih HAMCAN, Uğur BOZLAR, Tuncay HAZIROLAN

The effects of formaldehyde intoxication on the inducible nitric oxide synthase expression and nitric oxide level in the liver tissue of rats

Ferah ARMUTCU, Ergün UÇMAKLI, Alaattin ÖZTÜRK

AEG-1 expression in invasive ductal and lobular breast cancers and its relationship with prognostic parameters

Handan ANKARALI, Mehmet YAŞAR, Murat OKTAY, Havva ERDEM, Ümran YILDIRIM, Ali Kemal UZUNLAR

Intermittent pneumatic compression pump in upper extremity impairments of breast cancer-related lymphedema

Hülya UZKESER, Saliha KARATAY

Rehabilitation Idea Begins at Sumers

The İdea Of Rehabilitation Began With Th SUMERİANS

Investigation of the protective effects of L-carnitine and L-arginine on cardiovascular changes induced by ACTH and dexamethasone in rabbits

Metehan UZUN, Birkan TOPÇU

Cytokeratin 18 and h-FABP levels in intestinal ischemia–reperfusion injury: role of coenzyme Q10

Muaz BELVİRANLI, Nilsel OKUDAN, Hakkı GÖKBEL, Aysel KIYICI, Mehmet ÖZ, Ayşe KUMAK

Neurocognitive functioning in young high-risk offspring having a parent with bipolar I disorder

Erdem DEVECİ, Erol OZAN, İsmet KIRPINAR, Meltem ORAL, Ali Gökhan DALOĞLU, Nazan AYDIN, Ahmet ÖZTÜRK -

Can plasma-free DNA concentration be a diagnostic tool in critically ill septic patients?

Mustafa Necmettin ÜNAL, Başak Ceyda MEÇO, Melek TULUNAY, Fatma Handan CUHRUK, Mehmet ORAL

Muharrem DAĞLI, Fatma Fulya KÖYBAŞIOĞLU, İstemihan AKIN, Ünsal HAN, Binnur ÖNAL, Gülçin ŞİMŞEK