Diagnostic value of the ratio of AST to platelets in patients with hepatic steatosis

Abstract

Abstract. Metabolic-associated steatotic liver disease, which begins with the stage of metabolic-associated steatosis (MASP), affects up to a quarter of the population in developed countries and its frequency is constantly increasing. To diagnose liver fibrosis, it is proposed to determine the ratio of aspartate aminotransferase (AST) to platelets (AST/PLT), but its diagnostic value in patients with MASP has not be en established. The aim of the work was to study the level and diagnostic value of the AST/PLT ratio for the differentiation of metabolicassociated liver steatosis. Materials and methods. There were evaluated the results of the examination of 367 patients. All patients were divided into the main group with concomitant MASP (MG; n = 249), the control group with an intact liver (CG; n = 92) and the comparison group (CG; n = 265) with concomitant steatohepatitis (MASH), in which AST/PLT was calculated. The results were processed statistically with the determination of sensitivity and specificity, the odds ratio, the limits of the 95% confidence interval (CI), «p» deviation with a significance level of <0.05; correlation analysis was performed according to Pearson-Spearman. The results. Under the conditions of MASP, the average value of AST/PLT slightly exceeded the level under the conditions of an intact liver, while under the conditions of MASH, the values of AST/PLT were significantly higher than in MASP (0.253 vs 0.097, p < 0.05). According to the correlation analysis, in patients with concomitant MASP, the increase of AST/PLT occurred in parallel with the deterioration of the liver and heart. According to the probability analysis, an increase in AST/PLT ≥0.11 increased the probability of MASH by 11.72 times (95% CI = 2.55-53.90; p = 0.0016), and under the conditions of an increase in this ratio ≥0.15 — 2.90 times (95% CI = 0.99-8.53; p = 0, 05). Conclusions. An increase of the value of AST/PLT ≥0,11 can be a determinant of the transition of MASP to MASH and can be used to differentiate these conditions.