Noninvasive Indirect Markers of Liver Fibrosis in Alcoholics

Abstract

The aim of this study was to evaluate the diagnostic values of noninvasive indirect markers of liver fibrosis: APRI, GAPRI, Forns, FIB-4, Age-Platelet, and Hepascore in alcoholics. Blood samples were collected from a randomized group of 142 alcohol-dependent patients. The diagnosis of dependency was made according to the ICD-10 WHO criteria. The values of noninvasive markers were calculated with specific algorithms. The fibrosis stage was evaluated on the basis of FibroTest. The values of APRI, Forns, FIB-4, GAPRI, AP, and Hepascore differ between various stages of liver fibrosis. Patients with fibrosis stage F0 present lower values of APRI, Forns, FIB-4, GAPRI, and Hepascore in comparison to the patients with stages F1 and F0-F1. Patients with fibrosis stages < F2 have lower values of all noninvasive markers than patients with stages ≥F2. Patients with fibrosis stages ≥F2 but <F4 have lower values of APRI, Forns, FIB-4, GAPRI, and Hepascore than patients with stage F4. The values of noninvasive markers tested here differ in various stages of liver fibrosis. To our surprise, the patented marker, Hepascore, achieves a lower diagnostic value in alcoholics than simple markers involving only liver enzymes, platelet count, and cholesterol. The best marker of liver fibrosis in alcoholic patients seems to be the Forns index.