Value of serum adenosine deaminase in diagnosis of marked liver fibrosis in patients with chronic hepatitis B virus infection

Objective To investigate the value of serum adenosine deaminase (ADA) in the diagnosis of marked liver fibrosis in patients with chronic hepatitis B virus (HBV) infection.Methods A total of 493 patients with chronic HBV infection who underwent liver biopsy in Ningbo No.2 Hospital from May 2011 to October 2016 were enrolled, and according to the degree of liver fibrosis, these patients were divided into S0 group with 79 patients, S1 group with 254 patients, S2 group with 103 patients, S3 group with 35 patients, and S4 group with 22 patients.Biochemical parameters including total bilirubin (TBil) , alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , gamma-glutamyl transpeptidase (GGT) , albumin (Alb) , and ADA were measured, routine blood test was performed, and aspartate aminotransferase-to-platelet ratio index (APRI) was calculated.These indices were compared between groups.An analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between groups.The chi-square test was used for comparison of categorical data between groups.A dichotomous logistic regression analysis was performed for these indices, and the receiver operating characteristic (ROC) curve was used to analyze the value of ADA, APRI, or a combination of various indices in the diagnosis of marked liver fibrosis.Results There were significant differences in age, sex, TBil, ALT, AST, alkaline phosphatase, GGT, Alb, ADA, and APRI between the S0, S1, S2, S3, and S4 groups (F = 11.41, χ2= 14.45, 15.08, 28.27, 48.22, 48.65, 80.53, 17.03, 57.89, and 73.20, all P < 0.05) .Sex, age, and serum ADA were independent risk factors for marked liver fibrosis (odds ratio = 2.59, 1.05, and 1.12, all P < 0.01) .ADA, APRI, or a combination of various indices had a certain value in the diagnosis of marked liver fibrosis (all P < 0.01) , with an area under the ROC curve of 0.70, 0.73, and 0.75, respectively.Conclusion Serum ADA has a certain value in the diagnosis of marked liver fibrosis in patients with chronic HBV infection.