Value of globulin-platelet model in diagnosis of liver fibrosis in patients with chronic hepatitis B virus infection and alanine aminotransferase <2 ×upper limit of normal

Objective To investigate the value of globulin-platelet(GP) model in the diagnosis of liver fibrosis in patients with chronic hepatitis B virus(HBV) infection and alanine aminotransferase(ALT)<2 ×upper limit of normal(ULN).Methods A retrospective analysis was performed for the clinical data of 659 patients with chronic HBV infection who underwent liver biopsy in The Second Affiliated Hospital of Anhui Medical University from January 2010 to December 2018 and had an ALT level of <2 ×ULN. Based on the results of liver biopsy, the patients were divided into marked liver fibrosis(S≥2) group, severe liver fibrosis(S≥3) group, and liver cirrhosis(S4)group. The levels of globulin and platelets were measured to calculate the value of GP model, the receiver operating characteristic(ROC)curve was used to evaluate the clinical value of GP model in the diagnosis of liver fibrosis, and the GP model was compared with aspartate aminotransferase to platelet ratio index(APRI) and fibrosis-4(FIB-4). An analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the Kruskal-WallisHtest was used for comparison of non-normally distributed continuous data between multiple groups; the chi-square test was used for comparison of categorical data between multiple groups; a Spearman correlation analysis was used to investigate the correlation between noninvasive models and liver fibrosis stage.Results There was a significant difference in the value of GP model between the patients with different degrees of liver fibrosis (χ2= 126. 960,P< 0. 001). The value of GP model gradually increased with the aggravation of liver fibrosis, suggesting that the value of GP model was positively correlated with the degree of liver fibrosis(r =0.401,P< 0. 01). Globulin, APRI score, and FIB-4 index were positively correlated with the degree of liver fibrosis(r =0. 125, 0. 452, and 0. 414, allP<0. 01), and platelet was negatively correlated with the degree of liver fibrosis(r =-0.390,P<0. .="" gp="" model="" had="" similar="" areas="" under="" the="" roc="" curve="" to="" apri="" score="" and="" fib-4="" index="" in="" diagnosis="" of="" marked="" liver="" severe="" 0.834="" vs="" 0.824="" allp="">0. 05).Conclusion For patients with chronic HBV infection and ALT < 2 × ULN, GP model is a simple and accurate noninvasive assessment model forliver fibrosis, with a similar clinical value to APRI score and FIB-4 index.