Evaluation of the GA/HbA1c Ratio as Non-Invasive Method for Grading Liver Fibrosis in Hepatitis (C) Patients

Abstract

Our study showed that: • Chronic hepatitis c virus (HCV) is a major public health problem and a leading cause of chronic liver fibrosis. • Evaluation of the degree of liver fibrosis is very important in the assessment of the liver disease condition. • Liver biopsy was performed many years ago as a good invasive technique to evaluate the degree of liver fibrosis. • Searching for another non-invasive technique for the evaluation of liver fibrosis is mandatory to be more convenient and more economic • In the present retrospective study we analyzed the relationship between the histological grading of liver fibrosis and the GA/HbA1c ratio . • There were no significant differences between the patients as regard age and sex. • The mean values of GA/HbA1c ratio increased with the progression of the fibrosis stage, suggesting that the GA/HbA1c ratio was associated with the histological severity of liver fibrosis. • Comparing F0-F3(no cirrhosis) and F4(cirrhosis) groups, we found a significant difference in several parameters which correlated with hepatic function. Between the two groups, the GA/HbA1c ratio was significantly higher in patients with cirrhosis. • Comparing F0-F2(without severe fibrosis) and F3-F4(with severe fibrosis) groups, we found a significant difference in several parameters which correlated with hepatic function. Between the two groups, the GA/HbA1c ratio was significantly higher in patients with severe fibrosis. • Comparing F0-F1(without significant fibrosis) and F2-F4(with significant fibrosis) groups, we found a significant difference in several parameters which correlated with hepatic function. Between the two groups, the GA/HbA1c ratio was significantly higher in patients with significant fibrosis. • We evaluated the diagnostic performance of the increased GA/HbA1c ratio (>3.0) for the detection of patients with cirrhosis(F4),severe fibrosis(F3-F4) and significant fibrosis (F2-F4). • When we combined GA/HbA1c and APRI to distinguish between F0-F1 patients and F2-F4 patients, the sensitivity and the specificity for the detection of liver fibrosis increased.