title: Platelet count for predicting fibrosis in nonalcoholic fatty liver disease.
abstract: BACKGROUND
  The severity of liver fibrosis is known to be a good indicator for surveillance, and for determining the prognosis and optimal treatment of nonalcoholic fatty liver disease (NAFLD). However, it is virtually impossible to carry out liver biopsies in all NAFLD patients. The purpose of this study was to investigate the clinical usefulness of measuring the platelet count for predicting the severity of liver fibrosis in a large retrospective cohort of Japanese patients with NAFLD.
  
  
  METHODS
  A total of 1,048 patients with liver-biopsy-confirmed NAFLD seen between 2002 and 2008 were enrolled from nine hepatology centers in Japan. Laboratory evaluations were performed for all patients.
  
  
  RESULTS
  A linear decrease of the platelet count with increasing histological severity of hepatic fibrosis was revealed. The area under the receiver operating characteristic curve estimating the diagnostic performance of the platelet count for hepatic fibrosis Stage 3 was 0.774 (optimal cutoff value, 19.2 × 10(4)/μl; sensitivity, 62.7%; specificity, 76.3%), and that for Stage 4 was 0.918 (optimal cutoff value, 15.3 × 10(4)/μl; sensitivity, 80.5%; specificity, 88.8%).
  
  
  CONCLUSIONS
  The platelet count may be an ideal biomarker of the severity of fibrosis in NAFLD patients, because it is simple, easy to measure and handle, cost-effective, and accurate for predicting the severity of fibrosis. Furthermore, by using the platelet count cutoff value validated in our multiple large trials, efficient recruitment of NAFLD patients may be facilitated.
authors.affiliation: Division of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Yoneda
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hyogo
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Itoh
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ono
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Noriaki
authors.initials: N
authors.lastname: Aoki
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kanemasa
authors.forename: Kento
authors.initials: K
authors.lastname: Imajo
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Toshiji
authors.initials: T
authors.lastname: Saibara
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kawada
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D015331:Cohort Studies; D005234:Fatty Liver / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007564:Japan; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D010976:Platelet Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers