title: Red blood cell distribution width and globulin, noninvasive indicators of fibrosis and inflammation in chronic hepatitis patients.
abstract: OBJECTIVE
  We aimed to develop new simple predictive models for significant fibrosis and inflammation in chronic hepatitis patients using routine laboratory parameters.
  
  
  METHODS
  A total of 218 patients who had undergone liver biopsy were enrolled in our study. Among these, 116 had chronic hepatitis B, 65 had primary biliary cirrhosis, and 37 had autoimmune hepatitis. Patients were divided into two groups: absent-mild (S0-S1, G0-G1) and moderate-severe (S2-S4, G2-G4) according to the histologic severity of liver fibrosis and inflammation. All common demographics and routine laboratory parameters were analyzed.
  
  
  RESULTS
  Red blood cell distribution width (RDW) and globulin values increased with progressive liver fibrosis and inflammation. After adjustment for other potent predictors, liver fibrosis was associated independently with RDW and platelet (odds ratio=0.976 and 1.487, respectively), whereas significant inflammation was associated independently with globulin, alanine aminotransferase, red blood cell, and platelet (odds ratio=1.153, 1.017, 0.392, and 1.487, respectively). The sensitivity and specificity of model A were 73.4 and 79.1% for the detection of significant liver fibrosis [area under the receiver-operating characteristic curve (AUROC)=0.81, P<0.001]. The sensitivity and specificity of model B were 75.9 and 88.9% for predicting advanced liver inflammation (AUROC=0.89, P<0.001). Compared with pre-existing indicators, model A achieved the highest AUROC (0.81, P<0.001) for liver fibrosis, whereas model B showed the highest AUROC (0.89, P<0.001) for liver inflammation.
  
  
  CONCLUSIONS
  RDW may provide a useful clinical value for predicting liver fibrosis; meanwhile, globulin may provide a useful clinical value for predicting liver inflammation in chronic hepatitis patients with other markers.
authors.affiliation: Departments of aHepatology bPathology, the First Hospital of Jilin University, Jilin University cMinistry of Education Key Laboratory of Zoonosis dJilin Province Key Laboratory of Infectious Disease, Laboratory of Molecular Virology, Changchun, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Wang
authors.forename: Hongqin
authors.initials: H
authors.lastname: Xu
authors.forename: Limei
authors.initials: L
authors.lastname: Qu
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Wang
authors.forename: Ruihong
authors.initials: R
authors.lastname: Wu
authors.forename: Xiuzhu
authors.initials: X
authors.lastname: Gao
authors.forename: Qinglong
authors.initials: Q
authors.lastname: Jin
authors.forename: Junqi
authors.initials: J
authors.lastname: Niu
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D004909:Erythrocyte Indices; D005260:Female; D005916:Globulins / Q000032:analysis*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000821:virology; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D005916:Globulins; D018836:Inflammation Mediators