The gamma-glutamyl transferase to platelet ratio for noninvasive evaluation of liver fibrosis in patients with primary biliary cholangitis

Medicine (Baltimore). 2022 Oct 7;101(40):e30626. doi: 10.1097/MD.0000000000030626.


The gamma-glutamyl transferase to platelet ratio (GPR) has been reported to be as effective as the aspartate transaminase to platelet ratio index (APRI) and fibrosis index based on the 4 factors (FIB-4) in showing the fibrosis stage in patients with chronic hepatitis B. It has been demonstrated that APRI and FIB-4 are successful in the assessment of fibrosis in primary biliary cholangitis (PBC). We investigated the effectiveness of GPR in predicting advanced fibrosis and cirrhosis in patients with biopsy-proven untreated PBC. A total of 35 patients with biopsy-proven PBC were included in this study. The biopsy fibrosis stages of all patients at diagnosis were compared using the APRI, FIB-4, and GPR values. The diagnostic accuracy of GPR for detecting advanced fibrosis and cirrhosis was also investigated. The area under the receiver operating characteristic curve (AUROC) of GPR was 0.84, the cutoff point was 4.81, the sensitivity was 0.41, and the specificity was 0.96 for detecting advanced fibrosis. Our study showed that GPR was more sensitive than APRI and FIB-4 in detecting advanced fibrosis in patients with PBC. GPR could be used as an effective noninvasive marker in PBC to show advanced fibrosis at the time of diagnosis.

MeSH terms

  • Aspartate Aminotransferases
  • Biopsy
  • Hepatitis B, Chronic* / pathology
  • Humans
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis, Biliary* / complications
  • Liver Cirrhosis, Biliary* / diagnosis
  • Platelet Count
  • ROC Curve
  • Retrospective Studies
  • Severity of Illness Index
  • gamma-Glutamyltransferase


  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases