A Comparison of the Ratio of Serum Chitinase 3-like Protein-1 to PLT and FIB-4 Index in the Diagnosis of Mild and Moderate Chronic Hepatitis B
Objective To compare the ratio of CHI3L1 to PLT and FIB-4 index in the diagnosis of mild and moderate chronic hepatitis B.Methods A total of 122 patients with mild and moderate chronic hepatitis B(CHB)admitted to our hospital from January,2023 to December,2023 were collected for the study,including 30 patients with mild CHB(mild CHB group)and 92 patients with moderate CHB(moderate CHB group).There were 78 males and 44 females in this cohort.The youngest study subject was 12 years old,while the oldest subject was 68 years old,with the mean age of 38.3±11.1 years old.PLT,ALT,AST and CHI3L1 were collected on an empty stomach status in the morning,and these items were calculated as CPR and FIB-4 index.LSD-t test was applied for measurement data conforming to normal distribution and Mann-Whitney U test was used for comparisons with non-normal distribution.Chi-square test was applied for comparisons between datasets.Receiver operating characteristic(ROC)curve was drawn and 95％confidence zone(95％CI)were obtained using MedCalc statistical system.Results(1)There were significant differences in age,CHI3L1,PLT,ALT,AST,FIB-4 and CPR among the three groups(U=3.288,10.837,8.627,7.130,8.225,4.485,12.966,P＜0.01).CHI3L1,ALT and CPR in moderate CHB group were significantly higher than those in mild CHB group and control group(P＜0.05),and those in mild CHB group were significantly higher than those in the control group(P＜0.05).AST and FIB-4 in moderate CHB group were significantly higher than those in mild CHB group and control group(P＜0.05).The PLT in moderate CHB group was significantly lower than that in mild CHB group and control group(P＜0.05).The age of moderate CHB group was significantly lower than that of mild CHB group(P＜0.05).(2)The ROC curve of CHI3L1 in mild CHB patients showed that the AUC of CH13L1 was 0.774(95％CI 0.645-0.903).The AUC of FIB-4 was 0.551(95％CI 0.401-0.701)and the AUC for CPR was 0.742(95％CI 0.608-0.876).The sensitivity and specificity of CHI3L1 and CPR were superior to FIB-4.The difference between CHI3L1 and FIB-4 was statistically significant(Z=2.246,P＜0.05).There was significant difference between CPR and FIB-4 independent diagnosis(Z=2.183,P＜0.05).(3)The ROC curve of CHI3L1 in patients with moderate CHB showed that the AUC of CHI3L1 was 0.793(95％CI 0.717-0.870).The AUC of FIB-4 was 0.722(95％CI 0.629-0.814)and the AUC for CPR was 0.832(95％CI 0.762-0.901).The sensitivity and specificity of CHI3L1 and CPR were superior to FIB-4.There was significant difference between CPR and FIB-4 independent diagnosis(Z=2.244,P＜0.05).Conclusion The AUC of CPR in patients with mild and moderate CHB is significantly higher than that of FIB-4 in the same group,and the increasing trend of CPR is consistent with the severity of clinical manifestations,which could be used as a non-invasive indicator for clinical assessment of liver disease course in patients with CHB.
Chronic hepatitis BChitinase 3-like protein-1PlateletFIB-4 index
万方数据
维普
