Evaluation of red cell distribution width-to-platelet ratio and other laboratory markers in staging Fontan-associated liver disease.

IF 1.3 Q4 SURGERY

Kardiochirurgia I Torakochirurgia Polska Pub Date : 2025-06-25 eCollection Date: 2025-06-01 DOI:10.5114/kitp.2025.152440

Paweł Skorek, Beata Róg, Natalia Bajorek, Tadeusz Wilkosz, Lidia Tomkiewicz-Pająk

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Abstract

Introduction: Fontan-associated liver disease (FALD) is a common complication in patients with Fontan circulation.

Aim: We aimed to evaluate the red blood cell distribution width-to-platelet ratio (RPR) index as a non-invasive marker for assessing FALD severity, given its reported usefulness in in conditions such as hepatitis.

Material and methods: This retrospective, cross-sectional study included adult Fontan patients. Laboratory tests, liver elastography, and hemodynamic parameters were analyzed.

Results: Fifty-six patients (24 females, 43%; median age 24 years, interquartile range [22-28]) were enrolled. Patients were grouped by liver stiffness (LS) stage: METAVIR ≤ F2 (22 patients, 39%) and > F2 (34 patients, 61%). The RPR index was significantly higher in the > F2 group (0.08 vs. 0.12, p = 0.02), along with FIB-4 (0.68 vs. 1.06) and APRI (0.36 vs. 0.57). RPR correlated positively with liver stiffness (r = 0.27), total bilirubin (r = 0.43), cystatin C (r = 0.36), and creatinine (r = 0.38) but not with NT-proBNP, pulmonary artery pressure, or maximal oxygen consumption. The ROC curve analysis for predicting LS > F2 showed an AUC of 0.74 (95% CI: 0.61-0.87), comparable to FIB-4. Moreover, in the logistic regression model that accounted for age, gender, height, body weight, and systemic chamber morphology, RPR showed a significant association with LS > F2, with an odds ratio indicating a 1.4-fold (95% CI: 1.1-1.7) increase for every 0.01-unit increase in RPR.

Conclusions: The RPR index is a simple, helpful tool for evaluating FALD severity in Fontan patients.

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评价红细胞分布宽度与血小板比值及其他实验室标志物在方丹相关肝病分期中的作用。

前言：方丹相关性肝病（FALD）是方丹循环患者的常见并发症。目的：我们的目的是评估红细胞分布宽度与血小板比率（RPR）指数作为评估FALD严重程度的非侵入性标志物，鉴于其在肝炎等疾病中的有用性。材料和方法：这项回顾性、横断面研究包括成年Fontan患者。分析了实验室检查、肝弹性图和血流动力学参数。结果：56例患者中，女性24例，占43%；中位年龄24岁，四分位数范围[22-28])。患者按肝僵硬（LS）分期分组：METAVIR≤F2（22例，39%）和> F2（34例，61%）。> F2组RPR指数显著升高（0.08 vs. 0.12, p = 0.02）， FIB-4 （0.68 vs. 1.06）和APRI （0.36 vs. 0.57）也显著升高。RPR与肝硬度（r = 0.27）、总胆红素（r = 0.43）、胱抑素C （r = 0.36）和肌酐（r = 0.38）呈正相关，但与NT-proBNP、肺动脉压或最大耗氧量无关。预测LS > F2的ROC曲线分析显示AUC为0.74 (95% CI: 0.61-0.87)，与FIB-4相当。此外，在考虑年龄、性别、身高、体重和全身腔室形态的logistic回归模型中，RPR与LS > F2显著相关，比值比显示RPR每增加0.01个单位，增加1.4倍（95% CI: 1.1-1.7）。结论：RPR指数是评价Fontan患者FALD严重程度的一种简单、有效的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kardiochirurgia I Torakochirurgia Polska 医学-外科

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.