Serum cystatin C,monocyte/high-density lipoprotein-C ratio,and uric acid for the diagnosis of coronary heart disease and heart failure

BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.

Humic Acid Effects on Reducing Corn Leaf Burn Caused by Foliar Spray of Urea-Ammonium Nitrate at Different Humic Acid/Urea-Ammonium Nitrate Ratios

Technologies for reducing corn leaf burn caused by foliar spray of urea-ammonium nitrate (UAN) during the early growing season are limited. A field experiment was carried out to evaluate the effects of humic acid on corn leaf burn caused by foliar spray of undiluted UAN solution on corn canopy at Jackson, TN in 2018. Thirteen treatments of the mixtures of UAN and humic acid were evaluated at V6 of corn with different UAN application rates and different UAN/humic acid ratios. Leaf burn during 1 2, 3, 4, 5, 6, 7, and 14 days after UAN foliar spray significantly differed between with or without humic acid addition. The addition of humic acid to UAN significantly reduced leaf burn at each UAN application rate (15, 25, and 35 gal/acre). The reduction of leaf burn was enhanced as the humic acid/UAN ratio went up from 10% to 30%. Leaf burn due to foliar application of UAN became severer with higher UAN rates. The linear regression of leaf burn 14 days after application with humic acid/UAN ratio was highly significant and negative. However, the linear regression of leaf burn 14 days after application with the UAN application rate was highly significant and positive. In conclusion, adding humic acid to foliar-applied UAN is beneficial for reducing corn leaf burn during the early growing season.

Calcium-Magnesium Ca/Mg Ratios and Their Agronomic Implications for the Optimization of Phosphate Fertilization in Rainfed Rice Farming on Acidic Ferralsol in the Forest Zone of Ivory Coast

This study is a contribution to improving rice productivity on acidic plateau soils of the tropical rainforest zone. It is based on taking into account the cationic balances of the soil in order to optimize the phosphorus (P) nutrition of rice on these acidic soils, where this nutrient constitutes a limiting factor for agricultural production. Three (3) pot trials were conducted in Adiopodoumé in the forested south of Côte d’Ivoire. The interactive effects of calcium carbonate (0, 25, 50 and 75 kg Ca ha−1) and magnesium sulfate (0, 25, 50 and 75 kg Mg ha−1) were evaluated on the response of NERICA 5 rice at doses 0, 25, 50 and 75 kg P ha−1 of natural phosphate from Togo, applied only once at the start of the experiment. Additional fertilizers of nitrogen (N) (100 kg N ha−1) and potassium (K) (50 kg KCl ha−1) were added to each of the tests in a split-plot device. The test results revealed a paddy production potential of approximately 3 to 5 t⋅ha−1 for NERICA 5 on an acidic soil, under the effect of the interaction of P, Ca and Mg. The quadratic response of rice yield to the doses of these fertilizers would be more dependent on their balance, itself influenced by Ca nutrition. For the sustainability and maintenance of rice production in agro-ecology studied, it was recommended doses of 38 kg Ca ha−1, 34 kg Mg ha−1 in a Ca/Mg ratio (1/1) with intakes of 41 kg P ha−1, overall in a ratio 1/1/1 (P/Ca/Mg) more favorable to the availability of free iron considered a guiding element of mineral nutrition. Thus, these promising results should be confirmed in a real environment for better management of the fertilization of rice cultivated on acidic plateau soils in Côte d’Ivoire.

Preparation of activated carbon from sunflower straw through H_(3)PO_(4) activation and its application for acid fuchsin dye adsorption

With the development circular economy, the use of agricultural waste to prepare biomass materials to remove pollutants has become a research hotspot. In this study, sunflower straw activated carbon (SSAC) was prepared by the one-step activation method, with sunflower straw (SS) used as the raw material and H3PO4 used as the activator. Four types of SSAC were prepared with impregnation ratios (weight of SS to weight of H3PO4) of 1:1, 1:2, 1:3, and 1:5, corresponding to SSAC1, SSAC2, SSAC3, and SSAC4, respectively. The adsorption process of acid fuchsin (AF) in water using the four types of SSAC was studied. The results showed that the impregnation ratio significantly affected the structure of the materials. The increase in the impregnation ratio increased the specific surface area and pore volume of SSAC and improved the adsorption capacity of AF. However, an impregnation ratio that was too large led to a decrease in specific surface area. SSAC3, with an impregnation ratio of 1:3, had the largest specific surface area (1 794.01 m2/g), and SSAC4, with an impregnation ratio of 1:5, exhibited the smallest microporosity (0.052 7 cm3/g) and the largest pore volume (2.549 cm3/g). The adsorption kinetics of AF using the four types of SSAC agreed with the quasi-second-order adsorption kinetic model. The Langmuir isotherm model was suitable to describe SSAC3 and SSAC4, and the Freundlich isotherm model was appropriate to describe SSAC1 and SSAC2. The result of thermodynamics showed that the adsorption process was spontaneous and endothermic. At 303 K, SSAC4 showed a removal rate of 97.73% for 200-mg/L AF with a maximum adsorption capacity of 2 763.36 mg/g, the highest among the four types of SSAC. This study showed that SAAC prepared by the H3PO4-based one-step activation method is a green and efficient carbon material and has significant application potential for the treatment of dye-containing wastewater.

Influence of Ca/P ratio on the catalytic performance of hydroxyapatite for decarboxylation of itaconic acid to methacrylic acid

Methacrylic acid,an important organic chemical,is commercially manufactured starting from fossil feedstock.The decarboxylation of itaconic acid derived for biomass is a green route to the synthesis of methacrylic acid.In view of the problems existing in the researches on this route such as use of noble metal catalyst,harsh reaction conditions and low desired-product yield,we prepared a series of hydroxyapatite catalysts with different Ca/P molar ratios and evaluated their catalytic performance.The results showed that the hydroxyapatite catalyst with a Ca/P molar ratio of 1.58 had the best catalytic activity.The highest yield of MAA up to 61.2%was achieved with basically complete conversion of itaconic acid under the suitable reaction conditions of 1 equivalent of NaOH,2 MPa of N_(2),250℃,and 2 h.On this basis,a reaction network for the decarboxylation of itaconic acid to methacrylic acid catalyzed by hydroxyapatite was established.With the aid of catalyst characterization using X-ray powder diffraction,NH3/CO2 temperature-programmed desorption,N_(2)physisorption,inductively coupled plasma optical emission spectrometry,and scanning electron microscopy,we found that the distribution of surface acid sites and basic sites,crystal growth orientation,texture properties and morphology of hydroxyapatite varied with the Ca/P molar ratio.Furthermore,the change of the crystal growth orientation and its influence on the surface acidity and alkalinity were clarified.

Preparation and Characterization of Thermoplastic Starch from Sugar Palm (Arenga pinnata) by Extrusion Method

Sugar palm(Arenga pinnata)starch is considered an important renewable,biodegradable,and eco-friendly polymer,which is derived from agricultural by-products and residues,with great potential for the development of biocomposite materials.This research was aimed at investigating the development of TPS biocomposites from A.pinnata palm starch using an extrusion process.Palm starch,glycerol,and stearic acid were extruded in a twin-screw extruder.Scanning electron microscopy(SEM)analysis of TPS showed that the starch granules were damaged and gelatinized in the extrusion process.The density of TPS was 1.3695 g/mL,lower than that of palm starch,and the addition of stearic acid resulted in increased TPS density.X-ray diffraction(XRD)results showed that palm starch had a C-type pattern crystalline structure.The tensile strength,elongation at break,and modulus of elasticity of TPS were 7.19 MPa,33.95%,and 0.56 GPa,respectively.The addition of stearic acid reduced the tensile strength,elongation at break and modulus of elasticity of TPS.The rheological properties,i.e.,melt flow rate(MFR)and viscosity of TPS,were 7.13 g/10 min and 2482.19 Pa.s,respectively.The presence of stearic acid in TPS resulted in increased MFR and decreased viscosity values.The peak gelatinization temperature of A.pinnata palm starch was 70°C,while Tg of TPS was 65°C.The addition of stearic acid reduced the Tg of TPS.The thermogravimetric analysis(TGA)analysis showed that the addition of glycerol and stearic acid decreased the thermal stability,but extended the temperature range of thermal degradation.TPS derived from A.pinnata palm starch by extrusion method has the potential to be applied in industrial practice as a promising raw material for manufacturing bio-based packaging as a sustainable and green alternative to petroleum-based plastics.

Oils with different degree of saturation:effects on ileal digestibility of fat and corresponding additivity and bacterial community in growing pigs

Background Oils are important sources of energy in pig diets.The combination of oils with different degree of saturation contributes to improve the utilization efficiency of the mixed oils and may reduce the cost of oil supplemented.An experiment was conducted to evaluate the effects of oils with different degree of saturation on the fat digestibility and corresponding additivity and bacterial community in growing pigs.Methods Eighteen crossbred(Duroc×Landrace×Yorkshire)barrows(initial body weight:29.3±2.8 kg)were surgically fitted with a T-cannula in the distal ileum.The experimental diets included a fat-free basal diet and 5 oil-added diets.The 5 oil-added diets were formulated by adding 6%oil with different ratio of unsaturated to saturated fatty acids(U:S)to the basal diet.The 5 oils were palm oil(U:S=1.2),canola oil(U:S=12.0),and palm oil and canola oil were mixed in different proportions to prepare a combination of U:S of 2.5,3.5 and 4.5,respectively.Results The apparent and standardized ileal digestibility(AID and SID)of fat and fatty acids increased linearly(P<0.05)as the U:S of dietary oils increased except for SID of fat and C18:2.The AID and SID of fat and fatty acids differed among the dietary treatments(P<0.05)except for SID of unsaturated fatty acids(UFA)and C18:2.Fitted one-slope broken-line analyses for the SID of fat,saturated fatty acids(SFA)and UFA indicated that the breakpoint for U:S of oil was 4.14(R^(2)=0.89,P<0.01),2.91(R^(2)=0.98,P<0.01)and 3.84(R^(2)=0.85,P<0.01),respectively.The determined SID of fat,C18:1,C18:2 and UFA in the mixtures was not different from the calculated SID of fat,C18:1,C18:2 and UFA.However,the determined SID of C16:0,C18:0 and SFA in the mixtures were greater than the calculated SID values(P<0.05).The abundance of Romboutsia and Turicibacter in pigs fed diet containing palm oil was greater than that in rapeseed oil treatment group,and the two bacteria were negatively correlated with SID of C16:0,C18:0 and SFA(P<0.05).Conclusions The optimal U:S for improving the utilization efficiency of mixed oil was 4.14.The SID of fat and UFA for palm oil and canola oil were additive in growing pigs,whereas the SID of SFA in the mixture of two oils was greater than the sum of the values of pure oils.Differences in fat digestibility caused by oils differing in degree of saturation has a significant impact on bacterial community in the foregut.

Effects of Exogenous Trehalose on the Metabolism of Sugar and Abscisic Acid in Tomato Seedlings Under Salt Stress

Salt stress a ects the growth and development of plants, which results in a decrease in crop quality and yield. In this study, we used tomato seedlings treated with salt and trehalose as experimental materials and analyzed them using the technique for order preference by similarity to ideal solution analysis to select the optimal trehalose concentration for treatment. We also determined the contents of sugar and abscisic acid (ABA) and detected the expression of genes involved in the metabolism of sugar and ABA by quantitative real-time PCR. Results showed that the optimal trehalose concentration was 2 mmol/L for tomato seedlings under salt stress. Exogenous trehalose decreased the starch content and increased the soluble sugar con- tent by a ecting the expression of genes related to the metabolism of starch and soluble sugar. Exogenous trehalose altered the accumulation and distribution of sugar by inducing the upregulation of sugar transporter genes. Furthermore, trehalose increased the ABA content to induce salt stress response by regulating the expression of genes related to the synthesis and metabolism of ABA. In conclusion, trehalose can e ectively alleviate salt stress and enhance salt tolerance of tomato. These ndings provide a novel perspective and a better resource to investigate the salt tolerance mechanism and a new method for alleviating salt stress in tomato.

Evaluation of sugar and organic acid composition and their levels in highbush blueberries from two regions of China

Sweet and sour are the most important taste of blueberries,and they are produced by sugar and acid,respectively.Their contributions to the taste depend not only on the levels of sugar and acid,but also on the types and relative proportions of sugar and acid.Therefore,it is very important to evaluate the composition and levels of sugar and acid in blueberries.Regional differences and variety diversity also affect the sugar and acid characteristics of fruits.Therefore,this study selected two main producing regions in northern China(Weihai and Yingkou)to examine the sugar and acid characteristics of 11 common blueberry cultivars.The indexes measured included soluble sugars,organic acids,soluble solid content and titratable acidity.The results showed that glucose and fructose were the major sugars,and citric acid and quinic acid were the major organic acids.Correlation analysis showed that glucose,fructose,and sucrose were positively correlated with total sugar content;the citric acid content was positively correlated with the titratable acidity and total organic acids.Titratable acidity,glucose,fructose,sucrose,total sugar content,citric acid,shikimic acid and total acid content of the blueberries varied significantly between regions(P<0.05).In general,compared with Weihai blueberries,Yingkou blueberries had higher sugar content and lower acid content.The results of this study may provide useful references for the evaluation of sweet and sour flavors and cultivar selection of blueberries.

Effect of Starch/Polylactic Acid Ratio on the Interdependence of Two-Phase and the Properties of Composites

Starch/polylactic acid(PLA) composites were prepared by melt extrusion, with corn starch and PLA as raw materials, glycerol as the plasticizer. Effects of starch/PLA ratio on the interdependence of two-phase and other properties of the composites were studied. The combination of results of TGA with SEM indicated that the interdependence between starch and PLA was increased gradually as the starch/PLA ratio reduced. DSC results showed that the glass transition temperature(Tg), melting temperature(Tm) and degree of crystallinity of PLA in composites were increased gradually, whereas the cold crystallization temperature(Tc) was gradually decreased as the starch/PLA ratio reduced. The rheological properties of composites were closely related with the interdependence of two-phase, with reducing starch/PLA proportion, the interdependence was increased, and then the strain for storage modulus was firstl reduced and then gradually increased. Frequency scanning showed that the storage modulus and complex viscosity were decreased with reducing starch content. As the starch/PLA ratio reduced, the matrix phase PLA was increased, so that the strength of composites was increased gradually, whereas water absorption rate was decreased gradually.

Strategies for Fermentable Sugar Production by Using Pressurized Acid Hydrolysis for Rice Husks

This study investigated the use of leftover biomass(rice husks)as the raw material for the biotechnological production of platform chemicals and biopolymers.Following the biorefinery concept,different acid hydrolysates were studied and resulted into a wide range of treatment strategies.Chemometrics were applied throughout the procedures in multivariate experimental conditions.By using the best hydrolytic conditions of 6.0%H3PO4,135oC(45 MPa)and reaction time of 62 min,21.0 g/L sugar hydrolysates were produced;by using the best hydrolytic condition of 4.5%HNO3,135oC/35 min,16.1 g/L sugar hydrolysates were produced;and with the hydrolysates use of 1.5%H2SO4 and 1.5%HCl,135oC/62 min,18.2 and 17.8 g/L sugar hydrolysates were produced,respectively.The highest productivity,in terms of fermentable sugars,reached 68%of integral cellulose/hemicellulose fraction and surpassed those found in the literature,with regard to the processing of rice husks,by considering just one step process.Sulfuric hydrolysate,detoxified with active carbon,was used to prove this proposal viability,resulting in a fermentation substrate for A.terreus(ATCC10020)and R.radiobacter(LMG196)strains(natural producers of bioproducts),which certified the feasibility of the proposal.The production of fermentable sugars from leftover biomass should encourage a search for new bioconversion routes,which can result in economic and environmental benefits and a spread of knowledge.

Effect of Metaxenia on Sugars and Organic Acids and Taste Quality of Bagged Fuji Apple Fruits

In order to provide reference for the selection of appropriate pollination varieties facilitating the improvement of the flavor quality of bagged Fuji apple, the metaxenia effects of 5 pollination varieties on sugars, organic acids and flavor quality of bagged Fuji fruit were studied. The results showed that the 5 pollination varieties had significant metaxenia effects on sugars, organic acids and flavor quality of bagged Fuji fruit. For the sugar components, the fruits pollinated with Golden Delicious and Jinxiuhaitang showed higher glucose contents, and the fruit pollinated with Gala had the highest sucrose content; the fruits pollinated by Gala, Golden Delicious and Ruby exhibited higher malic acids, and the oxalic acid content and the succinic acid content were higher in the fruits pollinated with Jinxiuhaitang and Ruby ; and the fruit pollinated with Gala had the highest total sugar content, and the total acid content was higher in the fruits pollinated by Jinxiuhaitang and Ruby. The sugar-acid ratio was higher in the fruits pollinated with Gala and Golden Delicious, and the lowest in the fruit pollinated with Ruby. The senso- ry evaluation of fruits showed that the fruit pollinated with Ruby tasted sour-sweet, while the fruits pollinated with other 4 pollination varieties were sour and sweet moderately.

High Performance Liquid Chromatography Analysis of Sugars and Acid Components in ’Xintai Tianhong’ Hawthorn Fruit

[Objectives]This study was conducted to provide basic information for the utilization,quality control and deep processing of‘Xintai Tianhong’hawthorn fruit resources.[Methods]The contents of sugar and acid components in‘Xintai Tianhong’hawthorn fruit were determined by high performance liquid chromatography(HPLC).[Results]‘Xintai Tianhong’hawthorn fruit contained such four kinds of sugar components as fructose,sorbitol,glucose and sucrose,and such six kinds of organic acid components as oxalic acid,tartaric acid,malic acid,acetic acid,citric acid and succinic acid.The fruit had the highest sucrose content,accounting for 70.53%of the total sugar content,followed by fructose,glucose and sorbitol.For the organic acid components,the content of succinic acid was the highest,accounting for 47.32%of the total acid content,followed by citric acid,malic acid,oxalic acid and tartaric acid,and acetic acid had the lowest content.[Conclusions]‘Xintai Tianhong’hawthorn should be a succinic acid-type hawthorn variety,which can be used as a parent in genetic research and breeding practice.

Reactivity Ratios of Diethyldiallylammonium Chloride with Acrylamide or Acrylic Acid

The compositions of copolymers of diethyldiallylammonium chloride （DEDAAC） with acrylamide （AM）, acrylic acid （AA） or sodium acrylic acid （NaAA） at low conversion were determined by elemental analysis, and the reactivity ratios of monomers in copolymerization were obtained by Kelen-Tudos method. The results showed that the reactivity ratios rDE and rAM are 0.31 and 5.27 for DEDAAC with AM, rDE and rAA are 0.28 and 5.15 for DEDAAC with AA, and roe and rNsAA are 0.40 and 3.97 for DEDAAC with NaAA, respectively. The copolymerizations for DEDAAC with AM, AA or NaAA are non-ideal copolymerization and the products are random copolymers.

Isolation of lactic acid bacteria from sugar cane juice and production of lactic acid from selected improved strains

Lactic acid bacteria (LAB) were isolated from fresh sugar cane juice. It was found that several isolates exhibited a clear zone and growth on deMan, Rogosa, Sharpe (MRS) agar supplemented with sodium azide, bromocresol purple and sucrose. However, only 17 isolates which formed large yellow areas were selected for further investigations. These isolates were further identified according to their morphological and biochemical characteristics. It was found that 10 of these isolates were homofermenters. One of these 10 isolates was selected for mutagenesis using chemical (Ethidium bromide) and physical (UV-B) mutagens followed by biochemical characterisation. A total of 112 mutants were isolated and 9 homofermentative isolates were further investigated for their ability to produce lactic acid. 1H-NMR spectroscopy confirmed that all mutant isolates produced lactic acid as the sole fermentation product.

Branched-chain amino acids to tyrosine ratio value as a potential prognostic factor for hepatocellular carcinoma

The prognosis of hepatocellular carcinoma(HCC) depends on tumor extension as well as hepatic function.Hepatic functional reserve is recognized as a factor affecting survival in the treatment of HCC;the ChildPugh classif ication system is the most extensively used method for assessing hepatic functional reserve in patients with chronic liver disease,using serum albumin level to achieve accurate assessment of the status of protein metabolism.However,insuff icient attention has been given to the status of amino acid(AA) metabolism in chronic liver disease and HCC.Fischer's ratio is the molar ratio of branched-chain AAs(BCAAs:leucine,valine,isoleucine) to aromatic AAs(phenylalanine,tyrosine) and is important for assessing liver metabolism,hepatic functional reserve and the severity of liver dysfunction.Although this ratio is diff icult to determine in clinical situations,BCAAs/tyrosine molar concentration ratio(BTR) has been proposed as a simpler substitute.BTR correlates with various liver function examinations,including markers of hepatic f ibrosis,hepatic blood flow and hepatocyte function,and can thus be considered as reflecting the degree of hepatic impairment.This manuscript examines the literature to clarify whether BTR can serve as a prognostic factor for treatment of HCC.

Beneficial n-3 polyunsaturated fatty acid levels and n6:n3 ratios after 4-week EPA + DHA supplementation associated with reduced CRP: A pilot study in healthy young adults

Chronic systemic inflammation is associated with many conditions of aging such as atherosclerosis. Lowering high n-6:n-3 polyunsaturated fatty acid (PUFA) ratios are commonly found in Western diets aids in preventing inflammatory-related diseases. However, it is not clear whether dietary interventions designed to alter n-6:n-3 PUFA ratios can reduce systemic inflammation in younger adults. Studies that evaluate PUFA intake often use subjective data from food frequency questionnaires or food records rather than more precise physiological measures of PUFAs (e.g. plasma levels). Therefore, the purpose of this pilot study that analyzed data from the experimental parent study of younger adults (n = 18), was to determine whether plasma PUFA levels were associated with levels of C-reactive protein (CRP), an inflammatory marker, and if supplementation with n-3 PUFAs was correlated with rising n-3 PUFA concentrations in plasma and decreasing n-6:n-3 ratios. In the parent study, participants received daily either placebo or n-3 PUFA softgels (1.6 g eicosapentaenoic acid [EPA] and 1.2 g docosahexaenoic acid [DHA]). EPA and DHA are the biologically active components in fish oil. Measures included blood for PUFA quantification at baseline and four weeks later, when blister wounds were created and wound fluid and saliva were collected. The saliva samples were used to measure CRP in the present study. We report that CRP was significantly and negatively correlated with total n-3 PUFAs (tau-β = ?0.373, p = 0.031) and positively correlated with n-6:n-3 ratios (tau-β = 0.320, p = 0.063). Those consuming EPA + DHA supplements had significantly higher concentrations of total n-3 PUFAs and significantly lower n-6:n-3 ratios (p The present study has shown that beneficial levels of n-3 PUFAs and n-6:n3 ratios were achieved with 4-weeks of EPA + DHA supplementation and were associated with reduced CRP in young adults. EPA + DHA supplementation for some young adults may help prevent inflammatory conditions later in life.

Noninvasive assessment of liver fibrosis with combined serum aminotransferase/platelet ratio index and hyaluronic acid in patients with chronic hepatitis B

AIM:To construct a noninvasive assessment model consisting of routine laboratory data to predict significant fibrosis and cirrhosis in patients with chronic hepatitis B (CHB). METHODS: A total of 137 consecutive patients with CHB who underwent percutaneous liver biopsy were retrospectively analyzed. These patients were divided into two groups according to their aminotransferase (ALT) level. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), the likelihood ratio (LR) of aminotransferase/platelet ratio index (APRI)≥1.5 or <1.5 in combination with different hyaluronic acid (HA) cut-off points were calculated for the presence of moderate to severe fibrosis/cirrhosis (fibrosis stages 2 and 4) and no to mild fibrosis/cirrhosis (fibrosis stages 0 and 1). RESULTS: The APRI correlated with fibrosis stage in CHB patients. The APRI≥1.5 in combination with a cut-off HA cut-off point >300 ng/mL could detect moderate to severe fibrosis (stages 2-4) in CHB patients. The PPV was 93.7%, the specificity was 98.9%. The APRI <1.5 in combination with different HA cut-off points could not detect no to mild fibrosis in CHB patients. CONCLUSION: The APRI≥ 1.5 in combination with a HA cut-off point >300ng/mL can detect moderate to severe fibrosis (stages 2-4) in CHB patients.