Year 2024 / Volume 116 / Number 5
Review
Association between platelet indices and non-alcoholic fatty liver disease: a systematic review and meta-analysis

264-273

DOI: 10.17235/reed.2022.9142/2022

Li Li, Jianxiu Yu, Zhongwei Zhou,

Abstract
Background: Platelet indices have the potential for the evaluation of the activity of non-alcoholic fatty liver disease (NAFLD), but their associations are under hard debate. This meta-analysis aims to assess whether platelet count (PC), mean platelet volume (MPV) and platelet distribution width (PDW) are associated with NAFLD and its progression. Methods: A literature search was conducted using electronic databases to find publications up to July 2022, where the relationship between PC, MPV, PDW and NAFLD was evaluated. Random-effects models were applied to pool effect estimates that were presented as standardized mean differences (SMD) with 95% confidence interval (CI). Results: Nineteen studies involving 3592 NAFLD patients and 1194 healthy individuals were included. The pooled results showed that NAFLD patients had a lower PC (SMD=−0.66, 95% CI =−1.22 to −0.09, P=0.023) but a higher MPV (SMD=0.89, 95% CI=0.26-1.51, P=0.005) and PDW (SMD=0.55, 95% CI=0.11-0.99, P=0.014) compared to healthy controls. Patients with non-alcoholic steatohepatitis (NASH) exhibited a lower PC (SMD=−0.86, 95% CI=−1.20 to −0.52, P<0.001) and a higher MPV (SMD=0.71, 95% CI=0.40-1.02, P<0.001) than non-NASH individuals. A meta-regression analysis demonstrated that MPV was significantly positively correlated with aspartate aminotransferase (P=0.008), the total cholesterol (P=0.003), triglyceride (P=0.006) and low-density lipoprotein cholesterol (P=0.007), but was significantly negatively correlated with high-density lipoprotein cholesterol (P=0.010). Conclusion: This meta-analysis revealed that NAFLD patients presented a reduced PC but an increased MPV and PDW, and the changes might be associated with NAFLD severity. A higher MPV is associated with lipid metabolic disorders in NAFLD.
Share Button
New comment
Comments
No comments for this article
References
1. Lazarus JV, Mark HE, Villota-Rivas M, et al. The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge? J Hepatol 2022;76:771-80.
2. Horn CL, Morales AL, Savard C, et al. Role of Cholesterol-Associated Steatohepatitis in the Development of NASH. Hepatol Commun 2022;6:12-35.
3. Geier A, Tiniakos D, Denk H, et al. From the origin of NASH to the future of metabolic fatty liver disease. Gut 2021;70:1570-9.
4. Tilg H, Adolph TE, Dudek M, et al. Non-alcoholic fatty liver disease: the interplay between metabolism, microbes and immunity. Nat Metab 2021;3:1596-607.
5. Peiseler M, Schwabe R, Hampe J, et al. Immune mechanisms linking metabolic injury to inflammation and fibrosis in fatty liver disease - novel insights into cellular communication circuits. J Hepatol 2022.
6. Golabi P, Sayiner M, Fazel Y, et al. Current complications and challenges in nonalcoholic steatohepatitis screening and diagnosis. Expert Rev Gastroenterol Hepatol 2016;10:63-71.
7. Castera L, Friedrich-Rust M, Loomba R. Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2019;156:1264-81.e4.
8. Jiang Q, Mao R, Wu J, et al. Platelet activation during chronic hepatitis B infection exacerbates liver inflammation and promotes fibrosis. J Med Virol 2019.
9. Kabra H, Walimbe T, Stuart K, et al. Localized inhibition of platelets and platelet derived growth factor by a matrix targeted glycan mimetic significantly attenuates liver fibrosis. Biomaterials 2021;269:120538.
10. Madan SA, John F, Pitchumoni CS. Nonalcoholic Fatty Liver Disease and Mean Platelet Volume: A Systemic Review and Meta-analysis. J Clin Gastroenterol 2016;50:69-74.
11. Okushin K, Takahashi Y, Yamamichi N, et al. Helicobacter pylori infection is not associated with fatty liver disease including non-alcoholic fatty liver disease: a large-scale cross-sectional study in Japan. BMC Gastroenterol 2015;15:25.
12. Liu F, Zhou H, Cao L, et al. Risk of reduced platelet counts in patients with nonalcoholic fatty liver disease (NAFLD): a prospective cohort study. Lipids Health Dis 2018;17:221.
13. van Dijk GM, Maneva M, Colpani V, et al. The association between vasomotor symptoms and metabolic health in peri- and postmenopausal women: a systematic review. Maturitas 2015;80:140-7.
14. Masi A, Quintana DS, Glozier N, et al. Cytokine aberrations in autism spectrum disorder: a systematic review and meta-analysis. Mol Psychiatry 2015;20:440-6.
15. Rhodes KM, Turner RM, Higgins JP. Empirical evidence about inconsistency among studies in a pair-wise meta-analysis. Res Synth Methods 2016;7:346-70.
16. Kilciler G, Genc H, Tapan S, et al. Mean platelet volume and its relationship with carotid atherosclerosis in subjects with non-alcoholic fatty liver disease. Ups J Med Sci 2010;115:253-9.
17. L. W. Investigation of the association between mean platelet volume and non-alcoholic fatty liver disease. Chongqing Medical University 2010.
18. Ozhan H, Aydin M, Yazici M, et al. Mean platelet volume in patients with non-alcoholic fatty liver disease. Platelets 2010;21:29-32.
19. Das SK, Mukherjee S, Vasudevan DM, et al. Comparison of haematological parameters in patients with non-alcoholic fatty liver disease and alcoholic liver disease. Singapore Med J 2011;52:175-81.
20. Chen S-H, Zhang Y, Xia C, et al. Increased hemoglobin and thrombocytocrit in non-alcoholic fatty liver disease. Healthmed 2012;6:3777-82.
21. Celikbilek M, Gürsoy S, Deniz K, et al. Mean platelet volume in biopsy-proven non-alcoholic fatty liver disease. Platelets 2013;24:194-9.
22. Kamada Y, Akita M, Takeda Y, et al. Serum Fucosylated Haptoglobin as a Novel Diagnostic Biomarker for Predicting Hepatocyte Ballooning and Nonalcoholic Steatohepatitis. PLoS One 2013;8:e66328.
23. Cao Y, Li Z, Ma Y. Diagnostic value of P- LCR in non- alcoholic fatty liver. Chin J Gastroenterol Hepatol 2013;22:219-20.
24. Chwist A, Hartleb M, Lekstan A, et al. A composite model including visfatin, tissue polypeptide-specific antigen, hyaluronic acid, and hematological variables for the diagnosis of moderate-to-severe fibrosis in nonalcoholic fatty liver disease: a preliminary study. Pol Arch Med Wewn 2014;124:704-12.
25. Goh GB, Issa D, Lopez R, et al. The development of a non-invasive model to predict the presence of non-alcoholic steatohepatitis in patients with non-alcoholic fatty liver disease. J Gastroenterol Hepatol 2016;31:995-1000.
26. Abdel-Razik A, Mousa N, Shabana W, et al. A novel model using mean platelet volume and neutrophil to lymphocyte ratio as a marker of nonalcoholic steatohepatitis in NAFLD patients: multicentric study. Eur J Gastroenterol Hepatol 2016;28:e1-9.
27. Hirose K, Kanefuji T, Suda T, et al. Formulation for Effective Screening and Management of Nonalcoholic Steatohepatitis: Noninvasive NAFLD Management Strategy. Gastroenterol Res Pract 2016;2016:6343656.
28. Milovanovic Alempijevic T, Stojkovic Lalosevic M, Dumic I, et al. Diagnostic Accuracy of Platelet Count and Platelet Indices in Noninvasive Assessment of Fibrosis in Nonalcoholic Fatty Liver Disease Patients. Can J Gastroenterol Hepatol 2017;2017:6070135.
29. Saremi Z, Rastgoo M, Mohammadifard M, et al. Comparison of platelet number and function between nonalcoholic fatty liver disease and normal individuals. J Res Med Sci 2017;22:75.
30. Oral A, Sahin T, Turker F, et al. Evaluation of Plateletcrit and Platelet Distribution Width in Patients with Non-Alcoholic Fatty Liver Disease: A Retrospective Chart Review Study. Med Sci Monit 2019;25:9882-6.
31. Hanafy AS, Seleem WM, El-Kalla F, et al. Efficacy of a non-invasive model in predicting the cardiovascular morbidity and histological severity in non-alcoholic fatty liver disease. Diabetes Metab Syndr 2019;13:2272-8.
32. Gu Q, Wang H, Li M, et al. Clinical significance of ratio index of red cell distribution width to blood platelet count on the liver fibrosis assessment of nonalcoholic fatty liver disease. China Tropical Medicine 2019;19:263-6.
33. Li Y, Du Z, Wang M, et al. Analysis of the predictive value of platelets and average platelet volume on the progression of patients with non-alcoholic fatty liver. Med J of Communications 2020;34:340-4.
34. Michalak A, Cichoż-Lach H, Guz M, et al. Plateletcrit and Mean Platelet Volume in the Evaluation of Alcoholic Liver Cirrhosis and Nonalcoholic Fatty Liver Disease Patients. Biomed Res Int 2021;2021:8867985.
35. Johansson HE, Wåhlén A, Aldenbäck E, et al. Platelet Counts and Liver Enzymes After Gastric Bypass Surgery. Obes Surg 2018;28:1526-31.
36. Peck-Radosavljevic M. Thrombocytopenia in chronic liver disease. Liver Int 2017;37:778-93.
37. Baffy G, Bosch J. Overlooked subclinical portal hypertension in non-cirrhotic NAFLD: Is it real and how to measure it? J Hepatol 2022;76:458-63.
38. Polimeni L, Pastori D, Baratta F, et al. Spleen dimensions are inversely associated with lysosomal acid lipase activity in patients with non-alcoholic fatty liver disease. Intern Emerg Med 2017;12:1159-65.
39. Miller JB, Figueroa EJ, Haug RM, et al. Thrombocytopenia in Chronic Liver Disease and the Role of Thrombopoietin Agonists. Gastroenterol Hepatol (N Y) 2019;15:326-32.
40. Scharf RE. Thrombocytopenia and Hemostatic Changes in Acute and Chronic Liver Disease: Pathophysiology, Clinical and Laboratory Features, and Management. J Clin Med 2021;10.
41. Wada N, Uojima H, Satoh T, et al. Impact of Anti-GPIIb/IIIa Antibody-Producing B Cells as a Predictor of the Response to Lusutrombopag in Thrombocytopenic Patients with Liver Disease. Dig Dis 2021;39:234-42.
42. Saab S, Brown RS, Jr. Management of Thrombocytopenia in Patients with Chronic Liver Disease. Dig Dis Sci 2019;64:2757-68.
43. Okanoue T, Ebise H, Kai T, et al. A simple scoring system using type IV collagen 7S and aspartate aminotransferase for diagnosing nonalcoholic steatohepatitis and related fibrosis. J Gastroenterol 2018;53:129-39.
44. Sanai FM, Benmousa A, Al-Hussaini H, et al. Is serum alanine transaminase level a reliable marker of histological disease in chronic hepatitis C infection? Liver Int 2008;28:1011-8.
45. Senanayake GV, Fukuda N, Nshizono S, et al. Mechanisms underlying decreased hepatic triacylglycerol and cholesterol by dietary bitter melon extract in the rat. Lipids 2012;47:495-503.
46. Rosso C, Kazankov K, Younes R, et al. Crosstalk between adipose tissue insulin resistance and liver macrophages in non-alcoholic fatty liver disease. J Hepatol 2019;71:1012-21.
47. Baldane S, Ipekci SH, Kebapcilar A. Relationship Between Insulin Resistance and Mean Platelet Volume in Gestational Diabetes Mellitus. J Lab Physicians 2015;7:112-5.
48. Varol E, Akcay S, Ozaydin M, et al. Mean platelet volume is associated with insulin resistance in non-obese, non-diabetic patients with coronary artery disease. J Cardiol 2010;56:154-8.
49. Pogorzelska K, Krętowska A, Krawczuk-Rybak M, et al. Characteristics of platelet indices and their prognostic significance in selected medical condition - a systematic review. Adv Med Sci 2020;65:310-5.
50. Yuan J, Cai J, Zhao P, et al. Association Between Low-Density Lipoprotein Cholesterol and Platelet Distribution Width in Acute Ischemic Stroke. Front Neurol 2021;12:631227.
51. Izzi B, Gialluisi A, Gianfagna F, et al. Platelet Distribution Width Is Associated with P-Selectin Dependent Platelet Function: Results from the Moli-Family Cohort Study. Cells 2021;10:2737.
52. Artunc Ulkumen B, Pala HG, Calik E, et al. Platelet distribution width (PDW): A putative marker for threatened preterm labour. Pak J Med Sci 2014;30:745-8.
53. Shao LN, Zhang ST, Wang N, et al. Platelet indices significantly correlate with liver fibrosis in HCV-infected patients. PLoS One 2020;15:e0227544.
54. Iida H, Kaibori M, Matsui K, et al. Ratio of mean platelet volume to platelet count is a potential surrogate marker predicting liver cirrhosis. World J Hepatol 2018;10:82-7.
55. Terrin N, Schmid CH, Lau J, et al. Adjusting for publication bias in the presence of heterogeneity. Stat Med 2003;22:2113-26.
Related articles
Citation tools
Li L, Yu J, Zhou Z. Association between platelet indices and non-alcoholic fatty liver disease: a systematic review and meta-analysis. 9142/2022


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 981 visits.
This article has been downloaded 111 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 19/08/2022

Accepted: 07/10/2022

Online First: 20/10/2022

Published: 09/05/2024

Article revision time: 37 days

Article Online First time: 62 days

Article editing time: 629 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology