Comparison Of Platelet Count And Morphological Features Among Patients With Non-alcoholic Fatty Liver Disease

ObjectiveTo retrospectively analyze the differences of platelet count(PC),mean platelet volume(MPV),and platelet volume distribution(PDW)in nonalcoholic fatty liver disease(NAFLD)patients with different age,gender,body mass index(BMI)and the degree of disease progression.To evaluate the clinical value of PC,MPV,and PDW in evaluating liver steatosis and liver fibrosis in patients with NAFLD.Further explore the independent influencing factors of liver stiffness value(LSM),in order to provide a more convenient and practical NAFLD evaluation method for clinic.MethodsThe clinical data of the population from January 2016 to February 2017 and the physical examination center were collected.All the selected subjects had abdominal ultrasound and FibroScan examination.The abdominal ultrasound and FibroScan were simultaneously diagnosed as fatty liver.The inclusion criteria for the population,except alcoholic liver disease,viral liver disease,drug-induced liver injury,autoimmune liver disease,and infection,recent cardiovascular and cerebrovascular diseases and blood system diseases,were eventually included in 829 patients with nonalcoholic fatty liver disease.Subject of study.The PLT counts and the differences between MPV and PDW at different ages and different BMI values were analyzed and gender differences were compared.The subjects were divided into three groups according to different FibroScan CAP values,namely 238 ?CAP<259 group,259 ?CAP<292 group and CAP?292 group,which were divided into different LSM(liver hardness)values.Three groups,namely LSM<7.9kPa group,7.9?LSM<9.8kPa group and LSM?9.8kPa group,comparative analysis of PLT count and MPV,PDW difference between different CAP values and different LSM groups,and finally using multiple logistic regression analysis Determine the independent relevant factors that affect the LSM value? Results1.Comparing the results of patients with different ages of NAFLD showed that PC showed a decreasing trend with age,with statistical difference(p<0.001),and PC in male NAFLD patients was significantly lower than female(p<0.001).MPV and PDW only increased with age in female NAFLD patients,and there was a statistical difference(p=0.009;p=0.009),but there was no such trend in male NAFLD patients.2.PLT counts of male,female,or general NAFLD patients were highest at the level of obesity.In male and general NAFLD patients,the PLT counts of overweight patients decreased compared with obese patients,and were statistically significant(p=0.019).There was no significant statistical difference between MPV and PDW in different BMI values.3.Comparison of patients with different CAP values of NAFLD showed that PC showed a decreasing trend with increasing CAP value(p=0.023),and further comparison of gender differences did not reveal similar trends.MPV showed an increasing trend with increasing CAP value,which was statistically significant(p=0.027),and a similar trend was observed in male populations(p=0.037),while female groups did not.PDW showed an increasing trend with increasing CAP values in female NAFLD patients,with statistical differences(p=0.035),whereas males did not.4.The comparison between patients with different LSM values showed that PC showed a decreasing trend with the increase of LSM value,which was statistically significant(p<0.001),and this similar trend appeared in both male and female NAFLD patients(p=0.001;p=0.007).There was no statistical difference between MPV and PDW in different LSM value groups.5.Comparison of NAFLD patients with different liver function showed that PC,MPV and PDW were not statistically different between ALT abnormal group and ALT normal group or AST abnormal group and AST normal group.6.Multivariate analysis of LSM value related factors showed that BMI,CAP,AST,ALP,and PC were independent factors of LSM,and there was a positive correlation between BMI,CAP,AST,ALP and LSM values,and a negative correlation between PC and LSM values.Conclusions1.PC differs in gender and is affected by age and BMI,while MPV and PDW only have age-related differences in female NAFLD patients and are not affected by BMI.2.PC showed a decreasing trend with the increase of CAP value,and showed a decreasing trend with the increase of LSM value,and was not affected by AST and ALT.It was helpful to judge liver fat and fibrosis in patients with NAFLD when liver transaminase was normal.degree.MPV has an increasing trend with the increase of hepatic steatosis,and is not affected by AST and ALT,which is helpful to judge the degree of hepatic steatosis in patients with NAFLD when liver transaminase is normal.3.BMI,CAP,AST,ALP,and PC are independent factors related to LSM values.Compared with ALT,AST and ALP are more likely to be associated with higher LSM values.PC is also an important marker reflecting the progression of NAFLD.