Investigation of non-invasive indicators of liver fibrosis in thalassemia major patients

Although liver biopsy is a gold standard for evaluating liver fibrosis, due to the invasive nature of the biopsy and complications related to it in thalassemia major patients, it is important to use new, valid and non-invasive methods to estimate the stage of liver fibrosis. Therefore, this study aimed to evaluate the status of non-invasive liver parameters such as FIB-4, APRI, and AAR in thalassemia major patients. The present descriptive-analytical study was conducted in 2019 on patients with thalassemia major. In this study, 140 thalassemia patients were evaluated for demographic findings, liver enzymes and non-invasive indicators of liver fibrosis. Also, underlying diseases such as diabetes, ischemic heart disease and other cases were extracted from patients’ medical records. Finally, the data were entered into SPSS V20 software and evaluated. In the present study, 38.6% of the patients were male and the mean age of the patients was 18.47 ± 8.21 years with an age range of 1 to 37 years. Evidence from the present study indicated that patients with thalassemia who had an abnormal liver echo had a significantly higher abnormal APRI index that was consistent with an abnormal liver echo (P = 0.019). However, these items are not applicable for AAR and FIB-4 indicators (P˃0.05). The correlation coefficient of APRI and AAR indices with ALT, AST and ferritin was relatively high and was statistically significant (P˂0.05). Therefore, it can be concluded that these enzymes are well associated with changes in these indices, while there was no significant correlation between the ALKP enzyme and the above indicators. The evidence of the present study showed that non-invasive tests for liver fibrosis including APRI and AAR can have a suitable substitute in assessing the progression of liver fibrosis in thalassemia patients.