الفهرس 
Title : Validation of gamma-glutamyl transpeptidase to platelet ratio (gpr) for prediction of significant liver fibrosis in egyptian patients with non al-coholic fatty liver disease a cross sectional study
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Abstract
Background
Non-alcoholic Fatty Liver Disease (NAFLD) is a clinicopathological spectrum of liver disease that ranges from isolated steatosis, non-alcoholic steatohepatitis (NASH) and fibrosis up to cirrhosis. It is critical to identify patients with significant fibrosis or cirrhosis, liver biopsy was considered the goldstandard for assessment of significant liver disease however it is an invasive technique and carries many risks. Now there are simple, cheap, convenient and noninvasive indices help to assess degree of hepatic fibrosis using biochemical markers,GPR is a recently induced index.
Aim of the work
To validate the diagnostic accuracy of GPR in the prediction of significant liver fibrosis in NAFLD patients in comparison to transient elastography .
Methodology
This is a prospective cross sectional analytical study conducted on 112 NAFLD patients who were were subjected to clinical history taking and examination, laboratory tests, Abdominal ultrasound and APRI, FIB4, NAFLD fibrosis score and GPR were assessed for all patients and compared with transient elastography results.
Results
Overall, 47 were males (41.9%), 65 were females (58%). The mean age was 42.15±9.47 years. 50 patients had significant liver fibrosis (≥ F2) as evident by Fibroscan (44.6%). APRI, FIB-4,NFS and GPR showed good performance in prediction of significant fibrosis with AUC 0.84, 0.84, 0.813 and 0.926 for the cutoffs 0.45, 0.985, -0.585 and 0.145 respectively. These results were compared with the performance of the Fibroscan