Correlation between PLT, MPV, PDW and liver fibrosis and inflammatory activity in patients with NAFLD: A retrospective case-control study

This study investigates the association of platelet count (PLT), mean platelet volume (MPV), and platelet distribution width (PDW) with liver fibrosis and hepatic inflammatory activity in nonalcoholic fatty liver disease (NAFLD) and evaluate their noninvasive biomarker potential. This retrospective case-control study included 117 biopsy-confirmed NAFLD patients and 108 healthy controls. NAFLD patients were stratified by METAVIR scoring system fibrosis stage (F0-F4) and inflammatory activity grade (A0-A3). Platelet parameters, biochemical markers, and fibrosis markers were compared. Correlations were assessed using Spearman analysis, and multivariate logistic regression identified independent risk factors. NAFLD patients had lower PLT and higher MPV/PDW levels than controls (all P < .05). PLT negatively correlated with fibrosis stage (r = -0.640) and inflammatory grade (r = -0.556), while MPV (fibrosis: r = 0.523; inflammation: r = 0.319) and PDW (fibrosis: r = 0.417; inflammation: r = 0.440) showed positive correlations (all P < .01). Decreased PLT, increased MPV, PDW, alanine aminotransferase, aspartate aminotransferase, and procollagen type III N-terminal peptide were independent risk factors for fibrosis progression. Increased PDW, alanine aminotransferase, total cholesterol, hyaluronic acid, and procollagen type III N-terminal peptide were independent risk factors for inflammatory exacerbation (all P < .05). Altered platelet parameters (decreased PLT, increased MPV/PDW) in NAFLD patients correlate with, and independently predict, the severity of liver fibrosis and inflammation. These routine hematological indices show promise as noninvasive biomarkers for NAFLD assessment, warranting further prospective validation.