Evaluation of Platelet Parameters in Relation to Aspartate Aminotransferase to Platelet Ratio Index and Fibrosis-4 Scores among Non-alcoholic Fatty Liver Disease Patients and Healthy Controls: An Exploratory Study

Abstract Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent chronic liver condition closely linked with obesity and metabolic syndrome. Early detection of hepatic fibrosis is essential to prevent progression to cirrhosis. Platelet indices and non-invasive scoring systems such as the Aspartate Aminotransferase to Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) are emerging as useful tools in this context. Aim: This study evaluates platelet parameters and scoring systems and their correlation with non-invasive fibrosis markers in NAFLD patients. Patients and Methods: A cross-sectional study was conducted on 30 NAFLD patients (Group A) and 30 age- and sex-matched healthy controls (Group B) at a tertiary healthcare centre. Haematological and biochemical parameters were recorded, and platelet indices (mean platelet volume, platelet distribution width, plateletcrit [PCT]) were analysed. Liver stiffness was assessed by FibroScan®. APRI and FIB-4 scores were calculated and correlated with platelet indices and FibroScan values. Results: FibroScan scores were significantly higher in Group A compared to controls ( P < 0.001). Platelet count and indices showed no significant intergroup differences. However, APRI and FIB-4 scores negatively correlated with platelet count and PCT ( P < 0.01). A moderate positive correlation was observed between APRI and FIB-4 ( r = 0.391, P = 0.033). No significant correlation was found between FibroScan and fibrosis scores. Conclusion: APRI and FIB-4 correlated with platelet indices but not FibroScan values. Platelet indices alone did not differentiate NAFLD from controls. Larger, fibrosis-stratified studies are needed to clarify clinical relevance.