Glutamate dehydrogenase activity and non-ınvasive fibrosis ındices (APRI, AAR, FIB-4) compared to FibroScan in chronic hepatitis B and hepatocellular carcinoma

Glutamate dehydrogenase (GDH) levels are known to be important in predicting the development of complications associated with liver disease. In this study, we aimed to investigate the relationship between GDH activity and liver fibrosis grades, APRI, AAR, FIB-4 and AFP levels in patients with viral hepatitis B and hepatocellular carcinoma. The study group consisted of 95 individuals, including 65 HBV and 30 HCC patients, while the control group consisted of 45 healthy volunteers. Routine analyses, FibroScan evaluations, and non-invasive scoring were performed on the participants. GDH levels were determined using an ELISA kit. Serum GDH activity was significantly higher in the HBV and HCC groups compared to the control group (p < 0.001). Similarly, AAR, FIB-4, and APRI values showed a progressive increase in parallel with disease progression. In patients with chronic HBV infection, GDH, AAR, FIB-4, and APRI levels increased markedly with advancing fibrosis stages. In HCC cases, these parameters were also significantly elevated in the advanced fibrosis stage (F4) (p < 0.01 and p < 0.001). GDH demonstrated a high diagnostic performance, with an AUC of 0.808 in HCC. Correlation analysis revealed a significant positive association between GDH and AST levels in the HBV group (r = 0.35, p = 0.01). Moreover, FIB-4 and APRI indices showed strong positive correlations with AST, GGT, and LDH levels. These findings suggest that GDH, in conjunction with non-invasive fibrosis indices, may serve as a potential biomarker reflecting hepatic injury and fibrosis severity.