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

BACKGROUND: Glutamate dehydrogenase (GDH) levels are known to be important in predicting the development of complications associated with liver disease. AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: These findings suggest that GDH, in conjunction with non-invasive fibrosis indices, may serve as a potential biomarker reflecting hepatic injury and fibrosis severity.