ASSOCIATION OF IMMATURE PLATELET FRACTION WITH SIGNIFICANT LIVER FIBROSIS IN PATIENTS WITH METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common cause of chronic liver disease globally, and liver fibrosis is the most important predictor of poor clinical outcomes. Immature platelet fraction (IPF) is a new parameter of platelet turnover and inflammation, but its relationship with liver fibrosis in MASLD is not well studied. Objective: To determine the association between immature platelet fraction and significant liver fibrosis in patients with MASLD. Methods: This is an analytical cross-sectional study, which included 155 adults with MASLD who were recruited from Medical Teaching Institute, Mardan Medical Complex, Mardan, from 1st October, 2025 to 31st March, 2026, using consecutive sampling. Data on demographics, clinical, and lab findings, including IPF, were obtained. Transient elastography was used to assess liver fibrosis, and significant fibrosis was defined as stage ≥F2. SPSS 26 was used for analysis, and p ≤0.05 was considered significant. Results: Liver fibrosis was detected in 51(32.9%) patients. The IPF scores were significantly higher in patients with significant fibrosis compared to patients with no fibrosis (p<0.001). ROC analysis showed IPF had good diagnostic accuracy (AUC=0.841), with an optimum cut-off of 5.8% and a sensitivity of 82.4% and a specificity of 76.9%. When entered as independent variables into multivariable logistic regression, elevated IPF was independently associated with significant fibrosis (p<0.001) along with older age, diabetes mellitus, elevated AST, and decreased platelet count. Conclusion: Immature platelet fraction is an independent and readily available biomarker associated with significant liver fibrosis in MASLD and may improve non-invasive fibrosis risk stratification in routine clinical practice.