Background: Identifying patients at risk with Non-alcoholic fatty liver disease (NAFLD) related fibrosis is crucial. Many noninvasive fibrosis markers were developed recently in chronic hepatitis C and B patients, but a few were evaluated in NAFLD.
Aim: to assess the accuracy of the gamma-glutamyl transpeptidase and the other non-invasive markers gamma-glutamyl transpeptidase-to-platelet ratio and gamma-glutamyl transpeptidase-to-albumin ratio (GPR and GAR) versus fibroscan as indicators of hepatic fibrosis in NAFLD patients.
 
Patients and Methods: A total of 100 NAFLD patients were examined by abdominal ultrasound and then fibroscan to assess liver steatosis and fibrosis. They were grouped into the early fibrosis group and the advanced fibrosis group. Demographic data and laboratory investigation were collected.  GPR and GAR were calculated. The correlation between them and liver stiffness measurement (LSM) was reported. The accuracy of predicting liver fibrosis was assessed.
Results: There was a significant positive correlation between GPR and GAR and the degree of fibrosis. GPR (P <0.001*) and GAR (P <0.001*) were independent predictors for advanced hepatic fibrosis by multiple linear regression analysis. Fibrosis score was used as the dependent variable, with the other studied biomarkers as independent variables. The AUCs of GPR and GAR were 0.790 and 0.949 in assessing liver fibrosis, respectively.
Conclusion: GPR and GAR were positively correlated with hepatic fibrosis and may be used as a novel, simple, accurate, and low-cost parameter for diagnosing hepatic fibrosis in NAFLD patients.