AST and Platelets with APRI

TEST: 385375
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CPT: 84450; 85049
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Synonyms

  • Fatty Liver Disease
  • MASH
  • MASLD
  • Metabolic Dysfunction-Associated Steatohepatitis
  • Metabolic Dysfunction-Associated Steatotic Liver Disease
  • NAFLD
  • Nonalcoholic Fatty Liver Disease
  • Noninvasive Liver Biopsy
  • Steatohepatitis

Expected Turnaround Time

Within 1 day

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Information

Related Documents

For more information, please review the literature below.

NAFLD-NASH Capabilities Brochure

Specimen Requirements

Specimen

Serum and whole blood

Volume

0.5 mL (serum); fill tube to capacity (whole blood)

Minimum Volume

0.5 mL (serum), 0.5 mL (whole blood)

Container

Gel-barrier tube or red-top tube and lavender-top (EDTA) tube

Collection

Separate serum from cells within 45 minutes of collection; invert EDTA tube immediately 8 to 10 times once tube is filled at the time of collection.

Storage Instructions

Room temperature

Stability Requirements

Temperature

Period

Room temperature

1 day

Refrigerated

3 days

Frozen

Unstable

Freeze/thaw cycles

Unstable

Causes for Rejection

Serum: gross hemolysis; improper labeling

Whole blood: hemolysis; clotted specimen; tube not filled with minimum volume; improper labeling; transfer tubes with whole blood; specimen diluted or contaminated with IV fluid; specimen received with plasma removed; specimen collected in any anticoagulant other than EDTA

Test Details

Use

AST to Platelet Ratio Index (APRI) is reported to be a simple, noninvasive and readily available laboratory test index that can stratify patients with HCV and nonalcoholic steatohepatitis (NASH), now known as metabolic dysfunction-associated steatohepatitis (MASH), who are at high or low risk for significant fibrosis and cirrhosis with high degree of accuracy.

Limitations

Clumping may cause false low platelet count. Platelet satellitism around neutrophils will cause a pseudothrombocytopenia. RBC or WBC fragments including fragmented fragile leukemic cells and neutrophil pseudoplatelets may cause falsely elevated counts.

Methodology

AST: kinetic; Platelet Count: automated cell counter

References

Angulo P, Bugianesi E, Bjornsson ES, et al. Simple noninvasive systems predict long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology. 2013 Oct;145(4):782-789.23860502
Boursier J, Vergniol J, Guillet A, et al. Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in nonalcoholic fatty liver disease. J Hepatol. 2016 Sep;65(3):570-578.27151181
Chou R, Wasson N. Blood tests to diagnose fibrosis or cirrhosis in patients with chronic hepatitis C virus infection: a systematic review. Ann Intern Med. 2013 Jun 4;158(11):807-820.23732714
Lin ZH, Xin YN, Dong QJ, et al. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. Hepatology. 2011 Mar;53(3):726-736.21319189
Rinella ME, Sanyal AJ. Management of NAFLD: a stage-based approach. Nat Rev Gastroenterol and Hepatol. 2016 Apr;13(4):196-205.26907882
Sanyal A, Ratziu V, Goodman Z, et al. 507 APRI and FIB-4 index scores can enrich for subjects with fibrotic nonalcoholic steatohepatitis (NASH) in Clinical Trials - The CENTAUR trial data. Gastroenterol. 2016 Apr;150(4)Supp1:S1037-S1038.10.1016/S0016-5085(16)33508-9
Shaheen AA, Myers RP. Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C-related fibrosis: a systematic review. Hepatology. 2007 Sep;46(3):912-921.17705266
Tapper EB, Krajewski K, Lai M, et al. Simple non-invasive biomarkers of advanced fibrosis in the evaluation of nonalcoholic fatty liver disease. Gastroenterol Rep (Oxf). 2014 Nov;2(4):276-280.25002154

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
385375 AST and Platelets with APRI 001123 AST (SGOT) IU/L 1920-8
385375 AST and Platelets with APRI 015172 Platelets x10E3/uL 777-3
385375 AST and Platelets with APRI 011579 APRI Index 86465-2

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