INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. Accurate assessment of liver fibrosis is essential for the prognosis and management of NAFLD. Mean platelet volume (MPV), an index of platelet activation, has been associated with liver fibrosis in various chronic liver diseases
however, its role in NAFLD remains uncertain. METHODS: This study analyzed data from 70,830 patients with NAFLD who underwent a comprehensive health examination between 2015 and 2019. Patients were stratified into three groups based on the fibrosis-4 (FIB-4) index: low (<
1.30), indeterminate (1.30-2.67), and high (>
2.67). We evaluated the differences in MPV among these groups and analyzed the association between MPV and the FIB-4 index. RESULTS: MPV varied significantly across the three groups categorized by the FIB-4 index (p <
0.001). Additionally, a weak but statistically significant positive correlation was observed between MPV and the FIB-4 index (rho = 0.170, p <
0.001). Multivariable linear regression adjusted for multiple covariates showed that MPV remained significantly associated with the FIB-4 index (β = 0.01, p <
0.001). CONCLUSIONS: MPV may serve as a supplementary non-invasive marker for assessing liver fibrosis in patients with NAFLD. Further studies are required to validate these findings and explore the utility of MPV in conjunction with other non-invasive markers.