Are Systemic Inflammation Markers Reliable for Diagnosing Intrahepatic Cholestasis of Pregnancy? A Retrospective Cohort Study

IF 2.5 3区医学 Q3 IMMUNOLOGY American Journal of Reproductive Immunology Pub Date : 2024-10-05 DOI:10.1111/aji.13937

Sadullah Özkan, Alperen Aksan, Dilara Kurt, Ahmet Kurt, Fahri B. Fıratlıgil, Serap Sucu, Sadun Sucu, Yıldız A. Reis, Burcu G. Öztürk, Ali T. Çağlar

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Abstract

Problem

This study aims to evaluate the effectiveness of inflammation indexes (systemic immune-inflammation index [SII], systemic inflammation response index [SIRI], pan-immune inflammation value [PIV], and neutrophil-to-lymphocyte ratio [NLR]) in the diagnosis of intrahepatic cholestasis of pregnancy (ICP).

Method of Study

A retrospective study was conducted, reviewing medical records of patients diagnosed with ICP who delivered between October 1, 2022, and May 31, 2023, at the Perinatology clinic of Etlik City Hospital, Ankara. A control group of healthy pregnant women with uncomplicated pregnancies was also included. Demographic data, clinical characteristics, and laboratory results, including systemic inflammation indices and liver enzyme levels, were collected and analyzed.

Results

A total of 242 participants were included, with 121 ICP patients and 121 controls. White blood cell count, neutrophil count, and monocyte count showed significant differences between the two groups (p = 0.011, p = 0.004, and p = 0.039, respectively). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly elevated in the ICP group (p < 0.001 for both). SII and NLR were higher in the ICP group compared to controls (p = 0.032 and p = 0.010, respectively). Receiver operating characteristic (ROC) analysis revealed moderate predictive values for SII (area under the curve [AUC] = 0.581, p = 0.030) and NLR (AUC = 0.598, p = 0.009), with no significant difference in their predictive power (p = 0.502).

Conclusions

Systemic inflammation indices such as SII and NLR offer a cost-effective and rapid means of diagnosing ICP, potentially complementing or surpassing traditional biomarkers like bile acid levels and liver function tests (LFTs). These indices can be easily integrated into routine clinical practice, providing timely intervention to improve maternal and fetal outcomes. Further research is warranted to confirm these findings and establish standardized protocols for their use in ICP management.

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诊断妊娠期肝内胆汁淤积症的全身炎症标志物可靠吗？一项回顾性队列研究。

问题：本研究旨在评估炎症指数（全身免疫炎症指数[SII]、全身炎症反应指数[SIRI]、泛免疫炎症值[PIV]和中性粒细胞与淋巴细胞比值[NLR]）在妊娠肝内胆汁淤积症（ICP）诊断中的有效性：本研究采用回顾性研究方法，查阅了安卡拉埃特利克市医院围产期门诊 2022 年 10 月 1 日至 2023 年 5 月 31 日期间确诊为 ICP 患者的病历。对照组包括无并发症的健康孕妇。研究人员收集并分析了人口统计学数据、临床特征和实验室结果，包括全身炎症指数和肝酶水平：结果：共纳入 242 人，其中 121 人为 ICP 患者，121 人为对照组。两组患者的白细胞计数、中性粒细胞计数和单核细胞计数存在显著差异（分别为 p = 0.011、p = 0.004 和 p = 0.039）。ICP 组的天门冬氨酸氨基转移酶（AST）和丙氨酸氨基转移酶（ALT）水平明显升高（均为 p <0.001）。与对照组相比，ICP 组的 SII 和 NLR 较高（分别为 p = 0.032 和 p = 0.010）。接收者操作特征（ROC）分析显示，SII（曲线下面积 [AUC] = 0.581，p = 0.030）和 NLR（AUC = 0.598，p = 0.009）的预测值适中，两者的预测能力无显著差异（p = 0.502）：SII和NLR等全身炎症指数为诊断ICP提供了一种经济、快速的方法，有可能补充或超越胆汁酸水平和肝功能检测（LFT）等传统生物标志物。这些指数可以很容易地纳入常规临床实践，为改善孕产妇和胎儿的预后提供及时的干预。还需要进一步研究来证实这些发现，并建立在ICP管理中使用这些指标的标准化方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.