Predictive value of the aspartate aminotransferase to platelet ratio index and aspartate aminotransferase to alanine aminotransferase ratio in early diagnosis of intrahepatic cholestasis in pregnancy

Abstract

Objective: We aimed to investigate the predictive value of the first-trimester aspartate aminotransferase/platelet count ratio index (APRI) and aspartate aminotransferase/alanine aminotransferase ratio for intrahepatic cholestasis in pregnancy (ICP).
 Material and Methods: The clinical data of patients who admitted to the Obstetrics Department of Umraniye Training and Research Hospital, between 2015-2020 were analyzed retrospectively. The study group consisted of 44 patients with ICP and the control group consisted of randomly selected 92 healthy pregnant women.
 Results: The two groups were similar in terms of age, BMI, first and third-trimester platelet count and third-trimester hemoglobin level. Patients with ICP had a significantly higher first-trimester APRI and a lower first trimester AST/ALT ratio than the healthy controls (p <0.001, p = 0.001, respectively). According to the ROC analysis, the optimal cut-off value of the APRI to predict ICP was 0.191, with the sensitivity of 0.66 and specificity of 0.66 (AUC: 0,727), and the optimal cut-off value for AST/ALT ratio was 1.07, with the sensitivity of 0.64, and specificity of 0.62 (AUC: 0,681).
 Conclusion: The first-trimester APRI score and AST/ALT ratio is an easy, inexpensive, and non-invasive tool that may be useful in predicting ICP early.

İkinci-Üçüncü Trimesterde Aspartat Aminotransferaz Trombosit Oranı İndeksinin Gebeliğin İntrahepatik Kolestazı Öngörmesi ve İndeksin Yenidoğan Yoğun Bakım Gereksinimi ile İlişkisi: Üçüncü Basamak Bir Hastaneden Vaka Kontrol Çalışması

“…Tolunay et al found a significant positive correlation between fasting bile acid levels and first trimester APRI score in women with ICP and determined a cut-off value for the APRI score with high sensitivity and specificity to predict ICP in the first trimester (20). In another previous study, patients with ICP had significantly higher first trimester APRI scores and lower first trimester AST/ALT ratio than healthy controls (21). Studies have shown that ICP is an inflammatory process and there is a relationship between inflammation markers and the severity of the disease (22).…”