Neutrophil-to-lymphocyte ratio as a diagnostic marker of intrahepatic cholestasis of pregnancy

Eur J Obstet Gynecol Reprod Biol. 2014 Sep:180:12-5. doi: 10.1016/j.ejogrb.2014.05.042. Epub 2014 Jun 13.

Abstract

Introduction: In this study, we aimed to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR) and total bile acid (TBA) concentration in pregnant women with intrahepatic cholestasis of pregnancy (ICP).

Materials and methods: Fasting and postprandial TBA, NLR, and aminotransferase (AST/ALT) levels in the blood samples of 65 pregnant women with intrahepatic cholestasis were examined in this prospective case-control study. Thirty-three of the patients had mild disease and 32 had severe disease; 70 healthy women in uncomplicated pregnancies served as the control group.

Results: Not only was the mean NLR elevated in the pregnant women with cholestasis when compared to the controls, but it also predicted the severity of the cholestasis. The correlation between fasting TBA and NLR was significant.

Comments: Although TBA is still the diagnostic standard, NLR can be used as an initial screening tool due to its high specificity.

Keywords: Aminotransferase; Cholestasis of pregnancy; Hepatocellular injury; Inflammation.

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Bile Acids and Salts / blood*
  • Biomarkers / blood
  • Case-Control Studies
  • Cholestasis, Intrahepatic / blood*
  • Cholestasis, Intrahepatic / diagnosis
  • Female
  • Humans
  • Leukocyte Count
  • Lymphocyte Count
  • Neutrophils*
  • Pregnancy
  • Pregnancy Complications / blood*
  • Pregnancy Complications / diagnosis
  • Prospective Studies
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Bile Acids and Salts
  • Biomarkers
  • Aspartate Aminotransferases
  • Alanine Transaminase

Supplementary concepts

  • Intrahepatic Cholestasis of Pregnancy