Ankara Bilkent City Hospital, Department of Perinatology - Ankara, Turkey.
University of Health Sciences, Ankara Bilkent City Hospital, Department of Obstetrics and Gynaecology - Ankara, Turkey.
Rev Assoc Med Bras (1992). 2024 Oct 25;70(11):e20240860. doi: 10.1590/1806-9282.20240860. eCollection 2024.
The aim of this study was to examine the utility of the albumin-bilirubin score in cases of intrahepatic cholestasis of pregnancy.
A total of 413 patients (182 intrahepatic cholestasis of pregnancy, 50 suspected intrahepatic cholestasis of pregnancy, 181 healthy controls) enrolled in this study. Patients with typical pruritus and bile acid levels >10 μmol/L are defined as the intrahepatic cholestasis of pregnancy group. Patients with pruritus have the same pattern as intrahepatic cholestasis of pregnancy, but who are ultimately diagnosed with other dermatoses of pregnancy are defined as suspected intrahepatic cholestasis of pregnancy. Demographic data, laboratory parameters, and albumin-bilirubin scores were compared between three groups. Correlation analysis was performed on the albumin-bilirubin score and bile acid levels. Also, receiver operating curve analyses were performed to evaluate the predictive performance of the albumin-bilirubin score for intrahepatic cholestasis of pregnancy diagnosis.
The albumin-bilirubin score of the intrahepatic cholestasis of pregnancy group was significantly higher than the other groups. A positive, weak correlation was found between the albumin-bilirubin score and bile acid levels in the intrahepatic cholestasis of pregnancy group. The receiver operating curve curve analyses showed albumin-bilirubin score has significant performance for the prediction of intrahepatic cholestasis of pregnancy in all subjects (area under the curve: 0.726, 95%CI 0.679-0.774, p<0.001) (sensitivity: 69%, specificity: 64%). The detection rate for albumin-bilirubin score was calculated as 67.3%. The positive predictive value was 3.95% (CI 2.9-5.3%), and the negative predictive value was 98.9% (CI 98.6-99.2%).
This study indicated higher albumin-bilirubin score levels in the intrahepatic cholestasis of pregnancy group and a positive relationship between serum bile acid levels and albumin-bilirubin score. Therefore, albumin-bilirubin score could be a cost-effective liver function test for pregnant women with intrahepatic cholestasis of pregnancy.
本研究旨在探讨白蛋白-胆红素评分在妊娠肝内胆汁淤积症中的应用价值。
本研究共纳入 413 例患者（182 例妊娠肝内胆汁淤积症、50 例疑似妊娠肝内胆汁淤积症、181 例健康对照）。具有典型瘙痒和胆汁酸水平>10μmol/L 的患者被定义为妊娠肝内胆汁淤积症组。具有瘙痒症状且与妊娠肝内胆汁淤积症模式相同但最终被诊断为其他妊娠皮肤病的患者被定义为疑似妊娠肝内胆汁淤积症组。比较三组患者的人口统计学资料、实验室参数和白蛋白-胆红素评分。对妊娠肝内胆汁淤积症组的白蛋白-胆红素评分和胆汁酸水平进行相关性分析。同时，进行受试者工作特征曲线分析，评估白蛋白-胆红素评分对妊娠肝内胆汁淤积症诊断的预测性能。
妊娠肝内胆汁淤积症组的白蛋白-胆红素评分显著高于其他两组。在妊娠肝内胆汁淤积症组中，白蛋白-胆红素评分与胆汁酸水平呈正弱相关。受试者工作特征曲线分析显示，白蛋白-胆红素评分对所有受试者的妊娠肝内胆汁淤积症预测具有显著性能（曲线下面积：0.726，95%置信区间：0.679-0.774，p<0.001）（敏感性：69%，特异性：64%）。白蛋白-胆红素评分的检出率为 67.3%。阳性预测值为 3.95%（95%置信区间：2.9-5.3%），阴性预测值为 98.9%（95%置信区间：98.6-99.2%）。
本研究表明，妊娠肝内胆汁淤积症组的白蛋白-胆红素评分水平较高，且血清胆汁酸水平与白蛋白-胆红素评分呈正相关。因此，白蛋白-胆红素评分可能是一种具有成本效益的妊娠肝内胆汁淤积症孕妇肝功能检测方法。
