Demir Cendek Busra, Bayraktar Burak, Seyhanli Zeynep, Kocyildiz Ezgi, Golbasi Hakan, Can Ibanoglu Mujde, Engin Ustun Yaprak
Department of Obstetrics and Gynecology, Health Sciences University Etlik Zubeyde Hanim Maternity, Teaching and Research Hospital, 06010 Ankara, Turkey.
Department of Obstetrics and Gynecology, Republic of Turkey Ministry of Health Ankara Etlik City Hospital, 06710 Ankara, Turkey.
J Clin Med. 2024 Nov 30;13(23):7289. doi: 10.3390/jcm13237289.
: In this study, the aim was to investigate blood-based clinical biomarkers of inflammation and nutrition indices in hyperemesis gravidarum (HG). : This retrospective case-control study was conducted at a tertiary hospital between 2018 and 2022. A total of 820 pregnant women were enrolled in this study; 410 pregnant women were diagnosed with HG (HG group) at 6-14 weeks of gestation, and 410 pregnant women were healthy controls (control group) in the same gestational weeks. Patients' demographic and clinical characteristics and laboratory parameters were recorded. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, the modified-HALP (m-HALP) score, and the prognostic nutritional index (PNI) were calculated. : The HALP score (32.6 (IQR: 24.9-41.5) vs. 39.2 (IQR: 30.8-49.2), < 0.001) and the PNI score (50 (IQR: 46.3-53.6) vs. 51.3 (IQR: 48.6-53.8), < 0.001) were significantly lower in the HG group, whereas the m-HALP score was similar between the groups. The HALP score had an AUC of 0.625 (95% CI: 0.586-0.664), with the optimal cut-off value set at 35.8, resulting in a sensitivity of 59.7% and a specificity of 59.5% ( < 0.001). Similarly, the PNI score showed an AUC of 0.580 (95% CI: 0.541-0.619), and the optimal cut-off value was set at 50.6, resulting in a sensitivity of 54.9% and a specificity of 54.9% ( < 0.001). In regression analysis, lower HALP scores (OR: 0.906, 95% CI: 0.833-0.984, = 0.019) and lower PNI scores (OR: 0.941, 95% CI: 0.891-0.995, = 0.033) were significantly associated with HG, highlighting their potential as diagnostic markers. Additionally, a negative statistically significant correlation was observed between PNI scores and ketonuria (r = -0.073, = 0.036). : This study demonstrated a decrease in the HALP score and PNI score in cases of HG. However, the m-HALP score was similar in the HG and control groups.
本研究旨在调查妊娠剧吐（HG）患者基于血液的炎症临床生物标志物和营养指标。本回顾性病例对照研究于2018年至2022年在一家三级医院进行。本研究共纳入820名孕妇；410名孕妇在妊娠6至14周时被诊断为HG（HG组），410名孕妇为相同孕周的健康对照（对照组）。记录患者的人口统计学和临床特征以及实验室参数。计算血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分、改良HALP（m - HALP）评分和预后营养指数（PNI）。HG组的HALP评分（32.6（四分位间距：24.9 - 41.5）对39.2（四分位间距：30.8 - 49.2），<0.001）和PNI评分（50（四分位间距：46.3 - 53.6）对51.3（四分位间距：48.6 - 53.8），<0.001）显著更低，而两组间m - HALP评分相似。HALP评分的曲线下面积（AUC）为0.625（95%置信区间：0.586 - 0.664），最佳截断值设定为35.8，灵敏度为59.7%，特异度为59.5%（<0.001）。同样，PNI评分的AUC为0.580（95%置信区间：0.541 - 0.619），最佳截断值设定为50.6，灵敏度为54.9%，特异度为54.9%（<0.001）。在回归分析中，较低的HALP评分（比值比：0.906，95%置信区间：0.833 - 0.984，P = 0.019）和较低的PNI评分（比值比：0.941，95%置信区间：0.891 - 0.995，P = 0.033）与HG显著相关，突出了它们作为诊断标志物的潜力。此外，观察到PNI评分与酮尿症之间存在负的统计学显著相关性（r = -0.073，P = 0.036）。本研究表明HG患者的HALP评分和PNI评分降低。然而，HG组和对照组的m - HALP评分相似。
