Huang Deng, Hu Yanjun, Dong Biwen, Zheng Zhi, Wang Hai, Liao Tingting, Wang Wenhan, Zheng Xianjue, Xu Zitong, Xia Shuqi, Li Xiaoqing, Sun Congcong, Zhang Hongping, Zheng Jiayong
Department of Infectious Diseases, Wenzhou People's Hospital/Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China.
Department of Gynecology and Obstetrics, Wenzhou People's Hospital/Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China.
Biomark Med. 2025 Jun;19(12):455-462. doi: 10.1080/17520363.2025.2516998. Epub 2025 Jun 7.
This study assessed serum GP73, Nrf2, and CHE levels in pregnancy-associated liver injury and explored their nonlinear risk relationships using restricted cubic spline (RCS) models to establish diagnostic thresholds for early screening.
Conducted from December 2022 to December 2024, 105 pregnant women with liver injury (research group) and 187 healthy controls were retrospectively analyzed. Multivariate logistic regression, ROC curves, RCS models, and decision curve analysis (DCA) evaluated associations, predictive efficacy, dose-response relationships, and clinical utility of these biomarkers.
Elevated GP73 and Nrf2, multiple pregnancies, antipyretic/anti-infective medication use, and malnutrition were risk factors ( < 0.05), while high CHE was protective ( < 0.05). ROC analysis showed AUCs of 0.801 (GP73), 0.785 (Nrf2), and 0.726 (CHE) combined AUC reached 0.951. RCS revealed nonlinear dose-response relationships ( < 0.001), and DCA confirmed clinical significance (net benefit > 0) for individual and combined biomarkers, with the panel showing the highest utility.
GP73, Nrf2, and CHE demonstrated nonlinear associations with pregnancy-related liver injury, particularly GP73. Combined measurement enhances clinical value for early prediction.
本研究评估了妊娠相关肝损伤患者血清GP73、Nrf2和CHE水平，并使用受限立方样条（RCS）模型探讨它们的非线性风险关系，以建立早期筛查的诊断阈值。
回顾性分析2022年12月至2024年12月期间105例肝损伤孕妇（研究组）和187例健康对照。采用多因素逻辑回归、ROC曲线、RCS模型和决策曲线分析（DCA）评估这些生物标志物的相关性、预测效能、剂量反应关系及临床实用性。
GP73和Nrf2升高、多胎妊娠、使用退热/抗感染药物及营养不良为危险因素（<0.05），而高CHE具有保护作用（<0.05）。ROC分析显示，GP73、Nrf2和CHE的AUC分别为0.801、0.785和0.726，联合AUC达0.951。RCS显示存在非线性剂量反应关系（<0.001），DCA证实单个及联合生物标志物具有临床意义（净获益>0），联合检测效用最高。
GP73、Nrf2和CHE与妊娠相关肝损伤呈非线性关联，尤其是GP73。联合检测可提高早期预测的临床价值。
