Correlations of NLR, AT-Ⅲ, and SUA/Cr levels with disease severity and pregnancy outcomes in patients with acute fatty liver of pregnancy

Abstract

Abstract: Objective To investigate the clinical value of neutrophil/lymphocyte ratio (NLR), antithrombin Ⅲ (AT-Ⅲ) and serum uric acid/creatinine ratio (SUA/Cr) in patients with acute fatty liver of pregnancy (AFLP). Methods Twenty-nine pregnant women with AFLP diagnosed and treated from January 2021 to December 2024 were included in the observation group, and were grouped according to whether they developed acute liver failure (ALF) and adverse pregnancy outcome (APO). Fifty healthy parturients during the same period were selected and included in the control group. NLR, AT-Ⅲ, and SUA/Cr levels were detected and analyzed retrospectively. The levels of NLR, AT-Ⅲ, and SUA/Cr were compared between the observation group and the control group, as well as among subgroups in the observation group. The correlation between each index and APRI, Child-Pugh and Nesbitt scores of liver function was analyzed by Pearson, and the evaluation efficiency of each index was analyzed by ROC. Results The levels of NLR and SUA/Cr in the observation group were 3.85±0.79 and 5.37±0.86, which were higher than those in the control group (2.27±0.43 and 3.62±0.47). The AT-Ⅲ in the observation group was 57.49±4.81%, which was lower than that in the control group (74.68±3.56%). The difference was statistically significant (t=9.165, 10.536, 12.724, all P<0.05). The levels of NLR and SUA/Cr of 7 cases in the ALF subgroup were 4.73±0.91 and 5.74±0.97, higher than those in the non-ALF subgroup of 22 cases, (3.47 ± 0.62 and 4.39 ± 0.58), and the AT-Ⅲ level in the ALF subgroup was 52.36±5.28%, which was lower than that in the non-ALF subgroup (62.84±4.35%). The difference was statistically significant (t=7.462, 8.763, 8.017, all P<0.05). The levels of NLR and SUA/Cr in the APO subgroup of 23 cases were 4.58±0.86 and 5.36±0.85, which were higher than those in the non-APO subgroup of 6 cases (3.36±0.58 and 4.18±0.54). The AT-Ⅲ level in the APO subgroup was 53.27%±5.14%, which was lower than that in the non-APO subgroup (61.49%±4.26%). The difference was statistically significant (t=7.429, 7.254, 8.395, all P<0.05). Pearson analysis showed that NLR and SUA/Cr in AFLP pregnant women were positively correlated with APRI and Child-Pugh score, but negatively correlated with Nesbitt. AT-Ⅲ was positively correlated with Nesbitt and negatively correlated with APRI and Child-Pugh score (P<0.001). ROC curve showed that the AUC of NLR, AT-Ⅲ and SUA/Cr in the evaluation of ALF and APO in AFLP pregnant women were 0.679, 0.786, 0.713 and 0.936, and the sensitivity and specificity of the combined model were higher than those of any individual indicator (P<0.001). Conclusion The combined assessment of NLR, AT-Ⅲ, and SUA/Cr levels has high clinical value in the assessment of acute liver failure and adverse pregnancy outcomes in AFLP pregnant women.

Key words: AFLP, NLR, AT-Ⅲ, SUA/Cr, Pregnancy outcome

Qiu Yuyuan, Wang Lijuan, Gao Yanjie, Yang Yuanchen, Yang Jinyan. Correlations of NLR, AT-Ⅲ, and SUA/Cr levels with disease severity and pregnancy outcomes in patients with acute fatty liver of pregnancy[J]. Chinese Hepatolgy, 2026, 31(8): 1183-1187.

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