Systemic immune-inflammatory index and platelet-to-lymphocyte ratio in intrahepatic cholestasis of pregnancy

Objectives: To investigate the role of systemic immune-inflammation index (SII) in the diagnosis and severity of intrahepatic cholestasis of pregnancy (ICP).

Methods: This case-control research involved 173 pregnant women with ICP and 266 gestational age-related healthy pregnant women as the control group. Criteria for diagnosing ICP were acceptance of increased serum total bile acid (TBA) levels (≥10 μmol/L). The mild ICP group (n=109) had TBA levels ranging between 10-39 µmol/l, while the severe ICP group (n=64) had a minimum TBA level above 40 µmol/l. Sociodemographic data, laboratory results, and SII values were compared between groups. Cut-off values were calculated to predict ICP. The SII was calculated as the platelet count × neutrophil count/lymphocyte count.

Results: The leukocyte and neutrophil counts were lower (p<0.01), and the monocyte count was higher (p=0.026) in the severe ICP group compared to the controls. The platelet-to-lymphocyte ratio (PLR) was higher in mild ICP groups than in controls (p<0.01). The optimum PRL cut-off value was 126.2238, with a sensitivity of 57.2% and specificity of 57.1%.

Conclusion: Elevated SII values support the evidence for the inflammatory properties of ICP but do not aid in diagnosing and determining its severity. Platelet-to-lymphocyte ratio may be a useful marker in determining ICP.