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

Nihal Çallıoğlu; Güray Tuna; Özden Tandoğan; Fırat Ersan; Selçuk Atalay; Kübra K. Bilirer

doi:10.15537/smj.2024.45.11.20240760

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Figure 1
- Receiver operating characteristic analysis (the effect of platelet lymphocyte ratio value in predicting intrahepatic cholestasis of pregnancy). ROC: receiver operating characteristic

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Table 1

- Intergroup comparisons in terms of socio-demographic, obstetric characteristics, and laboratory values.

Variables	Control group (n=266)	Group with mild cholestasis (n=109)	Group with severe cholestasis (n=64)	P-values^{^†}
Age (year)	28.6±5.0	28.2±5.4	29.0±6.5	0.668
Gestational week^{^***}	33.0±3.5	32.6±3.4	33.1±2.9	0.350
Gravida (number)	2.4±1.4	2.2±1.4	2.3±1.5	0.321
Parity (number)	1.0±1.0	0.8±1.0	0.9±1.1	0.288
Height (cm)	162.4±4.4	162.5±3.9	162.3±4.5	0.725
Weight (kg)	74.7±8.4	75.8±8.6	74.6±9.0	0.342
BMI (kg/m²)	28.3±2.8	28.7±2.8	28.3±2.9	0.246
WBC (/mm×10)	10.15±2.52^a	9.51±2.86	9.35±3.56^b	0.002^{^**}
PLT (/mm×10)	236.74±61.56	246.18±79.55	249.97±82.92	0.637
Hb (g/dL)	11.41±1.29	11.26±1.47	11.47±1.20	0.568
Hct (g/dL)	34.22±3.36	34.26±3.86	34.04±5.11	0.927^{^††}
Neutrophil (×10/uL)	7.41±2.27^a	7.13±3.51	6.95±3.26^b	0.009^{^**}
Neutrophil (%)	71.69±7.85	70.96±8.45	70.19±11.45	0.272
Lymphocyte (×10/uL)	1.98±0.57	1.88±0.64	2.02±1.53	0.150
Lymphocyte (%)	20.04±6.00	20.96±8.08	21.58±9.32	0.444
Monocytes (×10/uL)	0.69±0.21^b	1.06±3.48	1.36±5.93^a	0.032^{^*}
Monocytes (%)	6.79±1.48	6.92±2.31	6.72±2.74	0.609
AST (U/L)	17.24±27.17^c	86.57±116.17^d	122.11±205.37^e	<0.01
ALT (U/L)	16.18±58.62^c	125.30±171.60^d	180.03±281.10^e	<0.01
TBA	5.23±2.14^f	21.11±8.21^g	65.95±26.93^h	<0.01

Values are presented as mean ± standard deviation (SD).

Dunnett’s T3 test: a>b, d>c, e>c, g>f, h>f, h>g.

BMI: body mass index, WBC: white blood cell count, Hb: hemoglobin, Hct: hematocrit, PLT: platelet count, AST: aspartate aminotransferase, ALT: alanine aminotransferase, TBA: total bile acid

↵^† Kruskal-Wallis test.
↵^†† One-way analysis of variance.
↵*** Gestational week at the time of initial itching for ICP patients and corresponding time for matched controls.
↵* p<0.05,
↵** p<0.01.

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Table 2

- Comparison of intergroup laboratory ratio values.

Variables	Control group (n=266)	Group with mild cholestasis (n=109)	Group with severe cholestasis (n=64)	P-values^{^†}
SII (109/L)	963.66±541.31	1041.46±790.77	1081.14±1044.98	0.823
PLR	127.51±48.08^a	144.16±61.99^b	146.65±73.83	<0.01
NLR	4.08±1.98	4.15±2.25	4.12±2.77	0.593
MLR	0.37±0.16	0.63±2.08	1.24±7.19	0.221

Values are presented as mean ± standard deviation (SD).

Dunnett’s T3 test: b>a.

SII: systemic immune-inflammation index, PLR: platelet lymphocyte ratio, NLR: neutrophil-to-lymphocyte ratio, MLR: monocytes-to-lymphocyte ratio

↵^† Kruskal-Wallis test.
** p<0.01.

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Table 3

- Receiver operating characteristic analysis results of systemic immune-inflammation index, platelet lymphocyte ratio, neutrophil-to-lymphocyte ratio, and monocytes-to-lymphocyte ratio values.

Variables	AUC (95% CI)	SE	Cut-off values	P-values	Sensitivity (%)	Specificity (%)	LR+
SII	0.517 (0.461-0.574)	0.029	833.8611	0.538	52.6	53.8	1.14
PLR	0.587 (0.531-0.644)	0.029	126.2238	<0.01	57.2	57.1	1.34
NLR	0.527 (0.470-0.584)	0.029	3.6874	0.343	53.8	50.0	1.08
MLR	0.522 (0.466-0.578)	0.029	0.3419	0.436	55.5	50.8	1.13

AUC: area under the curve, CI: confidence interval, SE: standard error, LR: likelihood ratio, SII: systemic immune-inflammation index, PLR: platelet lymphocyte ratio, NLR: neutrophil-to-lymphocyte ratio, MLR: monocytes-to-lymphocyte ratio