Endothelial Activation and Stress Index as a Novel Prognostic Marker in Intrahepatic Cholestasis of Pregnancy: A Case–Control Study

IF 2.4 3区医学 Q3 IMMUNOLOGY

American Journal of Reproductive Immunology Pub Date : 2025-09-15 DOI:10.1111/aji.70167

Dilara Duygulu Bulan, Ruken Dayanan, Merve Ayas Özkan, Zeynep Şeyhanlı, Gülşan Karabay, Ali Turhan Çağlar

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引用次数: 0

Abstract

Objective: This study aims to evaluate the clinical applicability and prognostic value of the endothelial activation and stress index (EASIX) in patients with intrahepatic cholestasis of pregnancy (ICP). By investigating the potential of the EASIX score to predict perinatal complications and the clinical course of ICP, we seek to contribute to the improved management and prognosis of ICP patients.

Methods: This retrospective cohort study aimed to investigate the prognostic value of the EASIX in patients diagnosed with ICP at Ankara Etlik City Hospital between January 2023 and January 2025. A total of 121 ICP patients and 133 control patients were included. The EASIX score was calculated using lactate dehydrogenase, creatinine and thrombocyte levels. The relationship between EASIX and perinatal complications, including preterm birth and neonatal distress, was assessed.

Results: The EASIX score was significantly higher in the ICP group compared to controls (p < 0.001), with severe ICP showing the highest EASIX scores (p = 0.019). Cut-off analysis indicated that an EASIX score > 0.64 had a sensitivity of 75% and specificity of 64% for severity prediction (AUC = 0.767, p < 0.001), while a score > 0.69 had a sensitivity of 62% and specificity of 61% for predicting composite adverse perinatal outcomes (AUC = 0.711, p < 0.001).

Conclusion: This study demonstrates that the EASIX score may serve as an important prognostic tool in predicting disease severity and neonatal outcomes in ICP. Given the limited availability of bile acid measurements in some clinics, the EASIX score provides a practical and accessible alternative for clinical use. This study evaluates the prognostic value of the endothelial activation and stress index (EASIX) in intrahepatic cholestasis of pregnancy, highlighting its potential to predict disease severity and neonatal outcomes, offering a practical tool for clinical use.

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内皮细胞激活和应激指数作为妊娠肝内胆汁淤积的一种新的预后指标：一项病例对照研究

目的：探讨内皮活化与应激指数（EASIX）在妊娠肝内胆汁淤积症（ICP）患者中的临床适用性及预后价值。通过研究EASIX评分预测围产儿并发症和ICP临床病程的潜力，我们试图为改善ICP患者的管理和预后做出贡献。方法：本回顾性队列研究旨在探讨EASIX对2023年1月至2025年1月在安卡拉埃特利克市医院诊断为ICP患者的预后价值。共纳入121例ICP患者和133例对照患者。EASIX评分采用乳酸脱氢酶、肌酐和血小板水平计算。评估EASIX与围产期并发症（包括早产和新生儿窘迫）之间的关系。结果：ICP组的EASIX评分明显高于对照组（p < 0.001），其中重度ICP的EASIX评分最高（p = 0.019）。截止分析显示，EASIX评分为>； 0.64时预测严重程度的敏感性为75%，特异性为64% (AUC = 0.767, p < 0.001)，而评分为>； 0.69时预测围产期综合不良结局的敏感性为62%，特异性为61% （AUC = 0.711, p < 0.001）。结论：本研究表明EASIX评分可作为预测ICP疾病严重程度和新生儿结局的重要预后工具。鉴于胆汁酸测量在一些诊所的可用性有限，EASIX评分为临床使用提供了一个实用和可访问的替代方案。本研究评估了内皮细胞激活和应激指数（EASIX）在妊娠肝内胆汁淤积中的预后价值，强调了其预测疾病严重程度和新生儿结局的潜力，为临床应用提供了实用工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.