{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:35:10Z","timestamp":1789475710284,"version":"build-2803163510"},"reference-count":49,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"name":"Key Medical Scientific Research Project of Hebei province","award":["No. 20231652"],"award-info":[{"award-number":["No. 20231652"]}]},{"DOI":"10.13039\/100016083","name":"Hebei Provincial Department of Human Resources and Social Security","doi-asserted-by":"crossref","award":["No. C20200358"],"award-info":[{"award-number":["No. C20200358"]}],"id":[{"id":"10.13039\/100016083","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n               <jats:title>Background<\/jats:title>\n               <jats:p>To determine the association between lipid metabolism and intrahepatic cholestasis of pregnancy (ICP), and explore the value of maternal alanine aminotransferase\/aspartate aminotransferase (ALT\/AST) and high-density lipoprotein (HDL) in predicting adverse neonatal outcomes in women with ICP.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Methods<\/jats:title>\n               <jats:p>A total of 147 pregnant women with ICP admitted to The Fourth Hospital of Shijiazhuang and 120 normal pregnant women in the same period were selected in this study. The Mann-Whitney U test and Chi-square tests were used to compare the differences in clinical data. Multivariate logistic regression was used to analyze the relationship between ALT\/AST and the occurrence of adverse pregnancy outcomes in patients with ICP. The combined predictive value of ALT\/AST and HDL was determined by receiver operating characteristic (ROC) curve analysis.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Results<\/jats:title>\n               <jats:p>Among 147 women with ICP, 122 women had total bile acid (TBA) levels of 10\u201339.9 \u00b5mol\/L, and 25 had TBA \u2265 40 \u00b5mol\/L. There was significantly lower gestational age in patients with severe ICP than in those with mild and control groups (all <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05), and the weight of newborns in the maternal ICP group was significantly lower than in the control group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). Increasing TBA levels was associated with higher AST, ALT, ALT\/AST, and lower HDL level (all <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). Meanwhile, higher levels of ALT\/AST was positively associated with neonatal hyperbilirubinemia [adjusted odds ratio (AOR) = 4.019, 95% CI [1.757\u20139.194, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001] and cardiac injury [AOR = 3.500, 95% CI [1.535\u20137.987], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.003]. HDL was a significant protective factor for neonatal hyperbilirubinemia and cardiac injury [AOR = 0.315, 95% CI [0.126\u20130.788], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.014; AOR = 0.134 (0.039\u20130.461), <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001]. The area under the ROC curve (AUC) for prediction of neonatal hyperbilirubinemia by ALT\/AST combined with HDL was 0.668 [95% CI [56.3\u201377.3%], <jats:italic>p<\/jats:italic> = 0.002], and the sensitivity and specificity were 47.1% and 84.0%, respectively. To predict neonatal cardiac injury, the AUC value was 0.668 [95% CI [56.4\u201377.1%], <jats:italic>p<\/jats:italic> = 0.002], with sensitivity and specificity were 41.2% and 87.1%, respectively.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Conclusions<\/jats:title>\n               <jats:p>The levels of higher ALT\/AST and lower HDL were significantly associated with the risk of ICP-related adverse neonatal outcomes. Moreover, ALT\/AST combined with HDL has moderate clinical value in predicting the adverse outcomes of neonatal hyperbilirubinemia and cardiac injury.<\/jats:p>\n            <\/jats:sec>","DOI":"10.7717\/peerj.17613","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T07:20:53Z","timestamp":1719213653000},"page":"e17613","source":"Crossref","is-referenced-by-count":7,"title":["Evaluation of alanine aminotransferase\/aspartate aminotransferase ratio and high-density lipoprotein for predicting neonatal adverse outcomes associated with intrahepatic cholestasis of pregnancy"],"prefix":"10.7717","volume":"12","author":[{"given":"Xizhenzi","family":"Fan","sequence":"first","affiliation":[{"name":"Research Center for Clinical Medical Sciences, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Scientific 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