The Role of Liver Function Characteristics in Preeclampsia Disease Pheno-types Based on Cluster Analysis and Its Pregnancy Complications
10.3969/j.issn.1003-6946.2025.09.014
- VernacularTitle:基于聚类分析探讨肝功能在子痫前期患者亚型分类及妊娠并发症评估中的作用
- Author:
Yanhong XU
1
;
Jiaying ZHENG
;
Chengcheng JIN
;
Xingyi QI
;
Xia XU
;
Jianying YAN
Author Information
1. 福建医科大学妇儿临床医学院福建省妇幼保健院产科福建省母胎医学临床医学研究中心,福建 福州 350001
- Publication Type:Journal Article
- Keywords:
Preeclampsia;
Subtype classification;
Liver function;
Cluster analysis;
Pregnancy complication
- From:
Journal of Practical Obstetrics and Gynecology
2025;41(9):760-764
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify different subtypes of patients with preeclampsia(PE)through clinical liver function index data-driven the cluster analysis,to explore the correlation between liver function of different sub-types and pregnancy complications.Methods:From January 2012 to December 2022,the general data of 2230 sin-gleton pregnant women with PE who underwent prenatal examination and delivered in Fujian Maternity and Child Health Hospital were collected.Using 13 liver function indexes before delivery as baseline variables,all included subjects were classified into subtypes by cluster method.The clinical characteristics of different subtypes of PE patients were compared.Single-factor Logistic regression was used to analyze the risk of pregnancy complications among subtypes.Results:PE patients were divided into 3 subgroups that represented different characteristics of patients' liver function.The first subtype(n=1065)exhibited abnormal liver enzymology index characterized by in-creased alkaline phosphatase(ALP)level.The second subtype(n=648)showed abnormal bilirubin metabolism index with the highest levels of total bilirubin(TBIL),direct(DBIL)and indirect bilirubin(IBIL).The third subtype(n=517)had abnormal liver enzymology indexes with elevated alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels,abnormal bile acid detection indexes with elevated total bile acid(TBA)levels,and abnormal liver synthesis function indexes with decreased total protein(TP),albumin(ALB),and globulin lev-els(GLB).Significant differences were observed among the three subtypes in age,severe PE,anemia,cardiac dysfunction,and renal dysfunction(P＜0.05).Single-factor Logistic regression demonstrated that the third sub-type had significantly higher risks of intrahepatic cholestasis of pregnancy,fetal growth restriction,premature rup-ture of membranes,and preterm birth compared to the first and second subtypes(P＜0.05),as well as a higher risk of placental abruption than the second subtype(P＜0.05).The first subtype had higher risks of placental ab-ruption and fetal growth restriction than the second subtype(P＜0.05).Conclusions:Cluster analysis could be used to subclassify PE patients by liver function characteristics,so as to identify the occurrence of pregnancy complications.The results had significance for understanding the heterogeneity of PE and promoting individualized management.
