Evaluation of the GGT-to-Albumin and GGT-to-Platelet Ratios in Preeclampsia

INTRODUCTION: The primary objective of this investigation was to determine the efficacy of the gamma-glutamyl transferase-to-albumin ratio (GAR) and the gamma-glutamyl transferase-to-platelet ratio (GPR) in diagnosing preeclampsia and their capacity to differentiate between early-onset and late-onset disease phenotypes.
METHODS: In this retrospective cohort study, 201 singleton pregnancies managed between 2019 and 2025, comprising 100 cases of preeclampsia and 101 normotensive controls, were analyzed.: Preeclamptic participants were categorized into two subgroups according to gestational age at clinical presentation: early-onset (<34 weeks; n=26) or late-onset (≥34 weeks; n=74). Demographic, clinical, and laboratory parameters at diagnosis were recorded, and GPR and GAR were calculated from routine tests. Group comparisons were performed using non-parametric methods, and discriminative performance was assessed using ROC curve analysis.
RESULTS: The study cohort comprised 201 participants, showing baseline homogeneity for maternal age and routine blood markers (p>0.05). Mean arterial pressure remained consistent across preeclampsia subtypes but was markedly higher than normotensive controls (p<0.001). Albumin levels dropped sequentially across groups, reaching minimum concentrations in the early-onset subtype (p<0.001). GAR varied significantly among cohorts (p=0.003), peaking in early-onset cases, while GPR showed no such differentiation (p=0.094). GAR identified preeclampsia with an AUC of 0.599 (p=0.014, threshold 0.246), whereas GPR was non-significant (p=0.199). For subtype stratification, GAR provided superior discrimination (AUC=0.679, p=0.008) compared to the non-significant GPR (p=0.102).
DISCUSSION AND CONCLUSION: Unlike GPR, the GAR index offers a modest but significant diagnostic performance, particularly for predicting early-onset preeclampsia, and holds potential as a complementary parameter for clinical risk stratification.

Keywords: Preeclampsia, Gamma-Glutamyltransferase, Albumins,