Soluble fms‐like tyrosine kinase 1 (sFlt‐1): A novel biochemical marker for acute fatty liver of pregnancy

Introduction Acute fatty liver of pregnancy (AFLP) substantially contributes to maternal and neonatal morbidity and mortality. Other liver‐associated pregnancy complications such as preeclampsia‐associated HELLP (hemolysis, elevated liver enzyme, low platelet) syndrome may be difficult to differentiate from AFLP as these diseases overlap with regard to multiple clinical and laboratory features. The aim of this study was to investigate angiogenic profiles by measuring soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) in pregnancies compromised by AFLP and to compare them with those complicated by HELLP syndrome. Material and methods Pregnant women affected by AFLP or HELLP syndrome were enrolled. The study population of women with HELLP syndrome was part of a larger data collection obtained in our clinic that has been used for previous work. Patients’ angiogenic profiles were assessed by measuring sFlt‐1 and PlGF serum levels. To assess the diagnostic potential of these angiogenic markers in AFLP, as well as discriminating it from HELLP syndrome, non‐parametric tests were used and receiver operating curves were calculated. Results Six women with AFLP and 48 women with HELLP syndrome were included in the study. Patients with AFLP showed significantly higher sFlt‐1 levels (median: 57 570 pg/mL; range 31 609–147 170 pg/mL) than patients with HELLP syndrome (9713 pg/mL; 1348–30 781 pg/mL; p