Aydan SEZGİN, Dursun NAR, Sanem Özcan KAHVECİ, Ali ÇITIRKE, Fatma Doğa ÖCAL, Dilek ŞAHİN
Van Medical Journal - 2026;33(3):366-372
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. Materials and 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. 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). 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.
