Hepatitis B virus-infected pregnant women often develop liver dysfunction. Although the NLRP3 inflammasome drives HBV-related liver injury, its predictive role in this group remains unclear. Participants were categorized into normal liver function (NLF, N = 73), abnormal liver function (ALF, N = 66) and control (N = 40) groups. Reverse transcription quantitative polymerase chain reaction was used to measure NLRP3 mRNA expression in peripheral blood mononuclear cells, and serum levels of interleukin 1 beta (IL-1β) and interleukin 18 (IL-18) were detected using enzyme-linked immunosorbent assay. Correlations between inflammatory markers and liver function parameters were analysed, and multivariate logistic regression and receiver operating characteristic curve analyses were performed to evaluate predictive performance. The ALF group showed significantly elevated NLRP3 mRNA expression and higher serum levels of IL-1β and IL-18 compared to the NLF and control groups (all P < 0.001). These inflammatory markers were positively correlated with ALT, AST and HBV-DNA levels (all P < 0.001). Multivariate analysis identified NLRP3, IL-1β, IL-18, ALT and HBV-DNA as independent risk factors for liver dysfunction. The combined model of NLRP3, IL-1β, IL-18 and HBV-DNA demonstrated superior predictive performance (AUC = 0.954) compared to any single indicator. This research shows that elevated NLRP3 expression and increased levels of IL-1β and IL-18 in early pregnancy are associated with liver dysfunction in HBV-infected pregnant women. The combination of these inflammatory markers with HBV-DNA provides a highly accurate diagnostic model for early identification of high-risk individuals, offering a potential strategy for early intervention and improved management.
Zhang et al. (2026) studied this question.