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| Analysis of bile acid profile among patients with intrahepatic cholestasis of pregnancy |
| HU Yujie, SHI Xinyan, SHEN Yonghai, ZHOU Yayuan, CHEN Yu
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| Hangzhou Obstetrics and Gynecology Hospital, Hangzhou, Zhejiang 310008, China |
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Abstract Objective To analyze the differences in bile acid profiles during different pregnancy durations of patients with intrahepatic cholestasis of pregnancy (ICP), so as to provide a reference for early prevention and treatment of ICP and optimization of maternal-infant health outcomes. Methods Pregnant women who underwent routine prenatal examinations and delivered at Hangzhou Obstetrics and Gynecology Hospital from 2021 to 2023 were selected as study subjects. According to the ICP guidelines (2020), pregnant women were categorized into normal group, mild ICP group, and moderate/severe ICP group. Age, parity, and gravidity were collected through the obstetric electronic medical record system, liver function indicators and seven bile acid levels were collected through the hospital's laboratory information system. Differences in bile acid profiles across pregnancy durations among the three groups were compared. Results A total of 238 pregnant women were enrolled, including 57 cases (23.95%) in the normal group, 136 cases (57.14%) in the mild ICP group, and 45 cases (18.91%) in the moderate/severe ICP group. There were statistically significant differences between the three groups in total bile acid (TBA), cholic acid (CA), chenodeoxycholic acid (CDCA), glycochenodeoxycholic acid (GCDCA), glycocholic acid (GCA), taurocholic acid (TCA) levels (all P<0.05). Compared with the normal group, CA, GCDCA and GCA, and TCA were higher in the mild and moderate/severe ICP groups; compared with the mild ICP group, GCA was higher in the moderate/severe ICP group (all P<0.05). Significant differences were observed in the levels of GCDCA, GCA, and TCA among three groups pregnant women in the early, mid, and late pregnancy (all P<0.05). Compared with the normal group, mild ICP group had higher GCDCA and GCA in the early and mid pregnancy; moderate/severe ICP group had higher TCA in the early pregnancy and higher GCDCA and GCA in the late pregnancy. Compared with the mild ICP group, mild ICP group had higher TCA in the early pregnancy and the moderate/severe ICP group had higher GCA in the late pregnancy. Conclusions GCDCA, GCA, and TCA levels remain higher in ICP patients than in normal pregnant women across all pregnancy durations. Personalized perinatal management plans can be developed based on bile acid profile dynamics to optimize maternal-fetal outcomes.
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Received: 22 January 2025
Revised: 29 June 2025
Published: 23 July 2025
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[1] 钟世林,杨璈,刘育祯,等.妊娠期肝内胆汁淤积症与妊娠期糖尿病的相关性研究[J].现代妇产科进展,2024,33(1):21-25.
ZHONG S L,YANG A,LIU Y Z,et al.The correlation between intrahepatic cholestasis of pregnancy and gestational diabetes mellitus[J].Prog Obstet Gynecol,2024,33(1):21-25.(in Chinese)
[2] WILLIAMSON C,GEENES V.Intrahepatic cholestasis of pregnancy[J].Obstet Gynecol,2014,124(1):120-133.
[3] 李菊红,邵勇.妊娠期肝内胆汁淤积症的研究进展[J].肝脏,2024,29(3):348-352.
LI J H,SHAO Y.Research progress of intrahepatic cholestasis of pregnancy[J].Chin Hepatol,2024,29(3):348-352.(in Chinese)
[4] LIU X X,XIN S M,XU F P,et al.Single-cell RNA sequencing reveals heterogeneity and differential expression of the maternal-fetal interface during ICP and normal pregnancy[J].J Matern Fetal Neonatal Med,2024,37(1):1-13.
[5] ZHANG P Z,TAN Z M,LI C,et al.The correlation between serum total bile acid and adverse perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy(ICP)and non-ICP hypercholanemia of pregnancy[J].Ann Med,2024,56(1):1-11.
[6] 宋对对,牛丽娜,张小娟,等.妊娠期肝内胆汁淤积症患者不良妊娠结局影响因素[J].中国计划生育学杂志,2024,32(7):1586-1590.
SONG D D,NIU L N,ZHANG X J,et al.Influencing factors of the adverse pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy[J].Chin J Fam Plan,2024,32(7):1586-1590.(in Chinese)
[7] KAWAKITA T,PARIKH L I,RAMSEY P S,et al.Predictors of adverse neonatal outcomes in intrahepatic cholestasis of pregnancy[J].Am J Obstet Gynecol,2015,213(4):1-16.
[8] CASTAÑO G,LUCANGIOLI S,SOOKOIAN S,et al.Bile acid profiles by capillary electrophoresis in intrahepatic cholestasis of pregnancy[J].Clin Sci(Lond),2006,110(4):459-465.
[9] 陈福芳,彭丽钦,汪洁.妊娠期肝内胆汁淤积症患者血清甘胆酸与肝生化指标、炎性细胞因子水平变化相关性分析[J].临床和实验医学杂志,2023,22(14):1534-1537.
CHEN F F,PENG L Q,WANG J.Correlation between serum glycocholic acid and liver biochemical indexes and inflammatory cytokines in patients with intrahepatic cholestasis of pregnancy[J].J Clin Exp Med,2023,22(14):1534-1537.(in Chinese)
[10] 夏显,漆洪波.美国母胎医学会《妊娠期肝内胆汁淤积症指南(2020版)》解读[J].实用妇产科杂志,2021,37(8):587-590.
XIA X,QI H B.Interpretation of American maternal and fetal medical association's Guidelines for Intrahepatic Cholestasis during Pregnancy(2020 edition)[J].J Pract Obstet Gynecol,2021,37(8):587-590.(in Chinese).
[11] CHIANG J Y L,FERRELL J M.Bile acid receptors FXR and TGR5 signaling in fatty liver diseases and therapy[J].Am J Physiol Gastrointest Liver Physiol,2020,318(3):554-573.
[12] 何靖恺,胡洁琼,张加玏,等.肠道菌群代谢产物与抑郁障碍研究进展[J].预防医学,2025,37(6):583-587.
HE J K,HU J Q,ZHANG J L,et al.Research progress on gut microbiome metabolites and depressive disorders[J].China Prev Med J,2025,37(6):583-587.(in Chinese)
[13] CAI J W,RIMAL B,JIANG C T,et al.Bile acid metabolism and signaling,the microbiota,and metabolic disease[J/OL].Pharmacol Ther,2022,237[2025-06-29].https://doi.org/10.1016/j.pharmthera.2022.108238.
[14] FUCHS C D,SIMBRUNNER B,BAUMGARTNER M,et al.Bile acid metabolism and signalling in liver disease[J].J Hepatol,2025,82(1):134-153.
[15] SHAO Y,CHEN S Y,LI H,et al.Maternal bile acid profile and subtype analysis of intrahepatic cholestasis of pregnancy[J].Orphanet J Rare Dis,2021,16(1):1-13.
[16] LIU W H,WANG Q,CHANG J X,et al.Circulatory metabolomics reveals the association of the metabolites with clinical features in the patients with intrahepatic cholestasis of pregnancy[J].Front Physiol,2022,13:1-16.
[17] SARKER M,ZAMUDIO A R,DEBOLT C,et al.Beyond stillbirth:association of intrahepatic cholestasis of pregnancy severity and adverse outcomes[J/OL].Am J Obstet Gynecol,2022,227(3)[2025-06-29].https://doi.org/10.1016/j.ajog.2022.06.013.
[18] 俞黎铭,施新颜,陈益明,等.高效液相色谱串联质谱法检测妊娠期肝内胆汁淤积症7种胆汁酸及其临床意义[J].中华全科医学,2020,18(7):1153-1156,1199.
YU L M,SHI X Y,CHEN Y M,et al.Comparison of seven bile acids in intrahepatic cholestasis by HPLC-MS/MS at different gestational stages and the clinical significance[J].Chin J Gen Pract,2020,18(7):1153-1156,1199.(in Chinese) |
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