Influence of ursodeoxycholic acid therapy on levels of fibroblast growth factor 21, adiponectin and biochemical parameters in intrahepatic cholestasis of pregnancy

Michał Kukla; Rafał Kierach; Magdalena Skonieczna; Dorota Hudy; Krzysztof Dąbrowski; Tomasz Menżyk; Aleksandra Derra; Dariusz Boroń; Beniamin Oskar Grabarek

doi:10.5114/ceh.2021.104419

Influence of ursodeoxycholic acid therapy on levels of fibroblast growth factor 21, adiponectin and biochemical parameters in intrahepatic cholestasis of pregnancy

Clin Exp Hepatol. 2021 Mar;7(1):13-24. doi: 10.5114/ceh.2021.104419. Epub 2021 Mar 25.

Authors

Michał Kukla^{1

2}, Rafał Kierach³, Magdalena Skonieczna^{4

5}, Dorota Hudy^{4

5}, Krzysztof Dąbrowski³, Tomasz Menżyk⁶, Aleksandra Derra⁷, Dariusz Boroń^{8

9

10}, Beniamin Oskar Grabarek^{8

10}

Affiliations

¹ Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Poland.
² Department of Endoscopy, University Hospital in Cracow, Poland.
³ Gynecology and Obstetrics Ward District Railway Hospital in Katowice, Poland.
⁴ Department of Systems Biology and Engineering, Silesian University of Technology, Gliwice, Poland.
⁵ Biotechnology Centre, Silesian University of Technology, Gliwice, Poland.
⁶ Department of Internal Medicine, Gastroenterology and Acute Intoxication, Regional Hospital, Tarnów, Poland.
⁷ Department of Neurology, Medical Centre of Upper Silesia, Katowice, Poland.
⁸ Department of Histology, Cytophysiology and Embryology in Zabrze, University of Technology, Faculty of Medicine, Katowice, Poland.
⁹ Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, Kraków, Poland.
¹⁰ District Hospital in Chrzanow, Poland.

Abstract

The aim was to assess whether fibroblast growth factor 21 (FGF-21) and adiponectin influence intrahepatic cholestasis of pregnancy (ICP) pathogenesis and whether ursodeoxycholic acid (UDCA) has an impact on their levels. 50 pregnant women with ICP (ICP PW), 50 with uncomplicated pregnancy (HPW) and 50 healthy nonpregnant women (HW) were included. In ICP PW the first blood sample was drawn at the time of diagnosis, while in HPW it was drawn in the 28^th week of pregnancy. The next blood samples were drawn in the 32^nd and 36^th week of pregnancy and one day after delivery. UDCA was administered when ICP was diagnosed. In ICP PW serum FGF-21 concentration was the lowest at the time of diagnosis with an evident increase after UDCA administration. Serum FGF-21 levels were significantly higher in ICP PW than in HPW from the first to the last measurement. There was a negative association between adiponectin and bile acids (BAs) levels in the later stage of pregnancy in ICP PW. Up-regulated FGF-21 serum levels in ICP patients compared to HPW persisted after delivery, suggesting its role in disease pathophysiology. The negative association between serum adiponectin and BAs of the later stage of pregnancy may suggest its role in regulation of BAs concentration. UDCA exerts a beneficial effect on insulin sensitivity and up-regulates FGF-21 in ICP.

Keywords: adiponectin; bile acids; fibroblast growth factor 21; insulin resistance; intrahepatic cholestasis of pregnancy; ursodeoxycholic acid.