Recognition of asymptomatic hypercholanemia of pregnancy: Different clinical features, fetal outcomes and bile acids metabolism from intrahepatic cholestasis of pregnancy

Yifan He; Xiaoqing Zhang; Yong Shao; Biao Xu; Yue Cui; Xiao Chen; Hong Chen; Can Luo; Min Ding

doi:10.1016/j.bbadis.2021.166269

Recognition of asymptomatic hypercholanemia of pregnancy: Different clinical features, fetal outcomes and bile acids metabolism from intrahepatic cholestasis of pregnancy

Biochim Biophys Acta Mol Basis Dis. 2022 Jan 1;1868(1):166269. doi: 10.1016/j.bbadis.2021.166269. Epub 2021 Sep 17.

Authors

Yifan He¹, Xiaoqing Zhang¹, Yong Shao², Biao Xu³, Yue Cui¹, Xiao Chen¹, Hong Chen¹, Can Luo¹, Min Ding⁴

Affiliations

¹ Key Laboratory of Laboratory Medical Diagnosis, Ministry of Education, School of Laboratory Medicine, Chongqing Medical University, China.
² Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, China; Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, China.
³ Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, China.
⁴ Key Laboratory of Laboratory Medical Diagnosis, Ministry of Education, School of Laboratory Medicine, Chongqing Medical University, China. Electronic address: dingmin@cqmu.edu.cn.

PMID: 34537368
DOI: 10.1016/j.bbadis.2021.166269

Abstract

Objective: To explore the clinical features, fetal outcomes and serum bile acids (BAs) metabolism in asymptomatic hypercholanemia of pregnancy (AHP), as well as the comparison with those in intrahepatic cholestasis of pregnancy (ICP) and normal pregnancies.

Methods: A study containing 676 pregnant women was performed to investigate the clinical informations, routine biochemical features and obstetric outcomes of AHP by the comparison with ICP and normal pregnancies. Within the study subjects, 203 pregnant women received prospective determination for 55 serum individual BAs based on a validated UPLC-QTOF-MS/MS method. The differences in clinical features and serum BAs metabolism among the three groups were then investigated.

Results: The risk of adverse fetal outcomes in AHP (28.3%) was significantly higher than that in normal pregnancies (8.9%, p < 0.001), but lower than that in ICP group (52.1%, p < 0.001). Multivariate statistics analysis indicated a distinctive serum BAs metabolic profiling among the three groups (PLS-DA, R²Y = 0.580, Q² = 0.537). Levels of serum BAs especially for deoxycholic acid species were found remarkably elevated in AHP as compared to those in ICP.

Conclusions: AHP group had distinguished clinical features and serum BAs metabolism as compared to ICP group and normal pregnancies.

Keywords: Asymptomatic hypercholanemia of pregnancy; Bile acids metabolism; Biomarkers; Differential diagnosis; Intrahepatic cholestasis of pregnancy.

MeSH terms

Adult
Asymptomatic Diseases / epidemiology
Bile Acids and Salts / blood*
Cholestasis, Intrahepatic / blood
Cholestasis, Intrahepatic / epidemiology
Cholestasis, Intrahepatic / metabolism*
Cholestasis, Intrahepatic / pathology
Cholic Acids / blood*
Cholic Acids / metabolism
Female
Fetus
Humans
Lipid Metabolism*
Metabolomics / standards
Multivariate Analysis
Pregnancy
Pregnancy Complications / blood
Pregnancy Complications / epidemiology
Pregnancy Complications / metabolism*
Pregnancy Complications / pathology
Steroid Metabolism, Inborn Errors / blood
Steroid Metabolism, Inborn Errors / epidemiology
Steroid Metabolism, Inborn Errors / metabolism*
Steroid Metabolism, Inborn Errors / pathology
Tandem Mass Spectrometry

Substances

Bile Acids and Salts
Cholic Acids

Supplementary concepts

Hypercholanemia, Familial
Intrahepatic Cholestasis of Pregnancy