Early diagnosis of intrahepatic cholestasis of pregnancy based on metabolic profiling analysis of serum bile acids

Abstract:

Objective：To investigate the value of metabolic profiling analysis of serum bile acids in the early diagnosis of intrahepatic cholestasis of pregnancy（ICP）. Methods：Ultra-performance liquid chromatography-triple quadrupole time-of-flight mass spectrome－try was used to measure the serum levels of 27 known bile acids and 29 identified bile acids in 50 healthy pregnant women，51 pa－tients with ICP，14 patients with early-stage ICP，and 21 pregnant women with liver dysfunction. A partial least squares-discriminant analysis was used to establish a diagnostic model of ICP，and the receiver operating characteristic（ROC） curve and logistic regression analysis were used to screen out the bile acids as the markers for the early diagnosis of ICP. Results：Compared with the normal pregnant women，the pregnant women with early-stage ICP had significant increases in the serum levels of taurocholic acid，glyco－cholic acid，glycine-conjugated bile acid with three hydroxyl-3（Gtri-3），and glycine-conjugated bile acid with three hydroxyl-5（Gtri-5，P<0.05），while no significant changes were observed in the pregnant women with liver dysfunction. The ICP diagnostic model had a sensitivity of 85.7% and a specificity of 95.2% in the diagnosis of early-stage ICP. Gtri-3 and taurine-conjugated bile acid with three hydroxyl-2（Ttri-2） were selected as the markers for the early diagnosis of ICP，with a sensitivity of 92.9% and a speci－ficity of 90.5%. Conclusion：The metabolic profiling analysis of serum bile acids is a highly specific and sensitive method for the early diagnosis of ICP.