Expression Profiles and Diagnostic Value of Serum Bile Acids in Intrahepatic Cholestasis of Pregnancy.

Abstract

Objective: This study aimed to ascertain serum bile acid levels and explore the diagnostic value of differential bile acids in patients with intrahepatic cholestasis of pregnancy (ICP).

Methods: 94 cases of ICP patients admitted to Wenzhou People's Hospital from Oct 2020 to July 2023 were selected as the ICP group, and 184 women who underwent normal prenatal examination in the same period as the healthy control group. The baseline data and 15 kinds of serum bile acid spectrum characteristics of the two groups of pregnant women were compared, and the risk factors of serum bile acid spectrum causing ICP were analyzed by univariate and multivariate logistic regression. A logistic regression model was constructed based on significant risk factors, and ROC curve was drawn to evaluate the diagnostic effect of the model.

Results: Compared with the healthy control group, the other 14 serum bile acids except LCA were highly expressed in the ICP group, and there was significant difference (p<0.05). Univariate analysis showed that 15 serum bile acids were statistically different from ICP (p<0.05). Multivariate analysis showed that both TCA and DCA were risk factors for ICP, with 95% CI of 1.010 (1.003-1.021) and 1.003 (1.000-1.007), respectively. ROC curve showed that TCA, DCA, and TCA+ DCA were the diagnostic criteria of ICP, and their maximum diagnostic value was TCA+ DCA (AUC 0.932). The AUC values of TCA and DCA were 0.929 and 0.615, respectively. TCA+ DCA could play a complementary role in the diagnosis of ICP, and its sensitivity and specificity were 90.7% and 88.9%, respectively.

Conclusion: TCA and DCA indicators are closely related to the occurrence of ICP, and the combined detection of TCA and DCA can significantly improve the efficiency of ICP diagnosis.