Inflammatory marker YKL-40 levels in intrahepatic cholestasis of pregnancy

Abstract

Intrahepatic cholestasis of pregnancy is a diagnosis of exclusion and presents with unexplained pruritus, abnormal liver function tests, and increased serum bile acid levels, particularly in the third trimester of pregnancy. Serum YKL-40 levels are increased in liver diseases and our aim was to investigate YKL-40 levels in pregnant women with ICP. 40 women with intrahepatic cholestasis of pregnancy and 40 healthy pregnant women were included in this cross-sectional study. Serum YKL-40 levels were measured in both groups and correlation analysis were performed between the YKL-40 and other liver function tests. Serum YKL-40 concentrations were higher in the intrahepatic cholestasis of pregnancy group than in the control group (103.46 ± 53.03 vs. 57.60 ± 30.30 ng/ml, p = .002). The cutoff YKL-40 serum concentration was 84.80 ng/ml for the diagnosis of intrahepatic cholestasis of pregnancy. There was no correlation between fasting bile acids and YKL-40 levels. However, there was a significant positive correlation between the YKL-40 levels and aspartate aminotransferase (r = 0.22, p = .04) and alanine aminotransferase (r = 0.24, p = .02). Raised YKL-40 levels might support the evidence on inflammatory processes in intrahepatic cholestasis of pregnancy.

摘要

妊娠期肝内胆汁淤积症是一个排除性的诊断, 表现为不明原因的皮肤瘙痒, 肝功能异常, 血清胆汁酸水平升高, 尤其是在妊娠晚期。血清YKL-40水平在肝脏疾病中有升高, 我们的目的是研究ICP孕妇血清YKL-40水平。此横断面研究纳入40例妊娠肝内胆汁淤积症妇女和40例健康孕妇。测定两组血清YKL-40水平, 并将其与其他肝功能检查指标进行相关性分析。妊娠期肝内胆汁淤积症组血清YKL-40浓度高于对照组(103.46 ± 53.03 vs. 57.60 ± 30.30 ng/ml, p=.002)。诊断妊娠期肝内胆汁淤积症的截断值血清YKL-40浓度为84.80 ng/ml。空腹胆汁酸水平与YKL-40水平无相关性。但是, YKL-40水平与天门冬氨酸转氨酶(r = 0.22, p=.04)和丙氨酸转氨酶(r = 0.24, p=.02)呈显著正相关。YKL-40水平升高可能是支持妊娠期肝内胆汁淤积症炎症过程的证据。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• YKL-40
• pregnancy
• cholestasis
• inflammation
• liver

Disclosure statement

No potential conflict of interest was reported by the authors.