Irak Kader, Bayram Mehmet, Cifci Sami, Acar Zuat, Kazezoglu Cemal, Ogutmen Koc Deniz, Arslan Oyku
Gastroenterology, Basaksehir Cam and Sakura City Hospital, Istanbul, TUR.
Gastroenterology, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR.
Cureus. 2021 Nov 17;13(11):e19654. doi: 10.7759/cureus.19654. eCollection 2021 Nov.
Background and objective Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease. G-protein-coupled bile acid receptor 1 (TGR5) agonists might be beneficial in ICP treatment. In this study, we aimed to investigate the relationship of serum TGR5 levels with ICP and associated itching. Methods Sixty-three pregnant women diagnosed with ICP based on a serum bile acid level of >10 µmol/L (patient group) and 47 healthy pregnant women as a control group were included in the study. In the patient group, ursodeoxycholic acid (UDCA) therapy was given at a dose of 15 mg/kg from the time of diagnosis until the termination of pregnancy. Serum transaminase levels were measured at the beginning and within 15 days after the onset of treatment, and the dose was increased in patients who were unresponsive to treatment. Results Bile acid level was found to be between 10-39 µmol/L in 61.9% of the ICP patients, and it was ≥40 µmol/L in 38.1% of the patients. The majority of the patients responded well to the treatment with UDCA. The mean TGR5 level was significantly higher in the patient group compared to the control group (0.98 ±0.95 ng/mL vs. 0.74 ±0.23 ng/mL, p=0.032). In the patient group, TGR5 level showed negative correlations with age and red cell distribution width and a positive correlation with lactate dehydrogenase level and lymphocyte count. Conclusions Based on our findings, it can be suggested that TGR5 may have a role in the pathogenesis but has no impact on the prognosis of the condition.
背景与目的 妊娠期肝内胆汁淤积症(ICP)是最常见的妊娠相关肝病。G蛋白偶联胆汁酸受体1(TGR5)激动剂可能对ICP治疗有益。在本研究中,我们旨在探讨血清TGR5水平与ICP及相关瘙痒之间的关系。方法 本研究纳入了63例根据血清胆汁酸水平>10 µmol/L诊断为ICP的孕妇(患者组)和47例健康孕妇作为对照组。在患者组中,从诊断时起至妊娠终止,给予熊去氧胆酸(UDCA)15 mg/kg的治疗剂量。在治疗开始时和治疗开始后15天内测量血清转氨酶水平,对治疗无反应的患者增加剂量。结果 发现61.9%的ICP患者胆汁酸水平在10 - 39 µmol/L之间,38.1%的患者胆汁酸水平≥40 µmol/L。大多数患者对UDCA治疗反应良好。患者组的平均TGR5水平显著高于对照组(0.98±0.95 ng/mL对0.74±0.23 ng/mL,p = 0.032)。在患者组中,TGR5水平与年龄和红细胞分布宽度呈负相关,与乳酸脱氢酶水平和淋巴细胞计数呈正相关。结论 根据我们的研究结果,可以认为TGR5可能在发病机制中起作用,但对病情预后无影响。