Ertaş Sinem, Ünver Gökhan, Gonca Okumuş Zihniye, Yılmaz Sibel, Dağ İsmail, Turhan Ugur
VKV American Hospital, Women's Health Center, İstanbul, Turkey.
Samsun Training and Research Hospital, Samsun, Turkey.
Gynecol Endocrinol. 2022 Nov;38(11):935-938. doi: 10.1080/09513590.2022.2119957. Epub 2022 Sep 6.
Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease related to pregnancy in women. Sortilin-1 is a sorting receptor belonging to the vacuolar protein sorting 10 (Vps10p) domain family, and recent studies have shown that Sortilin-1 has a distinct role in the pathogenesis of biliary fibrosis and cirrhosis. We aimed to evaluate maternal serum Sortilin-1 level as a potential biomarker in pregnant women with intrahepatic cholestasis. A prospective observational cohort study was conducted. We enrolled 80 pregnant women, 49 with the diagnosis of intrahepatic cholestasis of pregnancy and 31 healthy controls. Then, we measured maternal serum Sortilin-1 levels using an enzyme-linked immunosorbent assay method and compared them between groups. The mean Sortilin-1 level in the ICP group was higher than control group (3.3 ± 1.7 ng/mL vs. 2.0 ± 0.6 ng/mL, respectively, < .001). The receiver operating characteristic curve (ROC) analysis based on maternal serum Sortilin-1 levels to predict the presence of ICP was 85.3% controls [area under the curve (AUC), 0.853; 95% CI, 0.738-0.938, < .001]. The optimal cutoff value of Sortilin-1 was 2.24 ng/mL (71.4% sensitivity and 74.2% specificity) to detect intrahepatic cholestasis of pregnancy. Elevated maternal serum Sortilin-1 levels are associated with ICP and can be used as a disease biomarker. Sortilin-1 levels can be combined with total bile acids, transaminases, and blood coagulation profile in the follow-up of ICP.
妊娠期肝内胆汁淤积症（ICP）是妊娠期女性最常见的肝脏疾病。Sortilin-1是一种属于液泡蛋白分选10（Vps10p）结构域家族的分选受体，最近的研究表明，Sortilin-1在胆汁性肝纤维化和肝硬化的发病机制中具有独特作用。我们旨在评估孕妇血清Sortilin-1水平作为妊娠期肝内胆汁淤积症孕妇潜在生物标志物的价值。进行了一项前瞻性观察队列研究。我们纳入了80名孕妇，其中49例诊断为妊娠期肝内胆汁淤积症，31例为健康对照。然后，我们采用酶联免疫吸附测定法测量孕妇血清Sortilin-1水平，并在组间进行比较。ICP组的Sortilin-1平均水平高于对照组（分别为3.3±1.7 ng/mL和2.0±0.6 ng/mL，<0.001）。基于孕妇血清Sortilin-1水平预测ICP存在的受试者工作特征曲线（ROC）分析显示，对照组的曲线下面积（AUC）为0.853；95%CI为0.738-0.938，<0.001。Sortilin-1检测妊娠期肝内胆汁淤积症的最佳截断值为2.24 ng/mL（敏感性为71.4%，特异性为74.2%）。孕妇血清Sortilin-1水平升高与ICP相关，可作为疾病生物标志物。在ICP的随访中，Sortilin-1水平可与总胆汁酸、转氨酶和凝血指标相结合。
