Department of Perinatology, Başakşehir Çam ve Sakura City Hospital, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
J Obstet Gynaecol Res. 2022 Dec;48(12):3093-3102. doi: 10.1111/jog.15444. Epub 2022 Sep 26.
This study aimed to examine autotaxin (ATX) concentrations in the serum of pregnant women complicated with intrahepatic cholestasis of pregnancy (ICP) and compare them with individuals with uncomplicated healthy pregnancies.
This prospective case-control study took place with 83 pregnant women. The study group included 43 pregnant women presenting with a singleton pregnancy diagnosed with ICP in their third trimester of pregnancy. The diagnostic power of the ATX variable was examined by receiver operating characteristic analysis, and the cut-off value calculated according to the Youden index was summarized with the related sensitivity and specificity points.
The mean serum concentration of maternal ATX was significantly higher in the ICP cases (8.91 ± 2.69 pg/mL) compared to the pregnant women in the control group (3.59 ± 1.39 ng/mL, p < 0.001). According to the Youden index, a 5.80 ng/mL cut-off value of serum ATX concentrations can be used to diagnose ICP with 97.7% sensitivity and 97.5% specificity. A significant highly positive correlation was found between maternal serum ATX levels and maternal serum total bile acid levels (r = 0.633 and p < 0.001) and itch intensity, which was objectified by the visual analog scale score (r = 0.951 and p < 0.001).
Maternal serum ATX levels were significantly increased in ICP patients as compared with healthy pregnant women. Also, serum ATX activity was highly correlated with the itch intensity. We consider that ATX might represent a robust, accurate, and reliable circulating biomarker to diagnose ICP.
本研究旨在检测妊娠合并肝内胆汁淤积症（ICP）孕妇血清中的自分泌酶（ATX）浓度，并与正常妊娠孕妇进行比较。
本前瞻性病例对照研究共纳入 83 例孕妇。研究组包括 43 例在妊娠晚期诊断为 ICP 的单胎妊娠孕妇。通过受试者工作特征（ROC）曲线分析评估 ATX 变量的诊断能力，并根据约登指数计算出的最佳截断值总结相关的敏感性和特异性。
ICP 组孕妇血清中 ATX 的平均浓度（8.91±2.69pg/mL）显著高于对照组（3.59±1.39ng/mL，p<0.001）。根据约登指数，血清 ATX 浓度的 5.80ng/mL 截断值可用于诊断 ICP，其灵敏度为 97.7%，特异性为 97.5%。孕妇血清 ATX 水平与血清总胆汁酸水平（r=0.633，p<0.001）和瘙痒强度（用视觉模拟评分量表评估）呈显著正相关（r=0.951，p<0.001）。
与健康孕妇相比，ICP 患者血清 ATX 水平显著升高。此外，血清 ATX 活性与瘙痒强度高度相关。我们认为 ATX 可能是一种可靠的、准确的、灵敏的循环生物标志物，可用于诊断 ICP。
