Ren Shuai-Jun, Feng Jia-Ting, Xiang Ting, Liao Cai-Lian, Zhou Yu-Ping, Xuan Rong-Rong
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Ningbo University, Ningbo 315100, Zhejiang Province, China.
Health Science Center, Ningbo University, Ningbo 315211, Zhejiang Province, China.
World J Hepatol. 2024 Apr 27;16(4):601-611. doi: 10.4254/wjh.v16.i4.601.
Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver condition that typically arises in the middle and late stages of pregnancy. Short-chain fatty acids (SCFAs), prominent metabolites of the gut microbiota, have significant connections with various pregnancy complications, and some SCFAs hold potential for treating such complications. However, the metabolic profile of SCFAs in patients with ICP remains unclear.
To investigate the metabolic profiles and differences in SCFAs present in the maternal and cord blood of patients with ICP and determine the clinical significance of these findings.
Maternal serum and cord blood samples were collected from both patients with ICP (ICP group) and normal pregnant women (NP group). Targeted metabolomics was used to assess the SCFA levels in these samples.
Significant differences in maternal SCFAs were observed between the ICP and NP groups. Most SCFAs exhibited a consistent declining trend in cord blood samples from the ICP group, mirroring the pattern seen in maternal serum. Correlation analysis revealed a positive correlation between maternal serum SCFAs and cord blood SCFAs [r (Pearson) = 0.88, = 7.93e-95]. In both maternal serum and cord blood, acetic and caproic acids were identified as key metabolites contributing to the differences in SCFAs between the two groups (variable importance for the projection > 1). Receiver operating characteristic analysis demonstrated that multiple SCFAs in maternal blood have excellent diagnostic capabilities for ICP, with caproic acid exhibiting the highest diagnostic efficacy (area under the curve = 0.97).
Compared with the NP group, significant alterations were observed in the SCFAs of maternal serum and cord blood in the ICP group, although they displayed distinct patterns of change. Furthermore, the SCFA levels in maternal serum and cord blood were significantly positively correlated. Notably, certain maternal serum SCFAs, specifically caproic and acetic acids, demonstrated excellent diagnostic efficiency for ICP.
妊娠期肝内胆汁淤积症（ICP）是一种特定于妊娠的肝脏疾病，通常发生在妊娠中晚期。短链脂肪酸（SCFAs）是肠道微生物群的主要代谢产物，与多种妊娠并发症有重要联系，一些SCFAs具有治疗此类并发症的潜力。然而，ICP患者中SCFAs的代谢谱仍不清楚。
研究ICP患者母血和脐血中SCFAs的代谢谱及差异，并确定这些发现的临床意义。
收集ICP患者（ICP组）和正常孕妇（NP组）的母血清和脐血样本。采用靶向代谢组学评估这些样本中的SCFA水平。
ICP组和NP组母血中SCFAs存在显著差异。ICP组脐血样本中大多数SCFAs呈现一致的下降趋势，与母血清中的模式相似。相关性分析显示母血清SCFAs与脐血SCFAs呈正相关[r（Pearson）=0.88，P=7.93e-95]。在母血清和脐血中，乙酸和己酸被确定为导致两组SCFAs差异的关键代谢产物（投影变量重要性>1）。受试者工作特征分析表明，母血中的多种SCFAs对ICP具有出色的诊断能力，己酸的诊断效能最高（曲线下面积=0.97）。
与NP组相比，ICP组母血清和脐血中的SCFAs发生了显著改变，尽管它们呈现出不同模式的变化。此外，母血清和脐血中的SCFA水平显著正相关。值得注意的是，某些母血清SCFAs，特别是己酸和乙酸，对ICP显示出出色的诊断效率。
