Abstract
The objective of this study was to assess the value of serum leptin, adiponectin, apelin, and ghrelin as biomarkers for the prediction and diagnosis of intra-hepatic cholestasis (ICP). This prospective study included pregnant women in the third trimester of pregnancy: 63 with ICP, 48 and 15 of whom had mild and severe disease, respectively, and 32 as controls. ICP women had increased median levels of serum leptin, adiponectin, apelin, and ghrelin compared to the controls (p < 0.05). These biomarkers meaningfully changed regarding the severity of ICP: While leptin was reduced, apelin and ghrelin were increased, and adiponectin was increased somewhat. To predict and diagnose ICP, the predictive values of serum leptin, adiponectin, and apelin need to be accepted as comparable, with moderate to high sensitivity and specificity; however, the predictive value of serum ghrelin was somewhat lower. More research is needed to clarify the potential properties of adipokines to gain acceptance as a predictive or diagnostic biomarker for ICP.
Highlights
Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy specific disease and its cause has not been yet elucidated [1]
The potential roles of serum leptin, adiponectin, apelin, and ghrelin, as biomarkers for the prediction and diagnosis of ICP, were assessed with significant results: While serum leptin reduced, adiponectin, apelin, and ghrelin increased. These biomarkers revealed meaningful changes concerning the severity of ICP: While leptin was reduced, apelin and ghrelin were increased, and adiponectin was increased somewhat
For the diagnosis of ICP, the predictive values of serum leptin, adiponectin, and apelin need to be accepted as comparable, with moderate to high sensitivity and specificity, even if the predictive value of serum ghrelin was somewhat lower when compared to the other biomarkers
Summary
Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy specific disease and its cause has not been yet elucidated [1]. It is the second common liver disorder in pregnancy after viral hepatitis, which is often characterized by itching, liver dysfunction, and/or a high bile acid level in the late second or third trimester of pregnancy. ICP has been reported to be more common during winter months, correlated with poor selenium intake and vitamin D deficiency [3,4]. In addition to maternal complications such as itching, nausea, loss of appetite, pain in the right upper quadrant, meconium-staining of amniotic
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