Plasma lipid profiles of women with intrahepatic cholestasis of pregnancy.
OBJECTIVE
Intrahepatic cholestasis of pregnancy is associated with dyslipidemia, but the gestational lipid profile in relation to clinical diagnosis of the disease is unknown. The aim of this study was to undertake a detailed analysis of plasma lipids in women presenting with intrahepatic cholestasis of pregnancy and pruritus gravidarum.


METHODS
Plasma lipid concentrations were assessed in nonfasting blood samples from 63 women with intrahepatic cholestasis of pregnancy (n = 54, recruited at the time of diagnosis, and n = 9, who later developed the disease), 43 women with pruritus gravidarum, and 26 healthy pregnant controls during pregnancy and at 4-6 weeks postpartum.


RESULTS
Intrahepatic cholestasis of pregnancy was associated with an abnormal lipid profile. Low-density lipoprotein (LDL) cholesterol, apolipoprotein B-100, and total cholesterol concentrations were significantly raised during pregnancy in women with intrahepatic cholestasis of pregnancy compared with pruritus gravidarum and controls, and LDL-cholesterol was raised before clinical diagnosis. High-density lipoprotein cholesterol was lower in women with intrahepatic cholestasis of pregnancy compared with the pruritus gravidarum group. Ursodeoxycholic acid did not alter plasma lipid concentrations.


CONCLUSIONS
Intrahepatic cholestasis is associated with dyslipidemia, which may contribute to the pathogenesis of the disease. The elevation of LDL cholesterol and reduction of high-density lipoprotein cholesterol before clinical diagnosis may prove to be a useful biomarker for the early identification of intrahepatic cholestasis of pregnancy and differentiation from pruritus gravidarum.


METHODS
II-2.
Dann
Anthony T
AT
Division of Reproductive Health, Endocrinology and Development, King's College London, United Kingdom.
Kenyon
Anna P
AP
Wierzbicki
Anthony S
AS
Seed
Paul T
PT
Shennan
Andrew H
AH
Tribe
Rachel M
RM
D000328:Adult; D016022:Case-Control Studies; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000175:diagnosis*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D050356:Lipid Metabolism / Q000502:physiology; D008423:Maternal Age; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D011336:Probability; D018570:Risk Assessment
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL