Decreased 1,25-dihydroxy vitamin D levels in women with intrahepatic cholestasis of pregnancy.
OBJECTIVE
The pathogenesis of intrahepatic cholestasis of pregnancy (ICP) involves impaired bile acid and estrogen/progesterone metabolism and excretion based on genetic and environmental factors. The role of vitamin D is undefined.


METHODS
Observational study.


METHODS
Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden.


METHODS
Swedish.


METHODS
We measured serum 1,25-dihydroxy vitamin D3 (1,25-D3) and parathormone in 22 women with ICP at presentation, in comparison with 11 healthy women at delivery.


RESULTS
ICP women had significantly (p = 0.0041) lower levels of 1,25-D3 in serum (76.4 ± 23.1 vs. 112.0 ± 40 ng/L, mean ± SD), unrelated to serum bile acids. 1,25-D3 levels were inversely correlated (p < 0.05) to meconium staining of amniotic fluid. Parathormone levels did not differ between ICP and healthy women.


CONCLUSIONS
Lower 1,25-D3 levels in ICP are inversely correlated by meconium staining, a major indicator of fetal distress. Our finding may have pathogenetic and clinical implications since vitamin D regulates steroid metabolism and 1,25-D3 deficiency may impair fetal outcome.
Department of Obstetrics and Gynecology, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. elisabeth.wikstrom-shemer@ds.se
Elisabeth
E
Wikström Shemer
Hanns-Ulrich
HU
Marschall
D002117:Calcitriol / Q000097:blood / Q000378:metabolism*; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D010281:Parathyroid Hormone / Q000097:blood / Q000378:metabolism*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000378:metabolism*
D010281:Parathyroid Hormone; D002117:Calcitriol