title: The metabolic profile of intrahepatic cholestasis of pregnancy is associated with impaired glucose tolerance, dyslipidemia, and increased fetal growth.
abstract: OBJECTIVE
  Quantification of changes in glucose and lipid concentrations in women with intrahepatic cholestasis of pregnancy (ICP) and uncomplicated pregnancy and study of their influence on fetal growth.
  
  
  METHODS
  A prospective study comparing metabolic outcomes in cholestastic and uncomplicated singleton pregnancies was undertaken at two university hospitals in the U.K. and U.S. from 2011-2014. A total of 26 women with ICP and 27 control pregnancies with no prior history of gestational diabetes mellitus were recruited from outpatient antenatal services and followed until delivery. Alterations in glucose, incretins, cholesterol, and triglycerides were studied using a continuous glucose monitoring (CGM) system and/or a standard glucose tolerance test (GTT) in conjunction with GLP-1 and a fasting lipid profile. Fetal growth was quantified using adjusted birth centiles.
  
  
  RESULTS
  Maternal blood glucose concentrations were significantly increased in ICP during ambulatory CGM (P < 0.005) and following a GTT (P < 0.005). ICP is characterized by increased fasting triglycerides (P < 0.005) and reduced HDL cholesterol (P < 0.005), similar to changes observed in metabolic syndrome. The offspring of mothers with ICP had significantly larger customized birth weight centiles, adjusted for ethnicity, sex, and gestational age (P < 0.005).
  
  
  CONCLUSIONS
  ICP is associated with impaired glucose tolerance, dyslipidemia, and increased fetal growth. These findings may have implications regarding the future health of affected offspring.
authors.affiliation: Maternal and Fetal Disease Group, Institute of Reproductive and Developmental Biology, Imperial College London, London, U.K. Division of Obstetric and Consultative Medicine, Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI.
authors.forename: Marcus G
authors.initials: MG
authors.lastname: Martineau
authors.affiliation: Division of Research, Women & Infants Hospital of Rhode Island, Providence, RI.
authors.forename: Christina
authors.initials: C
authors.lastname: Raker
authors.affiliation: Maternal and Fetal Disease Group, Institute of Reproductive and Developmental Biology, Imperial College London, London, U.K. Women's Health Academic Centre, King's College London, London, U.K.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Dixon
authors.affiliation: Maternal and Fetal Disease Group, Institute of Reproductive and Developmental Biology, Imperial College London, London, U.K.
authors.forename: Jenny
authors.initials: J
authors.lastname: Chambers
authors.affiliation: Maternal and Fetal Disease Group, Institute of Reproductive and Developmental Biology, Imperial College London, London, U.K.
authors.forename: Mavis
authors.initials: M
authors.lastname: Machirori
authors.affiliation: Maternal and Fetal Disease Group, Institute of Reproductive and Developmental Biology, Imperial College London, London, U.K.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: King
authors.affiliation: Division of Obstetric and Consultative Medicine, Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Hooks
authors.affiliation: Maternal and Fetal Disease Group, Institute of Reproductive and Developmental Biology, Imperial College London, London, U.K.
authors.forename: Ramya
authors.initials: R
authors.lastname: Manoharan
authors.affiliation: Division of Obstetric and Consultative Medicine, Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Chen
authors.affiliation: Division of Obstetric and Consultative Medicine, Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI.
authors.forename: Raymond
authors.initials: R
authors.lastname: Powrie
authors.affiliation: Maternal and Fetal Disease Group, Institute of Reproductive and Developmental Biology, Imperial College London, London, U.K. Women's Health Academic Centre, King's College London, London, U.K. catherine.williamson@kcl.ac.uk.
authors.forename: Catherine
authors.initials: C
authors.lastname: Williamson
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D001786:Blood Glucose / Q000378:metabolism; D002780:Cholestasis, Intrahepatic / Q000378:metabolism*; D002784:Cholesterol / Q000378:metabolism; D016640:Diabetes, Gestational / Q000378:metabolism*; D050171:Dyslipidemias / Q000378:metabolism; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005320:Fetal Macrosomia / Q000378:metabolism; D005865:Gestational Age; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D018149:Glucose Intolerance / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism; D055442:Metabolome / Q000502:physiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D014280:Triglycerides / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D008055:Lipids; D014280:Triglycerides; D052216:Glucagon-Like Peptide 1; D002784:Cholesterol