title: Maternal circulating levels of irisin in intrahepatic cholestasis of pregnancy.
abstract: OBJECTIVE
  Intrahepatic cholestasis of pregnancy (ICP), the most common liver disease in pregnancy, is characterized by elevated serum total bile acid levels and pruritus. It has become clear that bile acids are no longer labeled as simple detergent-like molecules, but also represent complex hormonal metabolic regulators. ICP has also been associated with increased incidence rates of gestational diabetes mellitus. Irisin is a newly discovered myokine that is able to regulate glucose and lipid levels, thus improving insulin sensitivity. In this study, maternal serum irisin levels were analyzed in order to provide a new perspective on the pathogenesis of ICP.
  
  
  METHODS
  In this controlled cross-sectional study, 58 consecutive pregnant women with ICP (30 with mild and 28 with severe disease) and 30 healthy women with uncomplicated pregnancies (as the control group) were examined. The maternal irisin, fasting blood glucose, fasting insulin and homeostatic model assessment of insulin resistance levels of the two groups were compared.
  
  
  RESULTS
  Serum irisin levels were significantly higher in the severe ICP group than in the mild ICP and control groups (p = 0.005 and p < 0.001, respectively). At the best cut-off level of 908.875 pg/ml, irisin accurately predicted ICP [AUC = 0.827 (95% CI: 0.745-0.909; p < 0.001)] with sensitivity and specificity rates of 72.5 and 86.8%, respectively. There was a significant negative correlation between irisin and fasting blood glucose levels (r = -0.399; p = 0.021).
  
  
  CONCLUSIONS
  The results of this study indicate that serum irisin levels were significantly higher in women with ICP compared to healthy pregnant controls. However, it is difficult to infer whether high irisin level is a cause or effect of ICP.
authors.affiliation: a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey , and.
authors.forename: Ayse
authors.initials: A
authors.lastname: Kirbas
authors.affiliation: a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey , and.
authors.forename: Korkut
authors.initials: K
authors.lastname: Daglar
authors.affiliation: a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey , and.
authors.forename: Hakan
authors.initials: H
authors.lastname: Timur
authors.affiliation: a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey , and.
authors.forename: Ebru
authors.initials: E
authors.lastname: Biberoglu
authors.affiliation: b Department of Obstetrics and Gynecology , Konya Education and Research Hospital , Konya , Turkey.
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Inal
authors.affiliation: a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey , and.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Kara
authors.affiliation: a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey , and.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Yilmaz
authors.affiliation: a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey , and.
authors.forename: Gülenay
authors.initials: G
authors.lastname: Turkmen
authors.affiliation: a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey , and.
authors.forename: Nuri
authors.initials: N
authors.lastname: Danisman
mesh_terms: D000328:Adult; D001647:Bile Acids and Salts / Q000097:blood*; D016009:Chi-Square Distribution; D002780:Cholestasis, Intrahepatic / Q000097:blood*; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000097:blood; D005260:Female; D005353:Fibronectins / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011537:Pruritus / Q000209:etiology; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D001647:Bile Acids and Salts; C577593:FNDC5 protein, human; D005353:Fibronectins
keywords: Bile acid; FXR receptor; TGR5; insulin resistance; metabolic syndrome