Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 27, 2024; 16(4): 601-611
Published online Apr 27, 2024. doi: 10.4254/wjh.v16.i4.601
Expression and clinical significance of short-chain fatty acids in patients with intrahepatic cholestasis of pregnancy
Shuai-Jun Ren, Jia-Ting Feng, Ting Xiang, Cai-Lian Liao, Yu-Ping Zhou, Rong-Rong Xuan
Shuai-Jun Ren, Jia-Ting Feng, Ting Xiang, Cai-Lian Liao, Rong-Rong Xuan, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Ningbo University, Ningbo 315100, Zhejiang Province, China
Jia-Ting Feng, Ting Xiang, Cai-Lian Liao, Health Science Center, Ningbo University, Ningbo 315211, Zhejiang Province, China
Yu-Ping Zhou, Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo 315211, Zhejiang Province, China
Yu-Ping Zhou, Institute of Digestive Disease, Ningbo University, Ningbo 315020, Zhejiang Province, China
Author contributions: Ren SJ, Zhou YP and Xuan RR designed the research; Ren SJ, Feng JT, Xiang T and Liao CL performed the research; Feng JT, Xiang T and Liao CL analyzed the data; Ren SJ, Zhou YP and Xuan RR wrote the paper; all authors participated in primary and final drafting; all authors have read and approve the final manuscript; all authors significantly contributed to the study.
Supported by The Medical and Health Research Project of Zhejiang Province, No. 2023KY1105; and the Traditional Chinese Medical and Health Research Project of Zhejiang Province, No. 2022ZB328.
Institutional review board statement: The protocol for this research project has been approved by a suitably constituted Ethics Committee of the institution and it conforms to the provisions of the Declaration of Helsinki. Committee of The First Affiliated Hospital of ningbo university, Approval No. KY20220912. All informed consent was obtained from the subjects.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Data sharing statement: The data that support the findings of this study are available from the corresponding author at fyxuanrongrong@nbu.edu.cn upon reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rong-Rong Xuan, MAMS, Doctor, Teacher, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Ningbo University, No. 59 Liuting Street, Ningbo 315100, Zhejiang Province, China. fyxuanrongrong@nbu.edu.cn
Received: November 13, 2023
Peer-review started: November 13, 2023
First decision: January 23, 2024
Revised: February 4, 2024
Accepted: March 7, 2024
Article in press: March 7, 2024
Published online: April 27, 2024
Processing time: 162 Days and 17.2 Hours
Abstract
BACKGROUND

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver condition that typically arises in the middle and late stages of pregnancy. Short-chain fatty acids (SCFAs), prominent metabolites of the gut microbiota, have significant connections with various pregnancy complications, and some SCFAs hold potential for treating such complications. However, the metabolic profile of SCFAs in patients with ICP remains unclear.

AIM

To investigate the metabolic profiles and differences in SCFAs present in the maternal and cord blood of patients with ICP and determine the clinical significance of these findings.

METHODS

Maternal serum and cord blood samples were collected from both patients with ICP (ICP group) and normal pregnant women (NP group). Targeted metabolomics was used to assess the SCFA levels in these samples.

RESULTS

Significant differences in maternal SCFAs were observed between the ICP and NP groups. Most SCFAs exhibited a consistent declining trend in cord blood samples from the ICP group, mirroring the pattern seen in maternal serum. Correlation analysis revealed a positive correlation between maternal serum SCFAs and cord blood SCFAs [r (Pearson) = 0.88, P = 7.93e-95]. In both maternal serum and cord blood, acetic and caproic acids were identified as key metabolites contributing to the differences in SCFAs between the two groups (variable importance for the projection > 1). Receiver operating characteristic analysis demonstrated that multiple SCFAs in maternal blood have excellent diagnostic capabilities for ICP, with caproic acid exhibiting the highest diagnostic efficacy (area under the curve = 0.97).

CONCLUSION

Compared with the NP group, significant alterations were observed in the SCFAs of maternal serum and cord blood in the ICP group, although they displayed distinct patterns of change. Furthermore, the SCFA levels in maternal serum and cord blood were significantly positively correlated. Notably, certain maternal serum SCFAs, specifically caproic and acetic acids, demonstrated excellent diagnostic efficiency for ICP.

Keywords: Intrahepatic cholestasis of pregnancy; Short-chain fatty acids; Maternal serum; Cord blood; Caproic acid

Core Tip: Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver condition that typically arises in the middle and late stages of pregnancy. Short-chain fatty acids (SCFAs), prominent metabolites of the gut microbiota, have significant connections with various pregnancy complications. This work assesses the SCFA levels in maternal serum and cord blood samples which are collected from both patients with ICP and normal pregnant women by using targeted metabolomics, then the correlation between maternal and cord blood SCFAs are explored. At the same time, the clinical diagnostic potential of key differential SCFAs are assessed.