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

doi:10.4254/wjh.v16.i4.601

Expression and clinical significance of short-chain fatty acids in patients with intrahepatic cholestasis of pregnancy

World J Hepatol. 2024 Apr 27;16(4):601-611. doi: 10.4254/wjh.v16.i4.601.

Authors

Shuai-Jun Ren¹, Jia-Ting Feng^{1

2}, Ting Xiang^{1

2}, Cai-Lian Liao^{1

2}, Yu-Ping Zhou^{3

4}, Rong-Rong Xuan⁵

Affiliations

¹ Department of Obstetrics and Gynecology, The First Affiliated Hospital of Ningbo University, Ningbo 315100, Zhejiang Province, China.
² Health Science Center, Ningbo University, Ningbo 315211, Zhejiang Province, China.
³ Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo 315211, Zhejiang Province, China.
⁴ Institute of Digestive Disease, Ningbo University, Ningbo 315020, Zhejiang Province, China.
⁵ Department of Obstetrics and Gynecology, The First Affiliated Hospital of Ningbo University, Ningbo 315100, Zhejiang Province, China. fyxuanrongrong@nbu.edu.cn.

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