Relationship Between Serum Autotaxin Levels and Fasting Bile Acid in Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease, especially in the second and third trimesters of pregnancy. Autotaxin (ATX) has been reported to play a critical role, especially in cholestatic pruritus, and serum ATX levels are associated with ICP. The aim of this study was to determine the serum ATX level in ICP, to evaluate its relationship with fasting bile acid (FBA) level, and its use in the diagnosis of ICP.

Forty-three patients diagnosed with ICP and 45 healthy pregnant women were included in the study. Gestational week at diagnosis, serum parameters, FBA, pruritus intensity, gestational week, and birth weight were recorded. Venous blood was collected from all patients for ATX levels, stored under appropriate conditions, and measured enzymatically after the study was completed.

Although ATX level was found to be higher in patients with ICP (n = 43; 350.5 ± 348.7 pg/mL) compared to the control group (n = 45; 219.7 ± 131.5 pg/mL), this increase was not statistically significant (p = 0.325). Again, no significant correlation was found between ATX levels and FBA levels (p = 0.326). There was a weak correlation between the severity of pruritus and serum FBA levels (p = 0.024), but no correlation was found between ATX levels and pruritus severity (p = 0.437).

There was no significant difference in autotoxin levels in pregnant women with ICP compared to healthy pregnant women. These findings suggest that autotoxin activity may not be appropriate for the diagnosis of ICP, and larger clinical studies are needed to understand the effect of autotoxin in ICP.