Intrahepatic Cholestasis of Pregnancy is Associated with Gestational Diabetes Mellitus

Özet

OBJECTIVES: Intrahepatic (also known as obstetric) cholestasis of pregnancy is one of the most fre- quently diagnosed conditions for pregnancy-specific hepatic disease. It has consistently been found to be related to adverse pregnancy outcomes. In recent studies, a relationship between Intrahepatic cholestasis of pregnancy and gestational diabetes mellitus was demonstrated. However, the association between serum total total bile acid evel in Intrahepatic cholestasis of pregnancy and gestational diabetes mellitus is not fully understood. This study aims to evaluate the association between serum total total bile acid levels in Intrahepatic cholestasis of pregnancy disease with gestational diabetes mellitus. STUDY DESIGN: Eighty pregnant women diagnosed with Intrahepatic cholestasis of pregnancy and eighty healthy pregnant women as normal controls were included in the study. Their clinical character- istics and laboratory test results including liver function tests, glucose challenge tests, glucose tolerance tests, and fasting and postprandial total total bile acid levels were recorded. Cases with serumtotal total bile acid levels between 12-40 μmol/L were described as mild disease, >40 μmol/L was described as severe disease. RESULTS: The mean 50-g glucose challenge tests value was significantly higher in pregnant women with Intrahepatic cholestasis of pregnancy compared to the healthy controls (128.7±28.2, 106.6±27.0; p<0.0001) and it was slightly higher in women with severe disease than women with mild disease (132.7±30.1, 125.5±26.5; p=0.26). The percent of gestational diabetes mellitus diagnosis with Intrahepatic cholestasis of pregnancy disease (11.25%) was higher than in healthy pregnant women (6.25%) but the difference was not found to be statistically significant (p=0.187) and it was similar in pregnant women with mild and severe disease (11.1%, 11.4%; p=0.31). CONCLUSION: Our current study demonstrated that Intrahepatic cholestasis of pregnancy was not associated with gestational diabetes mellitus, also, we did not demonstrate a relationship of total total bile acid level with Intrahepatic cholestasis of pregnancy and gestational diabetes mellitus. It may be due to our study’s small sample size. Further and well-designed studies with larger sample sizes are necessary to determine the relationship between gestational diabetes mellitus and Intrahepatic cholestasis of pregnancy and also the function of total total bile acid in the pathogenesis of gestational diabetes mellitus disease.