Clinical value of serum TPOAb and 25- (OH) D3 combined detection in patients with intrahepatic cholestasis during pregnancy

Abstract

Abstract: Objective To investigate the clinical value of serum thyroid peroxidase antibody (TPOAb) combined with 25 hydroxyvitamin D [25- (OH) D3] in patients with intrahepatic cholestasis of pregnancy (ICP). Methods 90 ICP women who participated in physical examination filing and hospital delivery in the department of obstetrics and gynecology of our hospital from January 2018 to December 2020 were included in the observation group, and 60 healthy pregnant women who delivered in our hospital during the same period were included in the control group. Fasting venous blood samples were collected to determine serum levels of total bile acid (TBA), glycholic acid (CG), alanine aminotransferase (ALT) and alkaline phosphatase (ALP), as well as serum levels of TPOAb and 25- (OH) D3. The observation group was divided into severe and mild subgroups according to the levels of TBA, TPOAb and 25- (OH) D3, and the biochemical indexes between the observation group and the control group were compared. Pearson correlation was used to analyze the diagnostic efficacy of serum TPOAb and 25- (OH) D3 alone and in combination. Results The level of serum TPOAb in severe subgroup was (25.87 ± 4.63) ng/L, which was higher than that in mild subgroup (16.38 ± 3.71) ng/L and control group (9.75 ± 2.36) ng/L. The level of serum 25- (OH) D3 in severe subgroup was (22.37 ± 4.09) μg/mL, which was lower than that in mild group [(29.85 ± 4.63) μg/mL] and control group [(35.26 ± 5.74) μg/mL], the difference was statistically significant (F=17.482, 13.287, P<0.05). TBA, CG, ALT and ALP in high TPOAb subgroup were (48.65 ± 8.34) μmol/L, (410.98 ± 45.67) μmol/L, (92.23 ± 11.75) U/L and (164.75 ± 18.62) U/L, higher than those of low TPOAb subgroup [(22.78 ± 5.03) μmol/L, (249.71 ± 30.54) μmol/L, (67.38 ± 8.34) U/L and (112.65 ± 13.49) U/L], the difference was statistically significant (t=14.361, 11.578, 10.954, 9.803, all P<0.05). TBA, CG, ALT and ALP in high 25- (OH) D3 subgroup were (422.78 ± 5.03) μmol/L, (256.43 ± 31.57) μmol/L, (69.25 ± 8.06) U/L and (109.84 ± 12.36) U/L, lower than those in low 25- (OH) D3 subgroup [(47.29 ± 8.15) μmol/L, (412.59 ± 46.82) μmol/L, (91.72 ± 11.28) U/L and (165.37 ± 19.03) U/L]. The differences were statistically significant (t=13.297, 10.472, 9.716, 12.569, all P<0.05). The incidence of anemia, cesarean section, postpartum hemorrhage, fetal distress, premature delivery, low neonatal weight and other pregnancy outcomes in the high TPOAb subgroup were significantly higher than those in the low TPOAb subgroup. The incidence of pregnancy outcomes in high 25- (OH) D3 group were significantly lower than low 25- (OH) D3 group (P<0.05). After Pearson correlation analysis, the area under the curve (AUC) of serum TPOAb combined with 25- (OH) D3 level was significantly higher than that of single indicator (AUC = 0.763, 0.745, 0.869, P<0.01). Conclusion The combined detection of serum TPOAb and 25- (OH) D3 has high clinical application value for disease diagnosis, disease monitoring and prognosis evaluation of ICP patients.

Key words: Intrahepatic cholestasis of pregnancy, Thyroid peroxidase antibody, 25 hydroxyvitamin D, Clinical value

WU Ting, XU Xiao-ying, ZHENG Li. Clinical value of serum TPOAb and 25- (OH) D3 combined detection in patients with intrahepatic cholestasis during pregnancy[J]. Chinese Hepatolgy, 2022, 27(9): 1025-1029.

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