Changes And Correlation Of Irisin Levels In Intrahepatic Cholestasis During Pregnancy

Objective:To explore the correlation between irisin,in serum and umbilical vein blood,and intrahepatic cholestasis of pregnancy.The correlation between irisin and clinical index is discussed in this paper.To explore the etiology and treatment of intrahepatic cholestasis of pregnancy.Methods:From November 2017 to November 2018,a total of 108 normal pregnant women(group A),64 patients with mild ICP(group B)and 39 patients with severe ICP(group C)who underwent regular birth examination and delivery in the first affiliated Hospital of Chengdu Medical College were prospectively collected clinical data and blood samples.And retrospective analysis of experimental data.The experimental projects included age,BMI,blood pressure,umbilical blood flow(S/D,RI),gestational weeks of delivery,fetal birth weight,TBA,DBIL,ALT,AST,GGT,TC,TG,HDL-C,LDL-C etc.The concentration of Irisin was determined by ELISA.Results:1.General and laboratory index analysis: fetal birth weight and TG of pregnant women with mild ICP was lower than that of normal pregnant women;ALT,AST,GGT,TBA was higher than that of normal pregnant women with severe ICP.The S/D value of umbilical artery of the pregnant women with severe ICP was higher than that of normal pregnant women and mild ICP pregnant women.Gestational fetal birth weight HDL-C was lower than that of normal pregnant women and mild ICP pregnant women,urea was only lower than that of normal pregnant women,and the difference was statistically significant(P<0.05).2.Irisin concentration analysis: the concentration of irisin in peripheral blood of the three groups of pregnant women was significantly higher than that of umbilical vein irisin,with statistically significant differences(P<0.05).Serum irisin concentration in normal pregnant women was significantly lower than that in mild ICP pregnant womenand severe ICP pregnant women,respectively,The serum irisin concentration in severe ICP pregnant women was significantly higher than that in mild ICP pregnant women.The concentration of irisin in umbilical venous blood of pregnant women with severe ICP was significantly higher than that of normal pregnant women and mild ICP pregnant women,with statistically significant differences(P<0.05).However,there was no significant difference between normal pregnant women and mild ICP pregnant women,(P>0.05).3.Correlation analysis of irisin: there was a significant positive correlation between serum irisin and the concentration of umbilical venous blood irisin in the three groups of pregnant women(r=0.204,P=0.003).There was a significant positive correlation between serum irisin and the concentration of umbilical venous blood irisin in ICP patients(r=0.210,P=0.033).Serum irisin concentration was significantly positively correlated with ALT,AST,GGT,ALP,TBA,DBIL,creatinine,TG and TC(P<0.05).There was a significant positive correlation between the concentration of irisin in umbilical venous blood and the values of ALT,AST,GGT,ALP,TBA,TBIL,DBIL,TG,TC,LDL-C and S/D in umbilical artery.There was a significant negative correlation with fetal birth weight,(P<0.05).Stepwise multiple linear regression analysis shows that the quasi-sum model(P=0.003),indicating that the model is significant.Among them,ALT was an independent factor affecting serum irisin level in ICP patients(?=0.292;t=3.063;P=0.003).4.The ROC curve of irisin in predicting ICP: AUC=0.622(95%CI 0.543-0.701),(P<0.05),the optimal threshold =989.168pg/ml,sensitivity 60.9%,specificity 40.1%.For the ROC curve of irisin in predicting severe ICP: AUC=0.730(95%CI 0.648-0.813),(P<0.05).The optimal threshold=1033.99pg/ml,sensitivity 66.7%,specificity 38.2%.Conclusion:The concentration of irisin in peripheral blood was significantly higher than that in umbilical venous blood.Serum and umbilical venous blood irisin concentrations of ICP patients were higher than those of normal pregnant women,suggesting that irisin may play a role in the pathophysiological process of ICP.The reduction of fetal birth weight in ICP patients may be due to the role of irisin in energy and fat metabolism.The serumirisin concentration has certain reference significance for the diagnosis of ICP and severe ICP,suggesting that irisin may become a new cofactor in the diagnosis and classification of ICP.