Rare Pregnancy Complication Linked to Non-Alcoholic Fatty Liver Disease

By Megan Brooks

May 22, 2019

NEW YORK (Reuters Health) - New research suggests a link between intrahepatic cholestasis of pregnancy (ICP) and non-alcoholic fatty liver disease (NAFLD), which "could have important implications for treating both diseases," Dr. Tatyana Kushner from Icahn School of Medicine at Mount Sinai in New York City said May 9 during a Digestive Disease Week press briefing.

ICP affects about 1 of every 300 pregnancies and typically presents as severely itchy palms and soles of the feet. It is characterized by a buildup of bile acids during pregnancy and is associated with negative fetal outcomes if left untreated. Progression of NAFLD has been linked to the dysregulation of bile acid homeostasis. However, an association of NAFLD with ICP has not been previously evaluated, the researchers note in their meeting abstract.

"Our research shows that there is a connection between impaired bile acid metabolism in both disease processes," co-author Dr. Erica Monrose, also of the Icahn School of Medicine at Mount Sinai, said in a conference statement.

The study team took a look back at the medical records of 149 pregnancies complicated by ICP and a control group of 200 pregnant women without a diagnosis of ICP.

Compared with controls, ICP patients had higher median alanine aminotransferase, alkaline phosphatase and total bilirubin levels (P<0.0001 for all). They were also more likely to have alanine aminotransferase levels >50 U/L (2 times the upper limit of normal; odds ratio 3.22), to have a history of biliary disease (OR 3.29) and evidence of steatosis on liver imaging (OR 4.69).

Compared with controls, women with ICP were nearly six times more likely to have a diagnosis of NAFLD based on ICD-10 code or evidence of steatosis on liver imaging (odds ratio 5.7).

"Our research uncovered a connection between impaired bile acid metabolism in both fatty liver disease and cholestasis of pregnancy," Dr. Kushner told the briefing. "If this connection is confirmed with future studies, ICP may prove a novel model through (which) to investigate bile acid metabolism in patients with fatty liver disease and this could have implications for future management of fatty liver disease."

"Additionally, these findings suggest that ICP patients should be seen by a liver specialist because they "may go on to develop chronic liver disease or may have already existing underlying liver disease," she added.

SOURCE: http://bit.ly/30qwMih

Digestive Disease Week 2019.