NAFLD linked to intrahepatic cholestasis of pregnancy

Due to significantly higher rates of steatosis and liver imaging, researchers linked intrahepatic cholestasis of pregnancy and nonalcoholic fatty liver disease.

Tatyana Kushner, MD, MSCE, from the Icahn School of Medicine at Mount Sinai in New York discussed the findings during a press conference call on behalf of co-author Erica Monrose, MD, from the Icahn School of Medicine, who will present the study at Digestive Disease Week in San Diego.

“The connection between a rare condition that most notably causes severe itchiness in the palms and soles as well as [other areas] during pregnancy and nonalcoholic fatty liver disease is not immediately obvious,” Kushner said. “But the possible linkage of these two conditions in terms of the role of bile acids could have important implications for treating both diseases.”

The retrospective study included 149 women diagnosed with intrahepatic cholestasis of pregnancy (ICP) and 200 pregnant women without a diagnosis of ICP. Women with ICP were six times more likely to have a diagnosis of fatty liver disease compared with controls.

Specifically, women with ICP were more likely to have biliary disease prior to pregnancy (P = .0045), history of ICP prior to pregnancy (P < .0001), steatosis on liver imaging (P = .0014), NAFLD diagnosis or steatosis on imaging (P = .0006), liver imaging performed (P = .0005), and alanine aminotransferase levels higher than 2 times the upper limit of normal (P < .0001).

“Our research uncovered a connection between impaired bile acid metabolism in both liver disease and cholestasis of pregnancy,” Kushner said. “If this connection is confirmed with future studies, ICP may prove a novel model through which we can investigate bile acid metabolism in patients with fatty liver disease.”

Kushner added that these findings suggest that patients with ICP 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.” – by Talitha Bennett

Reference:

Monrose E, et al. Abstract Sa1562. Presented at: Digestive Disease Week; May 18-21; San Diego, California.

Disclosures: Kushner reports advisory committee or review panels roles with Gilead Pharmaceuticals. Monrose reports no relevant financial disclosures. Please see the DDW disclosure index for all other authors’ relevant financial disclosures.