The correlation between serum total bile acid and adverse perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP) and non-ICP hypercholanemia of pregnancy

Article

Author: Zhang, Peizhen ; Yin, Yuzhu ; Tan, Zhangmin ; Han, Zhenyan ; Li, Chuo ; Zhou, Jin

BACKGROUNDThe association between excessive serum total bile acid (TBA) and adverse perinatal outcomes in individuals with non-intrahepatic cholestasis of pregnancy (non-ICP) hypercholanemia has not been determined, and it is unclear if this link is similar to that observed in patients with ICP.OBJECTIVETo examine the adverse perinatal outcomes in two specific subcategories: those with ICP and those with non-ICP, including individuals with liver disease and asymptomatic hypercholanemia of pregnancy (AHP), at different levels of TBA. Investigate the correlation between TBA levels and adverse perinatal outcomes of ICP, liver disease, and AHP.METHODSFrom 2013 to 2021, pregnant women with excessive TBA levels were taken from the electronic medical record database of our hospital and categorized into three groups: ICP (n = 160), liver disease (n = 164), and AHP (n = 650). This was done as part of a retrospective cohort research project. Multivariable regression and subgroup analyses were performed to examine the association between TBA levels and adverse perinatal outcomes in each group.RESULTSThe study found no significant differences in adverse perinatal outcomes between the ICP and liver disease groups at different TBA levels. However, at moderate TBA levels, both groups had a higher risk of adverse perinatal outcomes than the AHP group (p < 0.017). Among liver disease cases with TBA ≥ 100µmol/L, three cases of perinatal deaths (6.67%) associated with moderate-to-severe acute hepatitis occurred between 27 and 33 weeks of gestation. A 59% higher chance of perinatal death was found for every 10 µmol/L rise in TBA, even after significant variables and confounders were taken into account (adjusted odds ratio (aOR) = 1.59; 95% confidence interval (CI): 1.06-2.40; p = 0.03).CONCLUSIONSIf a pregnant woman has moderate-to-severe liver disease and TBA ≥ 100µmol/L, preterm termination of pregnancy (before 34 weeks) may be considered.

31 Dec 2024·Journal of Obstetrics and Gynaecology

The correlation between blood lipids and intrahepatic cholestasis syndrome during pregnancy

Article

Author: Zhuoma, Gunsang ; Huang, Huibin ; Chen, Tianhua ; Li, Juan ; Gan, Yuebin ; Ye, Huiming ; Chen, Lijin ; Lu, Meidan

BACKGROUNDTo analyse changes in lipid levels during the development of intrahepatic cholestasis of pregnancy (ICP) and identify new biomarkers for predicting ICP.METHODSA retrospective case-control study was conducted to analyse 473 pregnant women who underwent regular prenatal examinations and delivered at the Women and Children's Hospital, School of Medicine, Xiamen University, between June 2020 and June 2023, including 269 normal pregnancy controls and 204 pregnant women with cholestasis.RESULTSPatients with ICP with gestational diabetes mellitus (GDM) have lower high-density lipoprotein (HDL) levels than in those without GDM. Total bile acid (TBA) levels were significantly higher in pregnant women with GDM than those without. The apolipoprotein A (APOA) level was lower in patients with ICP and hypothyroidism than those without hypothyroidism. TBA levels were significantly higher in pregnant women with hypothyroidism than those without. Triglyceride (TG) levels were significantly higher in patients with preeclampsia (PE) than those without. HDL and APOA levels were lower in women with ICP complicated by preterm delivery than those with normal delivery. The AUC (area under the curve) of the differential diagnosis of cholestasis of pregnancy for the APOA/APOB (apolipoprotein B) ratio was 0.727, with a sensitivity of 85.9% and specificity of 47.5%.CONCLUSIONSThe results suggested that dyslipidaemia is associated with an increased risk of ICP and its complications. The timely detection of blood lipid and bile acid levels can assist in the diagnosis of ICP and effectively prevent ICP and other complications.

01 Oct 2024·Journal of Dentistry

Clinical outcomes of single implant supported crowns utilising the titanium base abutment: A 7.5-year prospective cohort study

Article

Author: Endres, Janina ; Jung, Ronald E ; Thoma, Daniel S ; Strauss, Franz J ; Naenni, Nadja ; Smirani, Rawen ; Chantler, Jennifer Gm

OBJECTIVETo assess radiographic, clinical and patient-reported outcomes of single zirconia implant-supported crowns on titanium base abutments (TBA) over a 7.5-year period.METHODSTwenty-four patients received bone-level titanium implants and screw-retained zirconia implant crowns utilising TBA. Marginal bone level (MBL), clinical parameters (probing depth-PD, bleeding on probing-BoP, plaque control record-PCR), technical complications (USPHS criteria) and patient satisfaction were assessed at crown delivery (baseline), 1 year (FU-1) and at 7.5 years (FU-7.5) of follow-up.RESULTSEighteen patients were available for re-examination at 7.5 years. The mean MBL at FU-7.5 (0.35 ± 0.20mm) did not significantly change compared to baseline (0.54 ± 0.39, p=.352) and to FU-1 (0.54 ± 0.45mm, p=0.524). From baseline to 7.5 years, the mean PD increased significantly, from 3.0 ± 0.6mm to 3.7 ± 0.8mm (p=0.005). However, BoP and PCR did not significantly change; (BOP: from 27.1 ± 20.7% to 25.0 ± 20.0%, p=0.498; PCR: from 11.1 ± 21.2% to 25.0 ± 25.1%, p=0.100). Nine patients presented with more than one bleeding site. This denoted a peri-implant mucositis prevalence of 50%, whilst none of the implants presented peri-implantitis. One incidence of minor and major ceramic chipping were reported on 2 out of the 18 crowns, resulting in a prosthetic survival rate of 94.4%. Seventeen patients were highly satisfied with their result.CONCLUSIONSingle implant-supported zirconia crowns on TBA displayed: (i) minor number of technical complications, (ii) high prosthetic survival rate, (iii) stable marginal bone level and (iv) high patient satisfaction at 7.5 years.CLINICAL IMPLICATIONSTitanium base abutments despite their high use in clinical practice, lack medium- and long-term studies. The presented findings highlight their clinical performance at 7.5 years as they display satisfying radiographic, clinical and patient-related outcomes. TBA appear to be a suitable abutment choice for medium-term implant-supported restorations.

100 Deals associated with TBA-GLE

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Indication	Highest Phase	Country/Location	Organization	Date
Thrombosis	Preclinical	RU	Russian Academy of Sciences	10 Feb 2023

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