Increased Serum Met-enkephalin Level in Patients with Intrahepatic Cholestasis of Pregnancy

Abstract

Objective:To evaluate met-enkephalin levels in women with intrahepatic cholestasis of pregnancy (ICP) by comparison to healthy controls and to compare the pregnancy outcomes.Method:This cross-sectional study was conducted in 43 pregnant women with ICP and 40 randomly selected healthy pregnant women, who formed the control group. Serum met-enkephalin concentrations were measured using an enzyme-linked immunosorbent assay. The patients’ age, body mass index (BMI), gestational week, fasting serum bile acid, serum parameters, birth week, and APGAR scores at 1st and 5th minutes were recorded.Results:Maternal age, BMI and gestational age at blood sampling were similar between the two groups. Considering the pregnancy outcomes, birth week was significantly lower in the ICP group than in the control group (37 vs. 38 weeks, respectively; p<0.001). The median met-enkephalin level was significantly higher in the ICP group compared to the control group (273 vs. 121.5, respectively; p<0.001). A significant negative correlation was observed between met-enkephalin level and birth week (r=-0.33; p=0.002). The area under the curve was 91% for the cut-off point 145 of met-enkephalin (p<0.001). The specificity and sensitivity were 77.5% and 79%, respectively. A significant effect of metenkephalin on the diagnosis of cholestasis was observed (odds ratio: 1.01, p<0.001, 95% confidence interval: 1.007-1.02).Conclusion:Serum met-enkephalin levels were increased in patients with gestational cholestasis compared to healthy controls. Based on this, opioid receptor antagonists may be a promising treatment alternative.

Keywords

• bile acids
• cholestasis
• opioid
• pregnancy
• pruritus