Effects of ursodeoxycholic acid on conjugated bile acids and progesterone metabolites in serum and urine of patients with intrahepatic cholestasis of pregnancy

Abstract

Background/Aims and Methods: The mechanism(s) behind the effects of ursodeoxycholic acid on serum steroid sulphate profiles in patients with intrahepatic cholestasis of pregnancy is not clear. Conjugated progesterone metabolites and bile acids have therefore been analysed in serum and urine of patients with intrahepatic cholestasis of pregnancy before and during treatment with ursodeoxycholic acid using chromatographic and mass spectrometric methods. Results: The concentration of glycine-/taurine- conjugated bile acids decreased from 8.9±3 μmol/l (mean± SEM) before treatment to 1.8±0.6 μmol/l during treatment with ursodeoxycholic acid. The total bile acid excretion in urine decreased from 56±14 to 32±5.6 μmol/g creatinine. The proportion of cholic acid in serum and urine, and of 1β-, 2β- and 6α-hydroxylated cholic acids in urine decreased markedly during ursodeoxycholic acid while the percentages of 3α,12α-dihydroxy-3-oxo-4- cholenoic acid and chenodeoxycholic acid were unchanged. The