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Maternal cholestasis during pregnancy programs metabolic disease in offspring
Georgia Papacleovoulou, … , A.S. Knisely, Catherine Williamson
Georgia Papacleovoulou, … , A.S. Knisely, Catherine Williamson
Published June 24, 2013
Citation Information: J Clin Invest. 2013;123(7):3172-3181. https://doi.org/10.1172/JCI68927.
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Research Article

Maternal cholestasis during pregnancy programs metabolic disease in offspring

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Abstract

The intrauterine environment is a major contributor to increased rates of metabolic disease in adults. Intrahepatic cholestasis of pregnancy (ICP) is a liver disease of pregnancy that affects 0.5%–2% of pregnant women and is characterized by increased bile acid levels in the maternal serum. The influence of ICP on the metabolic health of offspring is unknown. We analyzed the Northern Finland birth cohort 1985–1986 database and found that 16-year-old children of mothers with ICP had altered lipid profiles. Males had increased BMI, and females exhibited increased waist and hip girth compared with the offspring of uncomplicated pregnancies. We further investigated the effect of maternal cholestasis on the metabolism of adult offspring in the mouse. Females from cholestatic mothers developed a severe obese, diabetic phenotype with hepatosteatosis following a Western diet, whereas matched mice not exposed to cholestasis in utero did not. Female littermates were susceptible to metabolic disease before dietary challenge. Human and mouse studies showed an accumulation of lipids in the fetoplacental unit and increased transplacental cholesterol transport in cholestatic pregnancy. We believe this is the first report showing that cholestatic pregnancy in the absence of altered maternal BMI or diabetes can program metabolic disease in the offspring.

Authors

Georgia Papacleovoulou, Shadi Abu-Hayyeh, Evanthia Nikolopoulou, Oscar Briz, Bryn M. Owen, Vanya Nikolova, Caroline Ovadia, Xiao Huang, Marja Vaarasmaki, Marc Baumann, Eugene Jansen, Christiane Albrecht, Marjo-Riitta Jarvelin, Jose J.G. Marin, A.S. Knisely, Catherine Williamson

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Figure 2

Female offspring from a cholestatic pregnancy are predisposed to metabolic disease.

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Female offspring from a cholestatic pregnancy are predisposed to metabol...
(A) Representative images of PAS- (upper panel) and toluidine blue–stained (lower panel) livers in NC-fed female offspring; n = 6 animals per group. Original magnification, ×20 and ×5 (insets). (B) Alterations in serum adipocytokines in CA NC female offspring as assessed in 6 serum samples per animal group. (C) Unsupervised hierarchical clustering of differentially expressed hepatic genes in CA NC compared with NC NC female offspring; n = 4 animals per group. (D) IPA of differentially expressed genes from C. Threshold denotes cutoff for statistical significance. NC NC and CA NC are as defined in Figure 1.

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