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In this study, proton nuclear magnetic resonance spectroscopy (<jats:sup>1<\/jats:sup>H\u2010NMR) was first performed on serum samples from 20 ICP patients and 20 matched healthy controls to screen for differential metabolites. UPLC\u2013MS\/MS was subsequently employed to quantify eight choline pathway metabolites across expanded cohorts, including 40 ICP patients, 17 UDCA\u2010treated ICP patients, and 40 healthy pregnant women.<jats:sup>1<\/jats:sup> H\u2010NMR metabolomics revealed significant perturbations in amino acid metabolism and choline\u2010related pathways in ICP patients. UPLC\u2013MS\/MS validation demonstrated marked elevations in serum choline (+92.0%), betaine (+22.0%), methionine (+37.7%), dimethylglycine (+163.1%), and cystathionine (+13.6%) compared to controls. UDCA intervention significantly reduced choline (\u221221.0%) and dimethylglycine (\u221232.5%) levels versus untreated ICP (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Serum levels of choline and dimethylglycine exhibited exceptional diagnostic performance, with areas under the receiver operating characteristic curve (AUROCs) exceeding 0.84. Furthermore, when these two metabolites were combined using a logistic regression model, an AUROC value of 0.88 was achieved. Our study identifies choline metabolic dysregulation as a characteristic feature of ICP. Serum choline and dimethylglycine as potential biomarkers for ICP screening and treatment monitoring merit further validation.<\/jats:p>","DOI":"10.1002\/bmc.70234","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T05:55:18Z","timestamp":1759816518000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Screening and Validation Serum Potential Biomarkers for Intrahepatic Cholestasis of Pregnancy Comparison to Healthy Controls by <sup>1<\/sup>H\u2010NMR and UPLC\u2013MS\/MS"],"prefix":"10.1002","volume":"39","author":[{"given":"Yufeng","family":"Deng","sequence":"first","affiliation":[{"name":"Modern Industrial College of Traditional Chinese Medicine and Health Lishui University  Lishui China"},{"name":"School of Pharmaceutical Science Nanchang University  Nanchang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiayi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Jiujiang First People's Hospital  Jiujiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dujuan","family":"Zhan","sequence":"additional","affiliation":[{"name":"Modern Industrial College of Traditional Chinese Medicine and Health Lishui University  Lishui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongrong","family":"Lei","sequence":"additional","affiliation":[{"name":"Modern Industrial College of Traditional Chinese Medicine and Health Lishui University  Lishui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Liu","sequence":"additional","affiliation":[{"name":"Modern Industrial College of Traditional Chinese Medicine and Health Lishui University  Lishui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Hu","sequence":"additional","affiliation":[{"name":"School of Pharmaceutical Science Nanchang University  Nanchang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengyuan","family":"Nie","sequence":"additional","affiliation":[{"name":"School of Pharmaceutical Science Nanchang University  Nanchang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanzhen","family":"Xiong","sequence":"additional","affiliation":[{"name":"School of Pharmaceutical Science Nanchang University  Nanchang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0685-1346","authenticated-orcid":false,"given":"Baogang","family":"Xie","sequence":"additional","affiliation":[{"name":"Modern Industrial College of Traditional Chinese Medicine and Health Lishui University  Lishui China"},{"name":"School of Pharmaceutical Science Nanchang University  Nanchang China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpath.2010.11.026"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00555.2010"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnmrs.2014.09.001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(19)31270\u2010x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e3799"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20347"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523\u20101755.2001.59780221.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.2049"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/72.6.1535"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010007\u20100167\u20109"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(09)61495\u20101"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2011.12.009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.R111.238691"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i46.7338"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.R700019\u2010JLR200"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M202487200"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2017.06.021"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.6064\/2012\/496489"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e328337238d"},{"issue":"3","key":"e_1_2_8_21_1","first-page":"323","article-title":"Recurrent Intrahepatic Cholestasis of Pregnancy. 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