{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T07:47:01Z","timestamp":1782200821849,"version":"3.54.5"},"reference-count":33,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objective: To investigate maternal serum silent information regulator-2 protein 1 (SIRT1) levels in pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP) and evaluate their diagnostic performance. Methods: This prospective case\u2013control study included 44 pregnant women with ICP and 44 healthy pregnant controls matched according to gestational age at blood sampling and maternal body mass index. Maternal serum SIRT1 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Clinical, laboratory, and obstetric outcomes were compared between groups. Correlation, receiver operating characteristic (ROC) curve, and exploratory multivariable logistic regression analyses were performed. Results: Maternal serum SIRT1 levels were significantly lower in the ICP group compared with controls [1.06 (1.05) ng\/mL vs. 1.54 (1.74) ng\/mL, p = 0.005]. ROC analysis demonstrated modest discriminative performance of maternal serum SIRT1 alone for identifying ICP (AUC: 0.674, 95% CI: 0.559\u20130.788, p = 0.005). A SIRT1 cut-off value of \u22641.28 ng\/mL yielded 63.6% sensitivity and 60.5% specificity. In contrast, ALT alone showed excellent discriminative performance (AUC: 0.927, 95% CI: 0.860\u20130.995, p &lt; 0.001). Combined ROC analyses demonstrated further improvement with the ALT + albumin model (AUC: 0.962, 95% CI: 0.925\u20130.999), whereas addition of SIRT1 resulted in only a minimal incremental increase in AUC to 0.966 (95% CI: 0.933\u20130.998). Maternal serum SIRT1 concentrations were not independently associated with ICP after adjustment for laboratory parameters. Conclusions: Although maternal serum SIRT1 levels were significantly reduced in pregnancies complicated by ICP, their diagnostic performance was modest and provided minimal incremental value beyond conventional biochemical markers. Nevertheless, reduced maternal serum SIRT1 concentrations may support the involvement of inflammatory and oxidative stress-related pathways in ICP pathophysiology and warrant further mechanistic investigation.<\/jats:p>","DOI":"10.3390\/diagnostics16121834","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:44:58Z","timestamp":1781484298000},"page":"1834","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Serum SIRT1 Concentrations in Intrahepatic Cholestasis of Pregnancy: Limited Diagnostic Utility in a Prospective Case\u2014Control Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7034-6811","authenticated-orcid":false,"given":"Din\u00e7er","family":"S\u00fcmer","sequence":"first","affiliation":[{"name":"Department of Perinatology, University of Health Sciences, Etlik City Hospital, Etlik \u015eehir Hastanesi Varl\u0131k Mahallesi Halil Sezai Erkut Cd. No: 5, Yenimahalle, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6137-0270","authenticated-orcid":false,"given":"Ahmet Arif","family":"Filiz","sequence":"additional","affiliation":[{"name":"Department of Perinatology, University of Health Sciences, Etlik City Hospital, Etlik \u015eehir Hastanesi Varl\u0131k Mahallesi Halil Sezai Erkut Cd. No: 5, Yenimahalle, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zg\u00fcr Volkan","family":"Akbulut","sequence":"additional","affiliation":[{"name":"Department of Perinatology, University of Health Sciences, Etlik City Hospital, Etlik \u015eehir Hastanesi Varl\u0131k Mahallesi Halil Sezai Erkut Cd. No: 5, Yenimahalle, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Figen","family":"G\u00fcnday","sequence":"additional","affiliation":[{"name":"Department of Perinatology, University of Health Sciences, Etlik City Hospital, Etlik \u015eehir Hastanesi Varl\u0131k Mahallesi Halil Sezai Erkut Cd. No: 5, Yenimahalle, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fclten","family":"\u00c7irkin Teke\u015f","sequence":"additional","affiliation":[{"name":"Department of Perinatology, University of Health Sciences, Etlik City Hospital, Etlik \u015eehir Hastanesi Varl\u0131k Mahallesi Halil Sezai Erkut Cd. No: 5, Yenimahalle, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4433-7344","authenticated-orcid":false,"given":"Kutlay","family":"B\u00fclb\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Etlik City Hospital, Varl\u0131k Mahallesi Halil Sezai Erkut Cd. No: 5, Yenimahalle, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demet","family":"S\u00fcmer","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Division of Surgical Oncology, University of Health Sciences, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Ba\u015fak\u015fehir Mahallesi G-434 Caddesi No: 2L, Ba\u015fak\u015fehir, 34480 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3429-3879","authenticated-orcid":false,"given":"Belgin","family":"Savran \u00dc\u00e7ok","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Health Sciences, Etlik City Hospital, Varl\u0131k Mahallesi Halil Sezai Erkut Cd. No: 5, Yenimahalle, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kadriye","family":"Yakut Y\u00fccel","sequence":"additional","affiliation":[{"name":"Department of Perinatology, University of Health Sciences, Etlik City Hospital, Etlik \u015eehir Hastanesi Varl\u0131k Mahallesi Halil Sezai Erkut Cd. No: 5, Yenimahalle, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.3748\/wjg.15.2049","article-title":"Intrahepatic cholestasis of pregnancy","volume":"15","author":"Geenes","year":"2009","journal-title":"World J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1038\/s41572-025-00633-2","article-title":"Intrahepatic cholestasis of pregnancy","volume":"11","author":"Dajti","year":"2025","journal-title":"Nat. Rev. Dis. 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