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Table 1.

Steroids quantified in the circulation of women with ICP and controls.

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Fig 1.

Algorithm for obtaining predictions of intrahepatic cholestasis of pregnancy (ICP).

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Table 2.

Levels of relevanta liver function tests and circulating steroids in patients with ICP and controls.

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Table 3.

Discrimination between women with ICP and age- and gender-corresponding controls on the basis of relevanta liver function tests and circulating steroids measured by GC-MS or RIA as evaluated by receiver operating characteristics (ROC).

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Table 4.

Relationships between ICP and circulating steroids measured by RIA (17-hydroxypregnenolone sulfate) and GC-MS (remaining steroids) as evaluated by OPLS model (for details see Statistical analysis).

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Table 5.

Relationships between ICP and circulating steroids measured exclusively by GC-MS, as evaluated by the OPLS model and by multiple regression (for details see Statistical analysis).

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Fig 2.

A simplified scheme of steroidogenesis in the Δ5 and Δ4 metabolic pathways in humans.

The symbols in parentheses “+” and “~” represent increased and unchanged steroid levels, respectively, in the ICP group.

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Fig 3.

A simplified scheme of 5α/β-reductive progesterone and 20α-dihydroprogesterone catabolism and interconversion between the steroid 20-oxo and 20α-hydroxy-counterparts.

The symbols in parentheses “+”, “~”, and ”−” represent increased, unchanged steroid and decreased steroids levels, respectively, in the ICP group.

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Fig 4.

A simplified scheme of 5α/β-reduced C19 steroid biosynthesis in the human “frontdoor pathway”.

The symbols in parentheses “+”, “~”, ”−“, and ”?” represent increased, unchanged, decreased and unknown steroids levels, respectively, in the ICP group.

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Fig 5.

A simplified scheme of 5α/β-reduced C19 steroid biosynthesis in human, “backdoor pathway”.

The symbols in parentheses “+”, “~”, ”−“, and ”?” represent increased, unchanged, decreased and unknown steroids levels, respectively, in the ICP group.

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Fig 6.

A simplified scheme of the biosynthesis of 5β-reduced C19 and C21 steroids in human.

The symbols in parentheses “+”, “~”, ”−“, and ”?” represent increased, unchanged, decreased and unknown steroids levels, respectively, in the ICP group.

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Fig 7.

Discrimination of women with intrahepatic cholestasis of pregnancy (ICP) from controls (C) on the basis of maternal circulating steroids measured by radioimmunoassay (17-hydroxypregnenolone sulfate) and GC–MS (remaining steroids) (panels A and B) and on the basis of steroids measured exclusively by GC-MS (panels C and D) using orthogonal projections to latent structures.

Panels A and C illustrate the comparison of the probability of pathology with the actual state, while Panels B and D show logarithms of the ratios of the probability that the subject is a patient to the probability that the subject is a control (logarithm of the likelihood ratio, LLR, actual probability of ICP for patients = 1, LLR = ∞, actual probability of ICP for controls = 0, LLR = -∞). A good discrimination using discrimination on the basis of steroids measured by radioimmunoassay and GC–MS (sensitivity of 0.933 (0.702, 0.988) and specificity of 1.000 (0.816, 1.000) (shown as estimates with 95% confidence limits)) as well as for that on the basis of the steroids measured exclusively by GC–MS (sensitivity of 0.933 (0.702, 0.988) and specificity of 0.941 (0.730, 0.990)).

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