Objective:To explore the correlation between intrahepatic cholestasis of pregnancy(ICP)and ad-verse pregnancy outcomes.Methods:A total of 511 singleton pregnant women with ICP treated at The Third Affili-ated Hospital of Guangzhou Medical University from August 2017 to January 2024 were selected as the study sub-jects.Among them,patients were divided into the adverse pregnancy outcome group(n=49)and the control group without adverse pregnancy outcomes(n=462).The general and clinical data of the two groups were com-pared and analyzed.Results:①General situation:The number of pregnancies and deliveries,ICU transfer rate,total hospital stay,and total hospitalization costs were significantly higher in the adverse pregnancy outcome group compared to the control group(P<0.05).The number of prenatal check-ups,diagnostic gestational weeks,and gestational weeks at delivery were significantly lower compared to the control group(P<0.05).②Clinical symp-toms:The incidence of itching in the adverse pregnancy outcome group was lower compared to the control group(10.2%vs.26.6%,P<0.05),while other symptoms such as rash,fatigue,jaundice,and gastrointestinal symp-toms showed no significant difference between the two groups(P>0.05).③Laboratory examinations:Compared with the control group,patients in the adverse pregnancy outcome group had significantly the increased levels of alanine aminotransferase,aspartate aminotransferase,uric acid,urea nitrogen,and triglycerides,and significantly the decreased levels of alkaline phosphatase and fasting blood glucose,with statistical significance(P<0.05).Other biochemical indicators showed no significant difference between the two groups(P>0.05).④ICP grading and complications:The proportion of early-onset ICP,severe and very severe ICP in the adverse pregnancy out-come group was significantly higher compared to the control group(P<0.001);the proportion of adverse preg-nancy outcome group with pregnancy-induced hypertension was significantly higher compared to the control group;the incidence of preterm birth,fetal growth restriction,meconium-stained amniotic fluid,and fetal distress in the adverse pregnancy outcome group was significantly higher compared to the control group(P<0.001).⑤Neo-natal outcomes:The neonatal Apgar scores(1 min,5 min,10 min)and neonatal weight in the adverse pregnancy outcome group were lower compared to the control group(P<0.001),and the incidence of mild neonatal asphyx-ia was significantly higher,with a statistically significant difference(P<0.001).Conclusions:The severity of ICP is closely related to the occurrence of adverse pregnancy outcomes.Therefore,it is clinically necessary to pay at-tention to the grading of ICP,closely monitor the levels of total bile acids and liver enzymes,and try to avoid ad-verse pregnancy outcomes,especially intrauterine fetal death.

Objective:To explore the correlation between intrahepatic cholestasis of pregnancy(ICP)and ad-verse pregnancy outcomes.Methods:A total of 511 singleton pregnant women with ICP treated at The Third Affili-ated Hospital of Guangzhou Medical University from August 2017 to January 2024 were selected as the study sub-jects.Among them,patients were divided into the adverse pregnancy outcome group(n=49)and the control group without adverse pregnancy outcomes(n=462).The general and clinical data of the two groups were com-pared and analyzed.Results:①General situation:The number of pregnancies and deliveries,ICU transfer rate,total hospital stay,and total hospitalization costs were significantly higher in the adverse pregnancy outcome group compared to the control group(P<0.05).The number of prenatal check-ups,diagnostic gestational weeks,and gestational weeks at delivery were significantly lower compared to the control group(P<0.05).②Clinical symp-toms:The incidence of itching in the adverse pregnancy outcome group was lower compared to the control group(10.2%vs.26.6%,P<0.05),while other symptoms such as rash,fatigue,jaundice,and gastrointestinal symp-toms showed no significant difference between the two groups(P>0.05).③Laboratory examinations:Compared with the control group,patients in the adverse pregnancy outcome group had significantly the increased levels of alanine aminotransferase,aspartate aminotransferase,uric acid,urea nitrogen,and triglycerides,and significantly the decreased levels of alkaline phosphatase and fasting blood glucose,with statistical significance(P<0.05).Other biochemical indicators showed no significant difference between the two groups(P>0.05).④ICP grading and complications:The proportion of early-onset ICP,severe and very severe ICP in the adverse pregnancy out-come group was significantly higher compared to the control group(P<0.001);the proportion of adverse preg-nancy outcome group with pregnancy-induced hypertension was significantly higher compared to the control group;the incidence of preterm birth,fetal growth restriction,meconium-stained amniotic fluid,and fetal distress in the adverse pregnancy outcome group was significantly higher compared to the control group(P<0.001).⑤Neo-natal outcomes:The neonatal Apgar scores(1 min,5 min,10 min)and neonatal weight in the adverse pregnancy outcome group were lower compared to the control group(P<0.001),and the incidence of mild neonatal asphyx-ia was significantly higher,with a statistically significant difference(P<0.001).Conclusions:The severity of ICP is closely related to the occurrence of adverse pregnancy outcomes.Therefore,it is clinically necessary to pay at-tention to the grading of ICP,closely monitor the levels of total bile acids and liver enzymes,and try to avoid ad-verse pregnancy outcomes,especially intrauterine fetal death.

Objective To evaluate the bidirectional association between periodontitis and Sj?gren's syndrome us-ing the Mendelian randomization(MR)method.Methods Genome-wide association study(GWAS)data of periodonti-tis(N=45 563)and Sj?gren's syndrome(N=214 435)were selected to meet the requirements of the same ethnicity and different regions.Inverse variance-weighted(IVW),MR-Egger,and weighted median(WM)tests were used to evalu-ate the causal effect.Cochran's Q statistics,MR-Egger intercept,MR-PRESSO and leave-one-out analysis were used as sensitivity analyses to assess the stability and reliability of the results.Results After screening,the GWAS data of Sj?gren's syndrome were based on the Finnish region,and the periodontitis GWAS data were based on the UK region,both of which originated from European ancestry.Using IVW(OR=1.017,95％CI=0.956-1.082),MR-Egger(OR=0.985,95％CI=0.956-1.082),and WM(OR=1.021,95％CI=0.948-1.099),no causal effect of Sj?gren's syndrome on periodontitis was found using any of the three methods.Conversely,no causal effect of periodontitis on Sj?gren s syn-drome was found(IVW,OR=1.024,95％CI=0.852-1.230;MR-Egger,OR=0.978,95％CI=0.789-1.212;WM,OR=1.024,95％CI=0.846-1.260).The sensitivity analyses indicated that the results were stable and reliable.Cochran's Q test and MR-PRESSO revealed that there was no significant heterogeneity among the instrumental variables,which included single nucleotide polymorphisms(SNPs).The intercept of MR-Egger regression indicated no pleiotropy in the included SNPs.No individual SNP was found that significantly affected the results using the leave-one-out method.Conclusion This study does not support a bidirectional causal effect between periodontitis and Sj?gren's syndrome.

Objective To evaluate the bidirectional association between periodontitis and Sj?gren's syndrome us-ing the Mendelian randomization(MR)method.Methods Genome-wide association study(GWAS)data of periodonti-tis(N=45 563)and Sj?gren's syndrome(N=214 435)were selected to meet the requirements of the same ethnicity and different regions.Inverse variance-weighted(IVW),MR-Egger,and weighted median(WM)tests were used to evalu-ate the causal effect.Cochran's Q statistics,MR-Egger intercept,MR-PRESSO and leave-one-out analysis were used as sensitivity analyses to assess the stability and reliability of the results.Results After screening,the GWAS data of Sj?gren's syndrome were based on the Finnish region,and the periodontitis GWAS data were based on the UK region,both of which originated from European ancestry.Using IVW(OR=1.017,95％CI=0.956-1.082),MR-Egger(OR=0.985,95％CI=0.956-1.082),and WM(OR=1.021,95％CI=0.948-1.099),no causal effect of Sj?gren's syndrome on periodontitis was found using any of the three methods.Conversely,no causal effect of periodontitis on Sj?gren s syn-drome was found(IVW,OR=1.024,95％CI=0.852-1.230;MR-Egger,OR=0.978,95％CI=0.789-1.212;WM,OR=1.024,95％CI=0.846-1.260).The sensitivity analyses indicated that the results were stable and reliable.Cochran's Q test and MR-PRESSO revealed that there was no significant heterogeneity among the instrumental variables,which included single nucleotide polymorphisms(SNPs).The intercept of MR-Egger regression indicated no pleiotropy in the included SNPs.No individual SNP was found that significantly affected the results using the leave-one-out method.Conclusion This study does not support a bidirectional causal effect between periodontitis and Sj?gren's syndrome.

Objective To evaluate the bidirectional association between periodontitis and Sj?gren's syndrome us-ing the Mendelian randomization(MR)method.Methods Genome-wide association study(GWAS)data of periodonti-tis(N=45 563)and Sj?gren's syndrome(N=214 435)were selected to meet the requirements of the same ethnicity and different regions.Inverse variance-weighted(IVW),MR-Egger,and weighted median(WM)tests were used to evalu-ate the causal effect.Cochran's Q statistics,MR-Egger intercept,MR-PRESSO and leave-one-out analysis were used as sensitivity analyses to assess the stability and reliability of the results.Results After screening,the GWAS data of Sj?gren's syndrome were based on the Finnish region,and the periodontitis GWAS data were based on the UK region,both of which originated from European ancestry.Using IVW(OR=1.017,95％CI=0.956-1.082),MR-Egger(OR=0.985,95％CI=0.956-1.082),and WM(OR=1.021,95％CI=0.948-1.099),no causal effect of Sj?gren's syndrome on periodontitis was found using any of the three methods.Conversely,no causal effect of periodontitis on Sj?gren s syn-drome was found(IVW,OR=1.024,95％CI=0.852-1.230;MR-Egger,OR=0.978,95％CI=0.789-1.212;WM,OR=1.024,95％CI=0.846-1.260).The sensitivity analyses indicated that the results were stable and reliable.Cochran's Q test and MR-PRESSO revealed that there was no significant heterogeneity among the instrumental variables,which included single nucleotide polymorphisms(SNPs).The intercept of MR-Egger regression indicated no pleiotropy in the included SNPs.No individual SNP was found that significantly affected the results using the leave-one-out method.Conclusion This study does not support a bidirectional causal effect between periodontitis and Sj?gren's syndrome.

Objective To evaluate the bidirectional association between periodontitis and Sj?gren's syndrome us-ing the Mendelian randomization(MR)method.Methods Genome-wide association study(GWAS)data of periodonti-tis(N=45 563)and Sj?gren's syndrome(N=214 435)were selected to meet the requirements of the same ethnicity and different regions.Inverse variance-weighted(IVW),MR-Egger,and weighted median(WM)tests were used to evalu-ate the causal effect.Cochran's Q statistics,MR-Egger intercept,MR-PRESSO and leave-one-out analysis were used as sensitivity analyses to assess the stability and reliability of the results.Results After screening,the GWAS data of Sj?gren's syndrome were based on the Finnish region,and the periodontitis GWAS data were based on the UK region,both of which originated from European ancestry.Using IVW(OR=1.017,95％CI=0.956-1.082),MR-Egger(OR=0.985,95％CI=0.956-1.082),and WM(OR=1.021,95％CI=0.948-1.099),no causal effect of Sj?gren's syndrome on periodontitis was found using any of the three methods.Conversely,no causal effect of periodontitis on Sj?gren s syn-drome was found(IVW,OR=1.024,95％CI=0.852-1.230;MR-Egger,OR=0.978,95％CI=0.789-1.212;WM,OR=1.024,95％CI=0.846-1.260).The sensitivity analyses indicated that the results were stable and reliable.Cochran's Q test and MR-PRESSO revealed that there was no significant heterogeneity among the instrumental variables,which included single nucleotide polymorphisms(SNPs).The intercept of MR-Egger regression indicated no pleiotropy in the included SNPs.No individual SNP was found that significantly affected the results using the leave-one-out method.Conclusion This study does not support a bidirectional causal effect between periodontitis and Sj?gren's syndrome.

Objective To evaluate the bidirectional association between periodontitis and Sj?gren's syndrome us-ing the Mendelian randomization(MR)method.Methods Genome-wide association study(GWAS)data of periodonti-tis(N=45 563)and Sj?gren's syndrome(N=214 435)were selected to meet the requirements of the same ethnicity and different regions.Inverse variance-weighted(IVW),MR-Egger,and weighted median(WM)tests were used to evalu-ate the causal effect.Cochran's Q statistics,MR-Egger intercept,MR-PRESSO and leave-one-out analysis were used as sensitivity analyses to assess the stability and reliability of the results.Results After screening,the GWAS data of Sj?gren's syndrome were based on the Finnish region,and the periodontitis GWAS data were based on the UK region,both of which originated from European ancestry.Using IVW(OR=1.017,95％CI=0.956-1.082),MR-Egger(OR=0.985,95％CI=0.956-1.082),and WM(OR=1.021,95％CI=0.948-1.099),no causal effect of Sj?gren's syndrome on periodontitis was found using any of the three methods.Conversely,no causal effect of periodontitis on Sj?gren s syn-drome was found(IVW,OR=1.024,95％CI=0.852-1.230;MR-Egger,OR=0.978,95％CI=0.789-1.212;WM,OR=1.024,95％CI=0.846-1.260).The sensitivity analyses indicated that the results were stable and reliable.Cochran's Q test and MR-PRESSO revealed that there was no significant heterogeneity among the instrumental variables,which included single nucleotide polymorphisms(SNPs).The intercept of MR-Egger regression indicated no pleiotropy in the included SNPs.No individual SNP was found that significantly affected the results using the leave-one-out method.Conclusion This study does not support a bidirectional causal effect between periodontitis and Sj?gren's syndrome.

Objective To evaluate the bidirectional association between periodontitis and Sj?gren's syndrome us-ing the Mendelian randomization(MR)method.Methods Genome-wide association study(GWAS)data of periodonti-tis(N=45 563)and Sj?gren's syndrome(N=214 435)were selected to meet the requirements of the same ethnicity and different regions.Inverse variance-weighted(IVW),MR-Egger,and weighted median(WM)tests were used to evalu-ate the causal effect.Cochran's Q statistics,MR-Egger intercept,MR-PRESSO and leave-one-out analysis were used as sensitivity analyses to assess the stability and reliability of the results.Results After screening,the GWAS data of Sj?gren's syndrome were based on the Finnish region,and the periodontitis GWAS data were based on the UK region,both of which originated from European ancestry.Using IVW(OR=1.017,95％CI=0.956-1.082),MR-Egger(OR=0.985,95％CI=0.956-1.082),and WM(OR=1.021,95％CI=0.948-1.099),no causal effect of Sj?gren's syndrome on periodontitis was found using any of the three methods.Conversely,no causal effect of periodontitis on Sj?gren s syn-drome was found(IVW,OR=1.024,95％CI=0.852-1.230;MR-Egger,OR=0.978,95％CI=0.789-1.212;WM,OR=1.024,95％CI=0.846-1.260).The sensitivity analyses indicated that the results were stable and reliable.Cochran's Q test and MR-PRESSO revealed that there was no significant heterogeneity among the instrumental variables,which included single nucleotide polymorphisms(SNPs).The intercept of MR-Egger regression indicated no pleiotropy in the included SNPs.No individual SNP was found that significantly affected the results using the leave-one-out method.Conclusion This study does not support a bidirectional causal effect between periodontitis and Sj?gren's syndrome.

Objective To evaluate the bidirectional association between periodontitis and Sj?gren's syndrome us-ing the Mendelian randomization(MR)method.Methods Genome-wide association study(GWAS)data of periodonti-tis(N=45 563)and Sj?gren's syndrome(N=214 435)were selected to meet the requirements of the same ethnicity and different regions.Inverse variance-weighted(IVW),MR-Egger,and weighted median(WM)tests were used to evalu-ate the causal effect.Cochran's Q statistics,MR-Egger intercept,MR-PRESSO and leave-one-out analysis were used as sensitivity analyses to assess the stability and reliability of the results.Results After screening,the GWAS data of Sj?gren's syndrome were based on the Finnish region,and the periodontitis GWAS data were based on the UK region,both of which originated from European ancestry.Using IVW(OR=1.017,95％CI=0.956-1.082),MR-Egger(OR=0.985,95％CI=0.956-1.082),and WM(OR=1.021,95％CI=0.948-1.099),no causal effect of Sj?gren's syndrome on periodontitis was found using any of the three methods.Conversely,no causal effect of periodontitis on Sj?gren s syn-drome was found(IVW,OR=1.024,95％CI=0.852-1.230;MR-Egger,OR=0.978,95％CI=0.789-1.212;WM,OR=1.024,95％CI=0.846-1.260).The sensitivity analyses indicated that the results were stable and reliable.Cochran's Q test and MR-PRESSO revealed that there was no significant heterogeneity among the instrumental variables,which included single nucleotide polymorphisms(SNPs).The intercept of MR-Egger regression indicated no pleiotropy in the included SNPs.No individual SNP was found that significantly affected the results using the leave-one-out method.Conclusion This study does not support a bidirectional causal effect between periodontitis and Sj?gren's syndrome.

Objective To evaluate the bidirectional association between periodontitis and Sj?gren's syndrome us-ing the Mendelian randomization(MR)method.Methods Genome-wide association study(GWAS)data of periodonti-tis(N=45 563)and Sj?gren's syndrome(N=214 435)were selected to meet the requirements of the same ethnicity and different regions.Inverse variance-weighted(IVW),MR-Egger,and weighted median(WM)tests were used to evalu-ate the causal effect.Cochran's Q statistics,MR-Egger intercept,MR-PRESSO and leave-one-out analysis were used as sensitivity analyses to assess the stability and reliability of the results.Results After screening,the GWAS data of Sj?gren's syndrome were based on the Finnish region,and the periodontitis GWAS data were based on the UK region,both of which originated from European ancestry.Using IVW(OR=1.017,95％CI=0.956-1.082),MR-Egger(OR=0.985,95％CI=0.956-1.082),and WM(OR=1.021,95％CI=0.948-1.099),no causal effect of Sj?gren's syndrome on periodontitis was found using any of the three methods.Conversely,no causal effect of periodontitis on Sj?gren s syn-drome was found(IVW,OR=1.024,95％CI=0.852-1.230;MR-Egger,OR=0.978,95％CI=0.789-1.212;WM,OR=1.024,95％CI=0.846-1.260).The sensitivity analyses indicated that the results were stable and reliable.Cochran's Q test and MR-PRESSO revealed that there was no significant heterogeneity among the instrumental variables,which included single nucleotide polymorphisms(SNPs).The intercept of MR-Egger regression indicated no pleiotropy in the included SNPs.No individual SNP was found that significantly affected the results using the leave-one-out method.Conclusion This study does not support a bidirectional causal effect between periodontitis and Sj?gren's syndrome.