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A simple, precise and sensitive method for separation and determination of free and conjugated bile acids in human serum without prior hydrolysis is described. The free, glycine-and taurine-conjugated bile acids were separated into groups by ion-exchange chromato graphy on a newly developed lipophilic gel, piperidinohydroxypropyl Sephadex LH-20. Bile acids in each group were determined by the enzymatic method using 3 a-hydroxysteroid oxidoreductase. The proposed assay system proved to be applicable to simultaneous quantitation of free and conjugated bile acids in serum with satisfactory precision. The serum bile acid levels were then measured in patients with hepatobiliary diseases by this method. In normal subjects serum bile acid levels were found in the following ranges: free 1.7±1.1, glycine-conjugated 2.1±0.7, taurine-conjugated 0.9±0.4, and total bile acids 4.7±1.9nmol/ml. The ratios of glycine-conjugated to taurine-conjugated bile acids (G/T ratio) and of free to total bile acids (F%) were 2.7±0.7 and 34.5±8.8% respectively. In patients with liver cirrhosis and obstructive jaundice, the level of total bile acids increased mainly due to a marked increase in conjugated bile acids. The level of free bile acids increased to a small extent only in the case of liver cirrhosis. The G/T ratio in obstructive jaundice was significantly lower than that in normal subjects, whereas the value in liver cirrhosis was similar to that in the normal. After PTC-drainage in obstructive jaundice the serum level of total bile acids decreased rapidly to 20nmol/ml in 48-72 hours and the GET ratio increased gradually.
財団法人日本消化器病学会の論文

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