Clinical Significance of Serum Bile Acid in Hepatobiliary Diseases

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Recently, serum bile acid determination was proposed as one of the highly sensitive tests of liver function. In our study, fasting serum bile acid (FSBA) measurement by enzymatic and fluorimetric method was performed on 12 normal subjects and 134 patients with various hepatobiliary diseases. A Correspondence was made between FSBA and other conventional "liver function" tests, in which contain mithochondrial GOT (m-GOT), ornithincarbamyl transferase (OCT), s-GOT, s-GPT, γ-glutamyl transpeptidase (γ-GTP), alkaline phosphatase (Al-P) and serum total bilirubin (T-Bil). FSBA levels were elevated in almost all patients with repatobiliary disease and most significantly correlated with serum total bilirubin. On the clinical course of acute viral hepatitis, FSBA level was shown a more sensitive index than other "liver function" tests such as s-GOT or s-GPT for liver dysfunction. Other major advantage of FSBA determination was found in several hepatobiliary diseases. Namely, in the case of chronic hepatitis with active type FSBA level was higher than that of inactive type. However, FSBA levels in both types were lower than that of liver cirrhosis. And also, FSBA levels were elevated in both patients with intra- and extra-hepatic cholestasis, but the level of m-GOT, OCT, r-GTP and Al-P were higher in the patients with intrahepatic cholestasis than those of other chronic liver diseases. It indicates that the grade of hepatic cell injury of chronic intrahepatic cholestasis was impaired markedly. To estimate not only FSBA but also m-GOT, OCT, γ-GTP, Al-P and serumbilirubin seems to be helpful for differencial diagnosis of various hepatobiliary diseases. Furthermore, it is worthy of notice that FSBA levels were slightly elevated even in the cases of asymptomatic gallstone and fatty liver without cirrhosis.
Japan Society of Clinical Chemistryの論文

Clinical Significance of Serum Bile Acid in Hepatobiliary Diseases

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