Prognostic Significance of Serum Bile Acids in Cirrhosis

Abstract

The value of serum bile acid concentrations for predicting prognosis in cirrhotics was compared with the prognostic significance of clinical and laboratory findings in a prospective 1-year study of 76 patients with cirrhosis. A commercial radioimmunoassay for total serum-conjugated primary bile acids was used. Of 76 patients, 16 died within the follow-up period. The concentration of bile acids in serum more closely correlated with mortality in cirrhosis than the commonly used clinical and laboratory parameters such as the Number Connection Test, ascites, albumin, pseudocholinesterase, bilirubin, prothrombin time and nutritional state. Serum bile acids alone yielded a prediction of mortality comparable to the Child classification. When logistic regression analysis was performed, optimal prediction of prognosis was achieved with the combination of serum bile acids and the Number Connection Test. Serum bile acid levels alone or in combination with the Number Connection Test may be a clinically useful prognostic index in cirrhosis.

Plasma metabolomics identifies lipid abnormalities linked to markers of inflammation, microbial translocation, and hepatic function in HIV patients receiving protease inhibitors

“…In rat models, bile acids have been shown to inhibit mitochondrial respiration in a dose dependent manner [79-81] and to enhance the permeability of mitochondria to protons [82]. Our findings, together with those of previous studies [77,83], suggest that plasma bile acids may represent a sensitive non-invasive marker of liver dysfunction in HIV patients.…”

“…Here, we found that intermediate/high FIB-4 and APRI scores and high levels of plasma YKL-40 were associated with increased plasma bile acids in HIV subjects on PI-based ART. Consistent with these findings, elevated serum bile acids have been reported in patients with cirrhosis and chronic HCV infection and were shown to correlate with the severity of liver fibrosis [30,77]. Bile acid levels (GCA and TCA) were positively correlated with acylcarnitines, a marker of incomplete fatty acid β-oxidation and mitochondrial dysfunction [52,78].…”

Serum Bile Acids Are Associated with Pathological Progression of Hepatitis B-Induced Cirrhosis

“…19, 21 Elevated serum bile acid concentrations have been shown to be a more sensitive test for the detection of liver cirrhosis than conventional liver function tests. 27, 28 However, the level of TBA in serum does not seem to offer any help in diagnosis or prognosis. 29, 30 The present study is designed to characterize the alteration of serum bile acid profiles associated with the pathophysiology of cirrhosis complementary to the conventional biochemical indices.…”

Elevated Soluble Tumour Necrosis Factor Receptor Serum Concentrations and Short-Term Mortality in Liver Cirrhosis without Acute Infections

“…Serum markers related to bile acid metabolism, e.g. total bile acids [20, 21]or 7α-hydroxycholesterol serum concentrations, were also related to mortality [22, 23]. The same prognostic value has been shown for albumin and postulated for prealbumin serum concentrations [24, 25, 26].…”