title: [Clinical examination of serum bile acids for the diagnosis of hepatobiliary diseases].
abstract: There are four major clinical methods for determination of serum total bile acids (TBA) levels. The first is fasting TBA (FTBA), which increases specifically in liver disorders. It increased more sensitively and normalized faster than transaminases in acute hepatic injury. Secondly, the bile acid loading test is useful to examine the degree of liver cell damage. This test improved the detection rate of FTBA for the liver dysfunction and reflects the severity of the diseases. The third is the profiles and dynamic changes of individual bile acids (IBA). In liver cirrhosis synthesis of cholic acid (CA) was lowered and the ratio of CA + deoxycholic acid (DCA)/chenodeoxycholic acid (CDCA) + lithocholic acid (LCA) was less than 1. On the other hand in cholestasis, secondary bile acids were reduced and CA increased markedly due to the regulation of bile acid metabolism, so that the ratio of CA + DCA/CDCA + LCA was more than 1. This phenomenon can be used for the differential diagnosis of liver cell damage and cholestasis. The last is the detection of unusual bile acids, such as 3 beta-hydroxy-5-cholenoic acid is useful for the marker of hepatic cell carcinoma and the screening of congenital biliary atresia.
authors.forename: K
authors.initials: K
authors.lastname: Fujiwara
mesh_terms: D001647:Bile Acids and Salts / Q000097:blood*; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D002793:Cholic Acids / Q000097:blood; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis*
chemical_list: D001647:Bile Acids and Salts; D002793:Cholic Acids; C026883:3 beta-hydroxychol-3-en-24-oic acid