[Conjugated bile acid profiles in serum, urine, and bile of patients with primary biliary cirrhosis under the ursodeoxycholic acid treatment].
We studied the conjugated bile acid profiles (sulfate, glucuronide, and nonsulfate-nonglucuronide) in serum, urine, and bile of 12 patients with primary biliary cirrhosis (PBC) before and under the ursodeoxycholic acid therapy (UDCA, 600mg/day, 6-8 months). Serum total bile acid concentration in those patients without the UDCA therapy was several times higher than those of healthy volunteers, and the percentage of sulfate to total bile acid was 24.8%. After the UDCA therapy, serum total bile acid concentration increased making a progression of Scheuer's stage. In patients with stage I-III, the percentage of sulfate to total was 13.7-65.0% (32.5%, mean), and that of glucuronide to total was 6.6-43.3% (24.0%). Then, the sum of sulfate and glucuronide conjugates was more than 50% to total. Although in patients with stage IV, serum total bile acid level rose markedly, the percentages of sulfate and glucuronide highly reduced. In urine of patients with stage I-III, a large amount of sulfate and glucuronide was found and the percentage of both conjugates was more than 65% of total. On the other hand, sulfate and glucuronide conjugates were only minor component in bile. Based on these data, we might be led to the following conclusion: (1) in patients with PBC (stage I-III), sulfated conjugates of serum bile acid are not minor component, (2) the increased UDCA in serum of patients with PBC during the UDCA treatment might be more easily extracted into urine as sulfate and glucuronide UDCA.
Aoshima
M
M
Second Department of Internal Medicine, Asahikawa Medical College, Japan.
Nakamura
K
K
Makino
I
I
D000368:Aged; D001646:Bile / Q000378:metabolism*; D005260:Female; D005965:Glucuronates / Q000378:metabolism*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000188:drug therapy / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D013431:Sulfates / Q000378:metabolism*; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage*
D005965:Glucuronates; D013431:Sulfates; D014580:Ursodeoxycholic Acid