Serum 7 alpha-hydroxycholesterol reflects hepatic bile acid synthesis in patients with obstructive jaundice after external biliary drainage.
To examine the hypothesis that serum levels of 7 alpha-hydroxycholesterol reflect bile acid synthesis in the liver, we analyzed serum 7 alpha-hydroxycholesterol and bile acid output in 13 patients with obstructive jaundice after relief of biliary obstruction. Before biliary drainage, the serum level of 7 alpha-hydroxycholesterol was 92 +/- 12 pmol/ml (mean +/- S.E.M.) and was significantly lower than the control value (226 +/- 26 pmol/ml, p < 0.01). After biliary drainage, serum 7 alpha-hydroxycholesterol level and biliary bile acid outputs began to rise in some patients, indicating reversible liver dysfunction. In other patients, serum 7 alpha-hydroxycholesterol levels and bile acid outputs did not increase, suggesting severe or irreversible liver dysfunction. On and after the third day of biliary decompression, serum 7 alpha-hydroxycholesterol levels correlated well with bile acid excretion (p < 0.01, r = 0.93). Other liver function parameters, such as serum bilirubin, serum bile acids, albumin, and bile flow, also revealed significant correlation with serum 7 alpha-hydroxycholesterol levels. We conclude that the serum 7 alpha-hydroxycholesterol level clearly reflects bile acid synthesis in the liver and that it may serve as a useful parameter for the assessment of hepatic functional recovery in patients with obstructive jaundice after biliary drainage.
Department of Surgery 1, Kyushu University Faculty of Medicine, Fukuoka, Japan.
S
S
Okamoto
K
K
Fukushima
H
H
Higashijima
I
I
Makino
M
M
Kishinaka
H
H
Oda
H
H
Yamashita
H
H
Ichimiya
K
K
Chijiiwa
S
S
Kuroki
D000368:Aged; D000369:Aged, 80 and over; D001646:Bile; D001647:Bile Acids and Salts / Q000096:biosynthesis*; D002779:Cholestasis / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D006888:Hydroxycholesterols / Q000097:blood*; D008099:Liver / Q000378:metabolism* / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged
D001647:Bile Acids and Salts; D006888:Hydroxycholesterols; C011724:cholest-5-en-3 beta,7 alpha-diol