title: Serum bile acids in patients with hepatopulmonary syndrome.
abstract: BackgroundHepatopulmonary syndrome (HPS) occurs in 20 - 30 % of patients with cirrhosis and is associated with increased mortality. Cholestasis and accumulation of bile acids (BAs) play a major role in chronic liver disease.AimWe aimed to evaluate the clinical role of serum BAs in patients with HPS.MethodsSeventy-four patients with cirrhosis were included in this prospective study. Marker for cholestasis as total and individual serum BAs, bilirubin, alkaline phosphatase (AP), and gamma-glutamyl transpeptidase (GGT) were analyzed in patients screened for HPS. Criteria of HPS were fulfilled in 26 patients (35 %).ResultsIn contrast to AP and GGT, bilirubin and serum BAs were significantly elevated in patients with HPS (median total BAs in HPS 83.5 μmol/L, IQR 43.1 - 148.9 vs. no HPS 26.9 μmol/L, 11 - 75.6; p < 0.001). Total BAs correlated with gas exchange by means of PaO2 / AaPO2 (r: -0.28, p < 0.05; r: 0.24, p < 0.05) and portal pressure (r: 0.33, p < 0.05). BAs were associated with HPS independently severity of underlying liver disease (OR: 1.012, 95 % CI: 1.001 - 1.023, p < 0.05).ConclusionBA retention is associated with HPS and gas exchange abnormalities. Future studies should assess whether modulation of BAs signaling may impact the course of HPS.
authors.affiliation: Dep. Internal Medicine 3, Div. Gastroenterology & Hepatology, Medical University of Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Horvatits
authors.affiliation: Dep. Internal Medicine 3, Div. Gastroenterology & Hepatology, Medical University of Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Drolz
authors.affiliation: Dep. Internal Medicine 3, Div. Gastroenterology & Hepatology, Medical University of Vienna, Austria.
authors.forename: Karoline
authors.initials: K
authors.lastname: Rutter
authors.affiliation: Dep. Internal Medicine 3, Div. Gastroenterology & Hepatology, Medical University of Vienna, Austria.
authors.forename: Kevin
authors.initials: K
authors.lastname: Roedl
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria.
authors.forename: Günter
authors.initials: G
authors.lastname: Fauler
authors.affiliation: Dep. Internal Medicine 3, Div. Gastroenterology & Hepatology, Medical University of Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.affiliation: Dep. of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kluge
authors.affiliation: Dep. Internal Medicine 3, Div. Gastroenterology & Hepatology, Medical University of Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Trauner
authors.affiliation: Dep. Internal Medicine 3, Div. Gastroenterology & Hepatology, Medical University of Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Schenk
authors.affiliation: Dep. Internal Medicine 3, Div. Gastroenterology & Hepatology, Medical University of Vienna, Austria.
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuhrmann
mesh_terms: D001647:Bile Acids and Salts / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D020065:Hepatopulmonary Syndrome / Q000097:blood / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D011446:Prospective Studies
chemical_list: D001647:Bile Acids and Salts; D015415:Biomarkers