Description of analytical method and clinical utility of measuring serum 7-alpha-hydroxy-4-cholesten-3-one (7aC4) by mass spectrometry

Donato, Leslie J.; Lueke, Alan; Kenyon, Stacy M.; Meeusen, Jeffrey W.; Camilleri, Michael

doi:10.1016/j.clinbiochem.2017.10.008

Cited by 22 publications

(13 citation statements)

References 21 publications

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“…P, 2019 [14]USARetrospective case-control study n = 124(109)IBS-D,IBS-C and healthy volunteersTotal fecal 48-h BA in combination with primary fecal BAs49%91%Primary BAs > 10% identified patients with increased fecal weight (sensitivity 49% and specificity 91%) and rapid colonic transit (sensitivity 48% and specificity 87%Vijayvargiya. P, 2019 [15]USARetrospective case-control study n = 220(171)HV, IBS-D and IBS-CFecal bile acids and fecal fat76%72%Reduced total and primary fecal bile acids and increased fecal lithocholic acid were significant predictors of decreased fecal weight, frequency and consistency.Battat R., 2019 [16]USAProspectively cross-sectional study n = 78 (47)Crohn’s disease (CD) - IR, NR-CD and UCC490%84%A cutoff concentration of C4 of 48.3 ng/mL or greater identified patients with diarrhea attributable to BAM with 90.9% sensitivity, 84.4% specificityDonato L., 2018 [17]USAProspectively cross-sectional study n = 184 (110)IBS-C, IBS-D, Healthy subjectsC482%53%Higher levels of C4 was found in patients with BAM compared to those without BAM with sensitivity/specificity of 82%/53%.Vijayvargiya P., 2017 [18]USAProspectively cross-sectional study n = 101 ( n = 83)IBS-DC4 and FGF1950%65%Data demonstrated a higher specificity (83%) with a higher cut-off of 52.5 ng/mL.Camilleri M., 2014 [19]USAProspectively cross-sectional study n = 124 (111)IBS-D, IBS-C and HSTotal fecal 48-h BA in combination with primary fecal Bas75%75%Estimated the specificity of the individual traits or models at 60% sensitivity for discriminating between the groups, with specificity ranging from 75% for IBS-D versus health, to 90% for IBS-D versus IBS-CPattni S., 2013 [11]UKProspectively cross-sectional study n = 72 (47)Chronic diarrhoea of unknown aetiologyFGF19 compare to SeHCAT67%77%NPV and PPV of FGF19 ≤ 145 pg/mL for a SeHCAT < 10% were 82 and 61%. Data suggest that FGF19 could predict response to sequestrant therapyPattni S., 2012 [20]UKProspectively cross-sectional study n = 258 (180)patients with chronic diarrheaFGF-19+C458%74%79%72%The sen...…”

Section: Resultsmentioning

confidence: 99%

“…P, 2019 [14]NoNoYesYesYesYesYesYesYesYesIncludeVijayvargiya. P, 2019 [15]NoNoYesYesYesNoYesYesYesYesIncludeBattat R., 2019 [16]YesYesYesYesYesNoNoYesYesYesIncludeDonato L., 2018 [17]YesYesYesNoYesYesNoYesNoYesIncludeVijayvargiya P., 2017 [18]YesYesYesNoYesYesNoYesNoYesIncludeCamilleri M., 2014 [19]YesYesYesYesYesNoNoYesYesYesIncludePattni S., 2013 [11]YesYesYesYesYesYesYesYesYesYesIncludePattni S., 2012 [20]YesYesYesNoYesNoNoYesYesYesIncludeBrydon WG., 2011 [21]YesYesYesNoYesNoNoYesYesYesIncludeLenicek M., 2011 [22]YesYesYesYesYesNoNoYesYesYesIncludeSauter GH, 1999 [23]NoYesYesNoYesYesYesNo...…”

Section: Resultsmentioning

confidence: 99%

“…Compared to < 10% 75 SeHCAT retention, Vijayvargiya et al confirmed that serum C4 assay demonstrated 90, 79, 73, and 92% sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), respectively [18]. Also, higher levels of C4 were found in patients with BAM compared to those without BAM with sensitivity/specificity of 82 and 53% [17].…”

Section: Resultsmentioning

confidence: 99%

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Methods for diagnosing bile acid malabsorption: a systematic review

et al. 2019

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BackgroundBile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests. We aimed to perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with BAM, despite a proven gold standard test is still lacking.MethodsA PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.ResultsOverall, more than one test was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n = 8 studies used 75Selenium-homotaurocholic-acid-test (75SeHCAT) with a < 10% retention threshold; n = 8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n = 3 studies involved total fecal bile acid (BA) excretion over 48 h; n = 4 studies assessed fibroblast growth factor 19 (FGF19). 75SeHCAT showed an average sensitivity and specificity of 87.32 and 93.2%, respectively, followed by serum C4 (85.2 and 71.1%) and total fecal BA (66.6 and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8 and 72.3%). All the extracted data were associated with substantial heterogeneity.ConclusionsOur systematic review indicates that 75SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Methods for diagnosing bile acid malabsorption: a systematic review

et al. 2019

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“…Compared to <10% 75 SeHCAT retention, Vijayvargiya et al confirmed that serum C4 assay demonstrated 90%, 79%, 73%, and 92% sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), respectively [17]. Also, higher levels of C4 were found in patients with BAM compared to those without BAM with sensitivity/specificity of 82% and 53% [18].…”

Section: Subgroup Analysis For Diagnostic Accuracy Of the C4mentioning

confidence: 97%

Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review

Lyutakov

Ursini

Penchev

et al. 2019

Preprint

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BackgroundBile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests.ObjectiveTo perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with bile acid malabsorption.DesignA PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.ResultsOverall, more than one tests was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n=8 studies used 75 Selenium-homotaurocholic-acid-test ( 75 SeHCAT) with a <10% retention threshold; n=8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n=3 studies involved total fecal bile acid (BA) excretion over 48h; n=4 studies assessed fibroblast growth factor 19 (FGF19). 75 SeHCAT showed an average sensitivity and specificity of 87.32% and 93.2%, respectively, followed by serum C4 (85.2% and 71.1%) and total fecal BA (66.6% and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8% and 72.3%). All the extracted data were associated with substantial heterogeneity.ConclusionsOur systematic review indicates that 75 SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.

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“…The supernatant is then injected directly onto the LC-MS/MS system for quantification. 33,34 This method is rapid and efficient and does not require specialist equipment for solvent evaporation unlike other published methods, making it an attractive option for a routine laboratory. This method may, however, be unsuitable with less sensitive mass spectrometers.…”

Section: Diagnosis Of Badmentioning

confidence: 99%

Bile acid diarrhoea: Current and potential methods of diagnosis

et al. 2020

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Chronic diarrhoea is common and mostly due to diarrhoea predominant irritable bowel syndrome (IBS-D). IBS-D affects about 11% of the population, however up to a third of these patients actually have bile acid diarrhoea (BAD). There are, therefore, more than one million sufferers of BAD in the UK. BAD is caused by small bowel malabsorption of bile acids and the increased bile acids in the large intestine cause diarrhoea. Once diagnosed, the treatment of BAD is simple and effective. BAD, however, is often not diagnosed because of a lack of easily available and reliable diagnostic methods. In the United Kingdom, the radiolabelled 23-seleno-25-homotaurocholic acid test (SeHCAT) is the gold-standard method of diagnosis. SeHCAT, however, is expensive, inconvenient to the patient, involves radiation exposure and has limited availability. As such, a laboratory biomarker is desirable. This review briefly discusses the pathophysiology and management of BAD and critically evaluates methods for its diagnosis, including serum 7Î±-hydroxy-4-cholesten-3-one, faecal bile acid measurement, serum fibroblast growth factor 19, urine-2-propanol, and the 14C-glycocholate breath and stool test.

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Description of analytical method and clinical utility of measuring serum 7-alpha-hydroxy-4-cholesten-3-one (7aC4) by mass spectrometry

Cited by 22 publications

References 21 publications

Methods for diagnosing bile acid malabsorption: a systematic review

Methods for diagnosing bile acid malabsorption: a systematic review

Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review

Bile acid diarrhoea: Current and potential methods of diagnosis

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