Serum Bile Acid Patterns Determined by an Enzymatic Method and High‐Performance Liquid Chromatography in Young Infants with Cholestasis

Abstract

SummarySerum unconjugated and conjugated bile acids in young infants with intrahepatic cholestasis (idiopathic neonatal hepatitis syndrome, n = 8) or extra‐hepatic cholestasis (preoperative extrahepatic biliary atresia, n = 8) were examined by an enzymatic procedure and high‐performance liquid chromatography. In comparison with the mean level of total serum bile acid of controls having no liver or gastrointestinal diseases, those of each group markedly increased (15.6 ± 5.1 vs. 120.9 ± 64.0 and 161.8 ± 54.2 nmollml), but those of unconjugated bile acid were almost unchanged (1.4 ± 0.5 vs. 1.0 ± 0.6 and 0.6 ± 0.2 nmol/ml). The ratios of cholate to chenodeoxycholate and glycine‐ to taurine‐conjugated bile acids (G/T) were not significantly different between the groups of intrahepatic and extrahepatic cholestasis. However, in the patients with intrahepatic cholestasis, the G/T ratio varied greatly and the quantitative determination of individual conjugated bile acids in serum revealed that a half of the patients examined had very low levels of taurine‐conjugated cholate and chenodeoxycholate, suggesting a bile acid metabolism alternation specific for underlying intrahepatic cholestasis.