Serum bile acids and their conjugates in breast-fed infants with prolonged jaundice

Tazawa, Yusaku; Yamada, Masaaki; Nakagawa, Michiko; Konno, Tasuke; Tada, Keiya

doi:10.1007/bf00491922

Cited by 15 publications

(11 citation statements)

References 13 publications

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“…Although there is significant relationship between the total bilirubin levels and the ratios of glycine-and taurine-conjugated bile acids in serum [14,15], serum TBA levels do not correlate with the serum total bilirubin levels in BMJ patients. Odell et al reported that elevations in serum bile acids occur in some neonates with unconjugated hyperbilirubinaemia and indicated the presence of cholestasis [11].…”

Section: Discussioncontrasting

confidence: 46%

“…In this study about one third of infants with BMJ demonstrated abnormally high levels of serum ALP, GGTP and/or TBA, reflecting the alterations in the hepatobiliary system. Serum bile acid levels, the most sensitive and specific marker for cholestasis, are often increased in infants with BMJ [4,14,15]. Postprandial increases of serum bile acid levels shown not only in infants with increased fasting bile acids but also in some with normal bile acids may also indicate abnormal bile acid metabolism suggesting the presence of mild cholestasis in BMJ.…”

Section: Discussionmentioning

confidence: 98%

“…Abnormal results of liver function tests in infants with BMJ have been reported [4,14], but its pathophysiology has not been well understood. In this study about one third of infants with BMJ demonstrated abnormally high levels of serum ALP, GGTP and/or TBA, reflecting the alterations in the hepatobiliary system.…”

Section: Discussionmentioning

confidence: 99%

“…Direct bilirubin was tested by an improved diazo-coupling method using a diazocompound consisting of dichlorophenyldiazonium and naphthalenedisulphonic acid, sodium salt [Sanassay D-BIL, Sanko Junyaku Co., Ltd., Tokyo, Japan]. Serum TBA levels were determined by an enzymatic method using 3a-hydroxysteroid dehydrogenase [14]. Serum levels of parameters were defined as abnormally high when the levels increased more than the mean plus 3 standard deviations for age-matched controls without hepatic or intestinal diseases.…”

Section: Patients Materials and Methodsmentioning

confidence: 99%

“…Signs of mild liver dysfunction or cholestasis have been repeatedly observed [4,14,15]. We designed this study to clarify the relationship between BMJ and the abnormal results of biochemical liver function tests.…”

Section: Offprint Requests To: Y Tazawamentioning

confidence: 97%

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Abnormal results of biochemical liver function tests in breast-fed infants with prolonged indirect hyperbilirubinaemia

et al. 1991

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To clarify the relationship between hyperbilirubinaemia and abnormal results of biochemical liver function tests in infants with breast milk jaundice (BMJ), 58 breast-fed infants with indirect hyperbilirubinaemia were enrolled in this study. Sera obtained from the above infants were subjected to routine liver function tests. Although serum transaminases were within normal limits in all 58 patients, serum alkaline phosphatase levels were abnormally increased in 13, gamma-glutamyltranspeptidase in 8 and total bile acids in 11 out of all patients examined. A total of 18 (31%) patients had abnormal results in at least one item of the liver function tests. The intrinsic bile acid loading test showed postprandial increases in bile acids in 5 of 16 (31%) patients examined at either 60 or 120 min, while all 13 breast-fed, age-matched controls had no abnormal results. The decrease in rate of serum bilirubin levels after the 3-day discontinuation of breast-feeding was significantly less in patients with increased fasting bile acids than in patients with normal fasting levels of serum bile acids. These results may suggest that mild hepatic dysfunction or cholestasis is associated with indirect hyperbilirubinaemia in some infants with BMJ.

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Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Patients Materials and Methodsmentioning

confidence: 99%

Section: Offprint Requests To: Y Tazawamentioning

confidence: 97%

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Abnormal results of biochemical liver function tests in breast-fed infants with prolonged indirect hyperbilirubinaemia

et al. 1991

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Alterations of Serum Bile Acid Profile in Breast‐Fed Infants with Prolonged Jaundice

Yamada,

Tazawa,

Nakagawa

et al. 1985

J. pediatr. gastroenterol. nutr.

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Summary:Serum bile acid conjugates in breast‐fed infants with prolonged jaundice were analyzed by a newly developed procedure using high‐performance liquid chromatography with fluorescence labeling. Major bile acids were cholate and chenodeoxycholate conjugates. Some of the breast‐fed jaundiced infants had high levels of serum bile acid conjugates (>25 μmol/L), but the mean levels of individual bile acid conjugates found in jaundiced breastfed infants were not significantly different from those in breast‐fed infants without jaundice. The glycine‐to taurine‐conjugated bile acid ratio in breast‐fed jaundiced infants was significantly lower than in breast‐fed nonjaundiced infants or bottle‐fed nonjaundiced infants. In breast‐fed infants, the portion of taurine‐conjugated bile acids increased in proportion to serum bilirubin levels. These findings suggest that alteration in conjugated bile acid patterns of breast milk jaundice is related to an increased enterohepatic circulation of bile acids as well as bilirubin in infants fed on breast milk that contains high amounts of taurine.

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A Study of the Relationship between Bile Salts, Bile Salt‐Stimulated Lipase, and Free Fatty Acids in Breast Milk

Forsyth,

Donnet,

Ross

1990

J. pediatr. gastroenterol. nutr.

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Summary:Breast milk jaundice has been reported to be associated with increased lipase activity and elevated free fatty acid (FFA) concentrations within breast milk. We have previously shown that bile salts are present in small concentrations in breast milk and the aim of this study was to examine the relationship of bile salt‐stimulated lipase (BSSL) activity, FFA concentration, and bile salt concentration in milks of normal infants and the milk of infants with breast milk jaundice. Mothers of healthy newborn infants were recruited in the early newborn period and 42 provided breast milk samples at 2 weeks, 30 at 6 weeks, 16 at 10 weeks, and 13 at 14 weeks postnatally. We initially studied the effect of lactation on bile salts and found there was a significant decline in both cholate and chenodeoxycholate levels with duration of lactation (p < 0.05). There was also a significant fall in BSSL activity with duration of lactation (p < 0.05), but no correlation was found between BSSL activity and bile salt concentration. FFA concentrations were similar throughout lactation and were not related to either BSSL activity or bile salt concentration. There was a significant increase in the concentration of cholate and the cholate‐to‐chenodeoxy‐cholate ratio in the milks of 12 infants with breast milk jaundice compared with normal milks, the BSSL activity was similar and contrary to previous reports, the FFA concentration was not increased in the milks of infants with breast milk jaundice.

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Serum bile acids and their conjugates in breast-fed infants with prolonged jaundice

Cited by 15 publications

References 13 publications

Abnormal results of biochemical liver function tests in breast-fed infants with prolonged indirect hyperbilirubinaemia

Abnormal results of biochemical liver function tests in breast-fed infants with prolonged indirect hyperbilirubinaemia

Alterations of Serum Bile Acid Profile in Breast‐Fed Infants with Prolonged Jaundice

A Study of the Relationship between Bile Salts, Bile Salt‐Stimulated Lipase, and Free Fatty Acids in Breast Milk

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