The role of serum bile acid profile in differentiation between nonalcoholic fatty liver disease and chronic viral hepatitis

Abstract

Background Bile acids are essential organic molecules synthesized from cholesterol in the liver. They have been utilized as indicators of hepatobiliary impairment because synthesis of BAs and their metabolism are influenced by liver diseases. We aimed to investigate the role of serum bile acid level and composition in differentiation between nonalcoholic fatty liver disease (NAFLD) and chronic viral hepatitis. An ultra-performance liquid chromatography coupled with mass spectrometry assay was used to measure the serum level of 14 bile acids in chronic viral hepatitis and NAFLD patients beside normal healthy control subjects. Results The mean serum levels of 11 out of the 14 bile acids (two primary, six conjugated, and three secondary) were significantly higher in viral hepatitis compared to control. Only 4 bile acids [2 primary, one glycine conjugated (GCDCA), and one secondary (LCA)] had statistically significant increase in their mean serum bile acid level in NAFLD compared to control. Comparing viral hepatitis group against NAFLD group revealed that the mean serum levels of five conjugated and one secondary bile acid (DCA) were significantly higher in viral hepatitis group. Receiver operating characteristic (ROC) curve analysis revealed that LCA had the best diagnostic performance for viral hepatitis followed by TCA and GCDCA. ROC curve for the combined three parameters had better sensitivity and specificity (70.55% and 94.87% respectively). Conclusion BA compositions including primary, secondary, and conjugated ones could differentiate between chronic viral hepatitis and NAFLD patients, and they might be potential distinguishing biomarkers for this purpose.

A synthetic receptor platform enables rapid and portable monitoring of liver dysfunction via engineered bacteria.

“…Bile salts are classi ed in two categories: primary bile salts (including taurocholic acid) are produced by the liver while secondary bile salts arise from modi cation of primary bile salts by gut microbiome metabolism. Primary bile salts are upregulated in serum and urine of patients with liver disease [27][28][29] . Previously identi ed virulence activating factors for V. cholerae include taurocholic acid, glycocholate, and cholic acid 42 .…”

“…For example, serum bile salts are highly correlated with the obstruction state of the bile duct and rapidly decrease when biliary stenting is performed 26 . Furthermore, speci c bile salt pro les may be associated with particular liver diseases [27][28][29] . Bile salts thus represent an ideal and speci c biomarker for diagnosis and dynamic monitoring of liver disease.…”

A synthetic receptor platform enables rapid and portable monitoring of liver dysfunction via engineered bacteria

“…Bile salts are classified in two categories: primary bile salts (including taurocholic acid) are produced by the liver while secondary bile salts arise from modification of primary bile salts by gut microbiome metabolism. Primary bile salts are upregulated in serum and urine of patients with liver disease [27][28][29] . Previously identified virulence activating factors for V. cholerae include taurocholic acid, glycocholate, and cholic acid 42 .…”

“…For example, serum bile salts are highly correlated with the obstruction state of the bile duct and rapidly decrease when biliary stenting is performed 26 . Furthermore, specific bile salt profiles may be associated with particular liver diseases [27][28][29] . Bile salts thus represent an ideal and specific biomarker for diagnosis and dynamic monitoring of liver disease.…”

Programmable receptors enable bacterial biosensors to detect pathological biomarkers in clinical samples

“…For example, serum bile salts are highly correlated with the obstruction state of the bile duct and rapidly decrease when biliary stenting is performed 30 . Furthermore, specific bile salt profiles may be associated with particular liver diseases 31 – 33 . Bile salts thus represent an ideal and specific biomarker for diagnosis and dynamic monitoring of liver disease.…”