Bajor Antal, Kilander Anders, Sjövall Henrik, Rudling Mats, Ung Kjell-Arne
Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, 41345, Gothenburg, Sweden.
Dig Dis Sci. 2008 Nov;53(11):2935-40. doi: 10.1007/s10620-008-0256-4. Epub 2008 Apr 25.
The stability of bile acid turnover rate was evaluated retrospectively using repeat SeHCAT tests in patients with chronic diarrhoea and prospectively for 16 years in healthy subjects. The SeHCAT values were stable in 39 patients with chronic diarrhoea, as shown by a comparison of the test results [data presented as median and (25th-75th percentile)]: 18% (8-23) in the first test versus 14% (9-21) in the second test [n = 39, P = 0.37, time interval 44 months (16-68), repeatability index >95%]. In contrast, they were reduced after 16 years in healthy subjects: 38% (30-49.5) in the first test versus 31% (21-49.5) in the second test (P < 0.03). In healthy subjects, the body mass index increased by 13% from 23.2 kg/m(2) (21-24.6) to 26.2 kg/m(2) (22.5-27.8) (P < 0.01) during the 16 years. There was a negative correlation between hepatic bile acid synthesis and the SeHCAT values (r = -0.615, P = 0.02, n = 14). In conclusion, the turnover rate of bile acids is stable over a long period of time in patients with chronic diarrhoea irrespective of bile acid malabsorption, suggesting that a repeat SeHCAT test is dispensable. There is a significant negative correlation between bile acid synthesis and SeHCAT test results in healthy subjects. The SeHCAT test values are slightly reduced in healthy subjects after 16 years.
采用重复硒-同型半胱氨酸-甲基丙二酸单酰辅酶A转移酶(SeHCAT)试验对慢性腹泻患者胆汁酸周转率的稳定性进行回顾性评估,并对健康受试者进行了为期16年的前瞻性评估。39例慢性腹泻患者的SeHCAT值稳定,试验结果比较[数据以中位数和(第25-75百分位数)表示]如下:第一次试验为18%(8-23),第二次试验为14%(9-21)[n = 39,P = 0.37,时间间隔44个月(16-68),重复性指数>95%]。相比之下,健康受试者在16年后其值降低:第一次试验为38%(30-49.5),第二次试验为31%(21-49.5)(P < 0.03)。在健康受试者中,16年间体重指数从23.2 kg/m²(21-24.6)增加了13%至26.2 kg/m²(22.5-27.8)(P < 0.01)。肝胆汁酸合成与SeHCAT值之间存在负相关(r = -0.615,P = 0.02,n = 14)。总之,慢性腹泻患者的胆汁酸周转率在很长一段时间内是稳定的,与胆汁酸吸收不良无关,这表明重复SeHCAT试验是不必要的。健康受试者中胆汁酸合成与SeHCAT试验结果之间存在显著负相关。健康受试者在16年后SeHCAT试验值略有降低。