Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Hepatol Res. 2011 Apr;41(4):358-63. doi: 10.1111/j.1872-034X.2011.00779.x. Epub 2011 Feb 23.
Urinary bile acids are mainly conjugated with sulfuric acid. In a previous work, we demonstrated that the levels of urinary sulfated bile acids (USBA) and serum total bile acids (TBA) were correlated very well and also that USBA was considered to be a more useful indicator of hepatic fibrosis than TBA in patients with hepatitis C virus (HCV)-related liver diseases. In the current study we aimed to confirm these finding in patients with primary biliary cirrhosis (PBC), a prototypic cholestatic liver disease.
Urinary sulfated bile acids were measured using an automatic assay kit in 50 patients with PBC, of whom 11 were diagnosed as having cirrhosis. We obtained specimens before ursodeoxycholic acid (UDCA) administration in four patients, and during UDCA in 46 patients. The correlations between USBA and various laboratory tests were studied.
The median USBA level was 67.9 µmol/g creatinine in PBC; 27.7 without cirrhosis and 210.3 with cirrhosis (P = 0.001). The number of PBC patients with elevated USBA was significantly higher than those with elevated TBA (82% vs. 56%). This significance was remarkable especially in early stages, non-cirrhotic patients (77% vs. 49%). USBA level was well correlated with TBA (r(s) = 0.72), and negatively correlated with platelet (r(s) = -0.34) and albumin (r(s) = -0.31).
Urinary sulfated bile acids and TBA are well correlated, and together with the findings that USBA is not affected by meals, USBA is considered to be more beneficial and convenient than TBA for earlier detection of fibrosis in PBC.
尿胆汁酸主要与硫酸结合。在之前的研究中，我们证明了尿硫酸化胆汁酸（USBA）水平与血清总胆汁酸（TBA）水平密切相关，并且在丙型肝炎病毒（HCV）相关肝病患者中，USBA 被认为是比 TBA 更能反映肝纤维化的指标。在本研究中，我们旨在在原发性胆汁性肝硬化（PBC）患者中证实这一发现，PBC 是一种典型的胆汁淤积性肝病。
使用自动分析试剂盒测量 50 例 PBC 患者的尿硫酸化胆汁酸，其中 11 例诊断为肝硬化。在 4 例患者中，我们在开始熊去氧胆酸（UDCA）治疗前，在 46 例患者中在接受 UDCA 治疗期间获得标本。研究了 USBA 与各种实验室检查之间的相关性。
PBC 患者的 USBA 中位数为 67.9 μmol/g 肌酐；无肝硬化患者为 27.7 μmol/g 肌酐，肝硬化患者为 210.3 μmol/g 肌酐（P = 0.001）。USBA 升高的 PBC 患者数量明显高于 TBA 升高的患者（82%比 56%）。这种差异在早期、非肝硬化患者中更为显著（77%比 49%）。USBA 水平与 TBA 密切相关（r(s) = 0.72），与血小板（r(s) = -0.34）和白蛋白（r(s) = -0.31）呈负相关。
尿硫酸化胆汁酸和 TBA 密切相关，并且 USBA 不受饮食影响，因此与 TBA 相比，USBA 更有利于更早地检测 PBC 中的纤维化。
