Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
Bristol Veterinary School, University of Bristol, Bristol, United Kingdom.
J Vet Intern Med. 2021 May;35(3):1333-1341. doi: 10.1111/jvim.16134. Epub 2021 May 6.
Serum bile acids (SBAs) are frequently measured in dogs. However, there is limited data comparing SBAs in different liver diseases diagnosed according to standardized histological criteria.
To compare resting and postprandial SBAs, and determine their sensitivity and specificity, for various liver diseases in dogs.
Three hundred and forty-one client-owned dogs with suspected liver disease that had a liver biopsy and SBAs measured.
Multicenter retrospective study. Cases were classified according to standardized histological criteria. The sensitivity and specificity of resting and postprandial SBAs for the diagnosis of each liver disease, and all liver diseases combined, were calculated.
The median resting SBAs were highest in dogs with cirrhosis (98.8 μmol/L; range, 6-135) and congenital circulatory anomalies (CCa; 79.45 μmol/L; 0.3-705). The highest median postprandial concentrations were found in CCa (126 μmol/L; 0-726) and chronic hepatitis (CH; 54.3 μmol/L; 0-260). Using the cut-off value of 10 μmol/L, the highest sensitivities of resting SBAs were recorded in dogs with CCa (87.5%; 95% confidence interval, 76.8-94.4) and CH (81.1%; 71.5-88.6). The sensitivities of postprandial SBAs were the highest in cholangitis (100%; 47.8-100.0) and CCa (91.1%; 78.8-97.5). The specificities of resting and postprandial SBAs for all diseases were 49.3% (37.6-61.1) and 29.7% (15.9-47.0), respectively.
Postprandial SBAs are more sensitive but less specific than resting SBAs for the diagnosis of liver disease. There were dogs in all categories of liver disease with resting SBAs <10 and >90 μmol/L. Therefore, careful interpretation of both normal and elevated values is required.
血清胆汁酸（SBAs）在犬中经常被测量。然而，比较根据标准化组织学标准诊断的不同肝脏疾病的 SBAs 的数据有限。
比较犬不同肝脏疾病的静息和餐后 SBAs，并确定其敏感性和特异性。
341 只患有疑似肝脏疾病的患犬，进行了肝活检和 SBAs 测量。
多中心回顾性研究。病例根据标准化组织学标准进行分类。计算静息和餐后 SBAs 对每种肝脏疾病以及所有肝脏疾病的诊断的敏感性和特异性。
肝硬化（98.8 μmol/L；范围 6-135）和先天性循环异常（CCa；79.45 μmol/L；0.3-705）犬的静息 SBAs 中位数最高。CCa（126 μmol/L；0-726）和慢性肝炎（CH；54.3 μmol/L；0-260）犬的最高中位餐后浓度。使用 10 μmol/L 的截断值，静息 SBAs 的最高敏感性见于 CCa（87.5%；95%置信区间 76.8-94.4）和 CH（81.1%；71.5-88.6）犬。餐后 SBAs 的敏感性在胆管炎（100%；47.8-100.0）和 CCa（91.1%；78.8-97.5）中最高。静息和餐后 SBAs 对所有疾病的特异性分别为 49.3%（37.6-61.1）和 29.7%（15.9-47.0）。
餐后 SBAs 比静息 SBAs 更敏感，但特异性较低，用于诊断肝脏疾病。所有肝脏疾病类别中都有静息 SBAs<10 和>90 μmol/L 的犬。因此，需要仔细解释正常和升高的值。
