Erythrocyte lipid alterations in pediatric cholestatic liver disease: relationship to serum bile acids.

Chronic pediatric cholestatic liver disease is accompanied by an elevated erythrocyte membrane cholesterol/phospholipid molar ratio. Since bile acids are known to affect erythrocyte membrane integrity, we sought to determine what relationship existed between serum bile acid concentrations and the observed alterations in erythrocyte membrane lipids. Ten children with chronic cholestasis (2 months-3 1/2 yrs) were evaluated a total of twenty-two times. For all studies a reliable correlation between erythrocyte membrane cholesterol and phospholipid was noted (r = 0.88, p less than 0.001). When total serum bile acids exceeding 100 mumol/L were excluded, a strong relationship between serum bile acids and erythrocyte cholesterol/phospholipid molar ratio was noted (r = 0.61, p less than 0.03). The results suggest that with mild to moderate cholestasis changes in serum bile acids influence erythrocyte membrane lipid composition with parallel increases in cholesterol and phospholipid.