Quantitative determination of non-sulfated bile acids in the serum of patients with hepatobiliary diseases by mass fragmentography.

Individual non-sulfated bile acids in the serum of 65 patients with hepatobiliary diseases were quantitated by mass fragmentography. Serum with deuterium labeled deoxycholic acid as an internal standard was hydrolyzed with strong alkali, extracted with ether after acidification under cooling, and quantitated by mass fragmentography as the hexafluoroisopropyl-trifluoracetyl derivatives. In obstructive jaundice, the ratio of cholic to chenodeoxycholic acid was significantly higher than others. Cholic or chenodeoxycholic acid levels were correlated with total bilirubin levels in obstructive jaundice and acute hepatitis. Lithocholic acid value was independent of the degree of liver injury. Total bile acid value was helpful in estimating the extent of liver cell injury and cholestasis, and these two pathological conditions can be distinguished to some extent by cholic to chenodeoxychoic acid ratio.