Increased serum bile acids in cirrhosis with normal transaminases.

Fasting and postprandial serum concentrations of total conjugated primary bile acids determined by radioimmunoassay have been compared with conventional liver function tests in patients with cirrhosis of the liver and normal transaminases. While gamma-glutamyl-transferase had the highest sensitivity (69%) among the conventional liver function tests, it was much less sensitive for the detection of cirrhosis with normal transaminases than fasting (93% sensitivity) or postprandial (93% sensitivity) bile acid concentrations in serum. When a combination of fasting and postprandial bile acid concentrations was used, the sensitivity increased to 97%.