Serum 7α–hydroxycholesterol reflects hepatic bile acid synthesis in patients with obstructive jaundice after external biliary drainage
✍ Scribed by Shuichiro Okamoto; Kazuhisa Fukushima; Hidetaka Higashijima; Ichiro Makino; Masanori Kishinaka; Hitoshi Oda; Hiroyuki Yamashita; Hitoshi Ichimiya; Kazuo Chijiiwa; Syoji Kuroki
- Publisher
- John Wiley and Sons
- Year
- 1994
- Tongue
- English
- Weight
- 547 KB
- Volume
- 20
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
To examine the hypothesis that serum levels of 7a-hydroxycholesterol reflect bile acid synthesis in the liver, we analyzed serum 7a-hydroxycholesterol and bile acid output in 13 patients with obstructive jaundice after relief of biliary obstruction. Before biliary drainage, the serum level of 7a-hydroxycholesterol was 92 f 12 pmol/ml (mean f S.E.M.) and was significantly lower than the control value (226 k 26 pmol/ml, p < 0.01). After biliary drainage, serum 7ahydroxycholesterol level and biliary bile acid outputs began to rise in some patients, indicating reversible liver dysfunction. In other patients, serum 7a-hydroxycholesterol levels and bile acid outputs did not increase, suggesting severe or irreversible liver dysfunction. On and after the third day of biliary decompression, serum 7a-hydroxycholesterol levels correlated well with bile acid excretion (p < 0.01, r = 0.93). Other liver function parameters, such as serum bilirubin, serum bile acids, albumin, and bile flow, also revealed significant correlation with serum 7a-hydroxycholesterol levels. We conclude that the senun 7a-hydroxycholesterol level clearly reflects bile acid synthesis in the liver and that it may serve as a useful parameter for the assessment of hepatic functional recovery in patients with obstructive jaundice after biliary drainage. (HEPATOLOGY 1994;20:95-100.)
Bile acid synthesis is one of the most important functions of the liver. Approximately 200 to 600 mg (about 0.5 to 1.5 mmol) of bile acid is synthesized in the liver and excreted in feces daily (1). The rate-limiting step of bile acid biosynthesis is catalyzed by microsomal cholesterol 7a-hydroxylase (2). Recently, highly sensitive, accurate, and reproducible methods were developed for the determination of microsomal cholesterol