Concentrations of cholestenoic acids in plasma from patients with reduced intestinal reabsorption of bile acids.

Abstract

The concentrations of 3 beta-hydroxy-5-cholestenoic acid, 3 beta,7 alpha-dihydroxy-5-cholestenoic acid, and 7 alpha-hydroxy-3-oxo-4-cholestenoic acid were determined in plasma from patients treated with cholestyramine or subjected to resection of the ileum or colon. The values were compared with those for conjugated and unconjugated C24 bile acids. Patients with an intact ileum but without colon had normal levels of cholestenoic acids. Patients treated with cholestyramine or with ileal resection had elevated levels of 7 alpha-hydroxy-3-oxo-4-cholestenoic acid (median values 189 and 233 ng/ml, respectively, compared to 85 ng/ml in controls). The levels of the other two C27 acids were normal in cholestyramine-treated and low in ileoresected patients and were positively correlated to each other but not to the 3-oxo-delta 4 acid. There were no consistent correlations between the levels of C27 acids and those of conjugated or unconjugated C24 bile acids. The results indicate an increased formation of 7 alpha-hydroxy-3-oxo-4-cholestenoic acid in subjects having a stimulated activity of cholesterol 7 alpha-hydroxylase.