Determinants of Serum Bile Acids in Chronic Liver Disease

Abstract

In normal subjects intestinal input of bile acids into the portal vein is the major determinant of peripheral bile-acid concentrations. In the present study some aspects of enterohepatic circulation of bile acids were analyzed for total bile acids, cholylglycine, and sulfolithocholylglycine in 8 patients with alcoholic liver disease. At the time of combined hepatic vein catheterization and transhepatic portal vein pressure measurement, simultaneous samples of blood were obtained for measurement of bile acids from portal vein, hepatic vein, and peripheral vein, both in the fasting state and during a 90-min period after injection of cholecystokinin. For all bile acids, concentrations were significantly lower in the hepatic vein than in the portal vein. No correlation was found between peripheral vein concentrations of bile acids and any of the liver status tests. Also, the ratio of hepatic vein to portal vein bile acids, an estimate of hepatic extraction of bile acids, did not correlate with peripheral vein levels, while it did with the prothrombin time, (r = -0.68, P