Urinary bile alcohols in liver dysfunction

Urinary bile alcohol profiles in healthy and cholestatic children

BACKGROUND

Bile alcohols are normal constituents of urine.

METHODS

To better understand bile alcohol profile in childhood, urinary specimens from 41 healthy children and 10 children with cholestasis, and 3 healthy adults, were analyzed by GLC and GC-MS.

RESULTS

Five bile alcohols, 27-nor-5beta-cholestane-3alpha,7alpha,12alpha,24S,25R-pentol, 5beta-cholestane-3alpha,7alpha,12alpha,24S, 25-pentol, 5beta-cholestane-3alpha,7alpha,12alpha,24S,26-pentol, 5beta-cholestane-3alpha,7alpha, 12alpha,25,26-pentol, and 5beta-cholestane-3alpha,7alpha,12alpha,26,27-pentol were identified in all specimens. C(26)-Pentol was the most abundant constituent, constituting 29.5 to 65% of bile alcohols. Among healthy children (n=41), no significant relationship was seen between proportions of the C(26)-pentol and age, but older children (n=15, 6 to 14 years) showed a significantly greater mean percentage of the C(26)-pentol than young children (n=26, 0 to 5 years; 58.1+/-4.23% vs. 46.0+/-9.24%, p<0.001). In children with cholestatic liver diseases, the percentage of C(26)-pentol in urinary bile alcohols was significantly lower than age-matched controls.

CONCLUSIONS

There is an increased composition of C(26)-pentol in older children and relatively decreased composition of C(26)-pentol in children with cholestatic liver diseases.

High-performance liquid chromatographic separation of ultraviolet-absorbing bile alcohol derivatives

This paper describes the high-performance liquid chromatographic separation of UV-absorbing bile alcohol derivatives. Bile alcohols were treated with 3 alpha-hydroxysteroid dehydrogenase to form the corresponding 3-keto bile alcohols. The 3-keto bile alcohols produced were converted to the 2,4-dinitrophenylhydrazone derivatives, separated using a Nova-Pak Phenyl column, and monitored at 364 nm. The separation of stereoisomers related to the configuration of hydroxyl groups on the side chain of the bile alcohols, which was not achieved by gas chromatography, could also be accomplished.

Measurement of serum bile alcohol levels in liver dysfunction, using isotope dilution-mass spectrometry

We determined the concentration of two major serum bile alcohols, 27-nor-5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25-pentol and 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25,26-pentol, in healthy controls and patients with acute hepatitis, chronic hepatitis, and cirrhosis, using isotope dilution-mass spectrometry. In healthy controls the mean total amount of the two major bile alcohols was 9.6 +/- 3.4 ng/ml (mean +/- SD). In patients with liver diseases the mean values were as follows: acute hepatitis, 44.8 +/- 18.2 ng/ml; chronic hepatitis, 18.2 +/- 5.6 ng/ml; Child grade A cirrhosis, 37.9 +/- 26.0 ng/ml; Child grade B, 42.7 +/- 22.0 ng/ml; and Child grade C, 71.2 +/- 24.2 ng/ml. The mean ratio of 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25,26-pentol to 27-nor-5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25-pentol in patients with Child grade C cirrhosis was significantly higher than that in healthy controls (1.42 +/- 0.92 versus 0.61 +/- 0.11; p less than 0.05).