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).