Urinary concentrations of bile acid glucuronides and sulfates in hepatobiliary diseases

Urinary bile acids in normal subjects and patients with obstructive jaundice and liver cirrhosis were quantitated by mass fragmentography after separation into nonglucuronidated-nonsulfated, glucuronidated and sulfated fractions. Mean values of total bile acids in urine were as follows: Control subjects (n = 7), 1.90 +/- 0.67; obstructive jaundice (n = 9), 77.90 +/- 40.39; liver cirrhosis, compensated (n = 6), 15.14 +/- 8.97, and decompensated (n = 6), 11.84 +/- 9.32 (mean +/- SD, mg/day). The percentages of each conjugate was 19-29% in the non-glucuronidated-nonsulfated fraction, 6-14% in the glucuronidated fraction and 60-74% in the sulfated fraction. Bile acids in urine and serum correlated well in each fraction (r = 0.82-0.84, p less than 0.001). The clearance of the three conjugates was the highest in the sulfates, and the clearance of glucuronides was higher than that of non-esterified bile acids. The glucuronidation and sulfation of bile acids play an important role in the detoxication of bile acids by excreting them into urine, especially in patients with elevated serum bile acids.