Individual serum bile aids in patients with primary hyperlipoproteinemias

Fasting serum concentrations of the individual bile acids were measured by gas chromatography in 27 patients with primary hyperlipoproteinemia (8 type IIa, 7 type IIb and 12 type IV) and in 14 healthy subjects. Total serum bile acid levels were 1618 +/- 244 ng/ml (SE) in type IIa, 1296 +/- 251 ng/ml in type IIb and 15609 +/- 263 ng/ml in type IV hyperlipoproteinemia. These values did not differ significantly from values in the control group (1505 +/- 200 ng/ml). Serum levels of cholic acid were significantly higher in patients with type IIa (551 +/- 78 ng/ml) than in those with type IIb (190 +/- 57 ng/ml, P < 0.01) and type IV (240 +/- 57 ng/ml, P < 0.02), while intermediate values were recorded in the control group (384 +/- 49 ng/ml). Ursodeoxycholic acid was found in larger amounts in hyperlipidemic patients than in controls. No significant differences with respect to other bile acids were observed between the groups examined. According to the current concepts on the enterohepatic circulation of bile acids, the findings support the hypothesis that the intestinal absorption of cholic acid may differ in various types of hyperlipoproteinemia.