SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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I. Burkard1 , A. von Eckardstein1 , K.M. Rentsch1

1Institut of Clinical Chemistry, Rämistrasse 100, CH-8091 Zurich

Objective: Differentiated quantification of the five most common bile acids as well as their glycine- and taurine-conjugated derivatives can be of clinical benefit for the diagnosis of selected cholestatic disorders and other diseases affecting bile acid metabolism. Furthermore, the bile acid pattern can also be useful in experimental and clinical research.
Methods: A HPLC-(tandem) mass spectrometry method was developed for the quantification of unconjugated as well as glycine- and taurine-conjugated cholic, chenodeoxycholic, deoxycholic, ursodeoxycholic and lithocholic acid, respectively. Preliminary normal ranges were determined in twenty-one healthy volunteers (10 men and 11 women; mean age, 34 years) with serum cholesterol concentration < 6.2 mmol/l (mean, 4.5 mmol/l).
Results: The within-day and between-day coefficients of variation were below 6% for all bile acids. The accuracy ranged between 94.6% and 103%, depending on the respective bile acid. The following mean plasma concentrations (± SD) of unconjugated, glycine- and taurine-conjugated bile acids were found in twenty-one healthy volunteers:
cholic acid 0.128 ± 0.142 µmol/l , 0.311 ± 0.265 µmol/l and 0.121 ± 0.128 µmol/l;
chenodeoxycholic acid 0.319 ± 0.299 µmol/l, 0.990 ± 0.756 µmol/l and 0.160 ± 0.164 µmol/l;
deoxycholic acid 0.459 ± 0.382 µmol/l, 0.389 ± 0.287 µmol/l and 0.073 ± 0.046 µmol/l;
ursodeoxycholic acid 0.081 ± 0.093 µmol/l, 0.254 ± 0.205 µmol/l and 0.014 ± 0.007 µmol/l;
lithocholic acid 0.018 ± 0.007 µmol/l, 0.037 ± 0.015 µmol/l and 0.002 ± 0.001 µmol/l.
Summary and Conclusion: Our sensitive and selective HPLC-(tandem) mass spectrometry method allows the quantification of unconjugated and conjugated bile acids in serum samples. This bile acid pattern can both provide useful diagnostic information when incorporated in the battery of standard liver function tests and be helpful for clinical research.

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