Journal of Lipid Research, Vol 30, 1877-1882, Copyright © 1989 by Lipid Research, Inc.
Concentrations of cholestenoic acids in plasma from patients with liver disease
M Axelson, B Mork, A Aly, O Wisen and J Sjovall
Department of Clinical Chemistry, Karolinska Hospital, Stockholm, Sweden.
The concentrations of 3 beta-hydroxy-5-cholestenoic acid, 3 beta,7
alpha-dihydroxy-5-cholestenoic acid, and 7 alpha-hydroxy-3-oxo-4-
cholestenoic acid were determined in plasma from patients with different
liver diseases and compared with those of unconjugated and conjugated C24
bile acids. The levels of the cholestenoic acids were similar in patients
with extrahepatic cholestasis and in controls (median concentration 153 and
162 ng/ml, respectively), whereas significantly elevated levels were found
in plasma from patients with primary biliary cirrhosis (median
concentration 298 ng/ml) and alcoholic liver cirrhosis (median
concentration 262 ng/ml). As expected, conjugated C24 bile acids were
elevated in most patients whereas the corresponding unconjugated compounds
were low in cholestasis and elevated in alcoholic liver cirrhosis. The
levels of the individual C27 acids were usually positively correlated to
each other and also to the levels of conjugated C24 bile acids in plasma
from patients with liver cirrhosis. In contrast, there was no correlation
between the levels of C27 acids and conjugated bile acids in patients with
extrahepatic cholestasis. The levels of unconjugated C24 bile acids were
not correlated to C27 acids or conjugated bile acids in any of the groups.
The results indicate that there is a close metabolic relationship between
the individual C27 acids, that they do not participate in an enterohepatic
circulation, and that the liver is important for their
elimination/metabolism.