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-5β-cholestane-3α, 7α, 12α, 24, 25-pentol and 5β-cholestane-3α, 7α, 12α, 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 5β-cholestane-3α, 7α, 12α, 25, 26-pentol to 27-nor-5β-cholestane-3α, 7α, 12α, 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 < 0.05).