Serum bile acids in primary biliary cirrhosis: effect of ursodeoxycholic acid therapy

Hepatology. 1993 Apr;17(4):599-604. doi: 10.1002/hep.1840170412.

Abstract

Serum bile acid levels and distributions were studied every 6 mo in patients with primary biliary cirrhosis who were randomly assigned to receive ursodeoxycholic acid (13 to 15 mg/kg/day) (n = 73) or a placebo (n = 73) over a 2-yr period. In the ursodeoxycholic acid group, ursodeoxycholic acid was the predominant serum bile acid at 6 mo and throughout the 2-yr treatment period. The total concentration of endogenous bile acids decreased with a reduction in cholic acid (in the ursodeoxycholic acid group and the placebo group, respectively [mean +/- S.E.]: 13.0 +/- 2.2 and 12.6 +/- 2.5 mumol/L at entry vs. 3.5 +/- 0.6 and 9.0 +/- 2.2 mumol/L at 2 yr; p < 0.002), chenodeoxycholic acid (in the ursodeoxycholic acid group and the placebo group, respectively: 12.1 +/- 1.7 and 12.7 +/- 2.3 mumol/L at entry vs. 5.8 +/- 0.8 and 10.7 +/- 2.2 mumol/L at 2 yr; p < 0.02) and 3 beta-hydroxy-delta 5-cholenoic acid. The concentration of deoxycholic acid did not change, whereas that of lithocholic acid increased significantly (in the ursodeoxycholic acid group and the placebo group, respectively: 0.63 +/- 0.06 and 0.81 +/- 0.12 mumol/L at entry vs. 1.26 +/- 0.12 and 0.90 +/- 0.15 mumol/L at 2 yr; p < 0.001). These changes were independent of the histological stage of the disease. Thus during ursodeoxycholic acid administration the liver was exposed to a lower level of endogenous bile acids and to an increased concentration of ursodeoxycholic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bile Acids and Salts / blood*
  • Chenodeoxycholic Acid / blood
  • Cholic Acid
  • Cholic Acids / blood
  • Deoxycholic Acid / blood
  • Female
  • Humans
  • Lithocholic Acid / blood
  • Liver Cirrhosis, Biliary / blood*
  • Liver Cirrhosis, Biliary / drug therapy*
  • Liver Cirrhosis, Biliary / physiopathology
  • Male
  • Middle Aged
  • Placebos
  • Ursodeoxycholic Acid / therapeutic use*

Substances

  • Bile Acids and Salts
  • Cholic Acids
  • Placebos
  • Deoxycholic Acid
  • Chenodeoxycholic Acid
  • Lithocholic Acid
  • Ursodeoxycholic Acid
  • Cholic Acid