Urinary Bile Acid Excretion in Correlation to Liver Histopathology in Cystic Fibrosis

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Abstract
Urinary bile acid excretion and liver morphology were compared in 25 patients with cystic fibrosis (CF). None showed clinical signs of liver disease. Most of the patients had normal liver function tests. Bile acids were determined in 24-h samples by a modification of the method of Almé. All patients had increased urinary excretion of trihydroxy bile acids, mainly cholic, 3β,7β, 12α- and 3α,7β,12α-trihydroxy-5β-cholanoic acids. Lithocholic acid excretion was lower in CF than in normal children. The urinary excretion of 3β-hydroxy-5-cholenoic acid was not increased in CF. In three patients with cirrhosis the urinary excretion of chenodeoxycholic acid was increased. The ratio of cholic to 3β-hydroxy-5-cholenoic acids was increased in all but three patients, and the ratio of chenodeoxycholic to 3β-hydroxy-5-cholenoic acids was increased in those with cirrhosis. These ratios differed more between cirrhotic and non-cirrhotic CF patients in this series than the ratio of cholic to chenodeoxycholic acids.