The Diagnostic Value of Fasting Serum Total Bile Acid Concentration in Patients with Suspected Liver Disease

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Abstract
To assess the diagnostic value of fasting serum total bile acids (STBA) in liver disease, STBA together with serum bilirubin (BIL), serum alkaline phosphatase (AP), and serum aspartate aminotransferase (ASAT) were measured in 66 consecutive patients who had a liver biopsy. Twenty-four of the patients who had normal liver histology all had normal STBA values (< 8 μmol/l). In the remaining 42 patients with abnormal liver histology STBA values were elevated in 21, corresponding to a sensitivity of 0.50. The same figures for BIL, AP, and ASAT were 0.52, 0.76, and 0.79, respectively. The predictive values of elevated (PVpos) and normal (PVneg) STBA for disclosing or excluding liver disease, respectively, were not better than the figures for BIL, AP, and ASAT. None of the tests were suited for distinguishing among various liver diseases. It is concluded that STBA had no diagnostic advantage as compared with the commonly used liver function tests BIL, AP, and ASAT.

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