Comparative analysis of bile acid spectrum in non-alcoholic fatty liver disease and cholelithiasis. 2019

Ya M Vakhrushev, and А Р Lukashevich, and I A Penkina, and E V Suchkova
Izhevsk State Medical Academy of the Ministry of Health of the Russian Federation, Izhevsk, Russia.

OBJECTIVE Сomparative studying of changes in the spectrum of bile acids in bile in patients with nonalcoholic fatty liver disease and cholelithiasis. METHODS 140 patients were included in the survey: 50 - with nonalcoholic fatty liver disease and 90 - with cholelithiasis. The diagnosis of nonalcoholic fatty liver disease was established on the basis of ultrasound examination of the liver, the elasticity and fibrosis of liver by using the sonoelastography and liver biopsy. The prestone stage of cholelithiasis was established on the basis of ultrasound examination of the gallbladder and biochemical examination of bile. The level of total cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase and gamma glutamyl transpeptidase were studied using the analyzer "Labsystems" (Finland). The spectrum of bile acids in bile is studied by mass spectrometry on AmazonX apparatus (Bruker Daltonik GmbH, Bremen, Germany). RESULTS Biochemical blood test revealed increase of cholesterol, triglycerides, cytolysis markers, and cholestasis, the most pronounced in patients with nonalcoholic fatty liver disease. Biochemical study of bile showed increase of cholesterol, decrease the total amount of bile acids and cholatecholesterol coefficient in the vesicle and hepatic bile in patients with nonalcoholic fatty liver disease and cholelithiasis. Mass spectrometry showed decrease the total amount of free bile acids (choloidal, chenodeoxycholic, deoxycholic) and increase the content of conjugated bile acids (glycocholic, glycodesoxycholic, taurocholic, taurodeoxycholic, ursodeoxycholic), the most pronounced in patients with nonalcoholic fatty liver disease. CONCLUSIONS Unidirectional changes in the spectrum of bile acids in nonalcoholic fatty liver disease and cholelithiasis give reason to believe that the trigger mechanism in the disturbance of bile acids metabolism is the liver. Reduction of primary bile acids, imbalance of phospholipids and cholesterol disrupt the stabilization of bile, resulting in unfavorable conditions in the bile ducts to form stones.

UI MeSH Term Description Entries
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D002769 Cholelithiasis Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS). Gallstone Disease,Cholelithiases,Gallstone Diseases
D005704 Gallbladder A storage reservoir for BILE secretion. Gallbladder allows the delivery of bile acids at a high concentration and in a controlled manner, via the CYSTIC DUCT to the DUODENUM, for degradation of dietary lipid. Gallbladders
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001646 Bile An emulsifying agent produced in the LIVER and secreted into the DUODENUM. Its composition includes BILE ACIDS AND SALTS; CHOLESTEROL; and ELECTROLYTES. It aids DIGESTION of fats in the duodenum. Biliary Sludge,Sludge, Biliary
D001647 Bile Acids and Salts Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. Bile Acid,Bile Salt,Bile Salts,Bile Acids,Acid, Bile,Acids, Bile,Salt, Bile,Salts, Bile
D001706 Biopsy Removal and pathologic examination of specimens from the living body. Biopsies
D054459 Elasticity Imaging Techniques Non-invasive imaging methods based on the mechanical response of an object to a vibrational or impulsive force. It is used for determining the viscoelastic properties of tissue, and thereby differentiating soft from hard inclusions in tissue such as microcalcifications, and some cancer lesions. Most techniques use ultrasound to create the images - eliciting the response with an ultrasonic radiation force and/or recording displacements of the tissue by Doppler ultrasonography. ARFI Imaging,Acoustic Radiation Force Impulse Imaging,Elastograms,Elastography,Magnetic Resonance Elastography,Sonoelastography,Tissue Elasticity Imaging,Vibro-Acoustography,ARFI Imagings,Elasticity Imaging Technique,Elasticity Imaging, Tissue,Elasticity Imagings, Tissue,Elastogram,Elastographies,Elastographies, Magnetic Resonance,Elastography, Magnetic Resonance,Imaging Technique, Elasticity,Imaging Techniques, Elasticity,Imaging, ARFI,Imaging, Tissue Elasticity,Imagings, ARFI,Imagings, Tissue Elasticity,Magnetic Resonance Elastographies,Resonance Elastographies, Magnetic,Resonance Elastography, Magnetic,Sonoelastographies,Technique, Elasticity Imaging,Techniques, Elasticity Imaging,Tissue Elasticity Imagings,Vibro Acoustography,Vibro-Acoustographies
D065626 Non-alcoholic Fatty Liver Disease Fatty liver finding without excessive ALCOHOL CONSUMPTION. Fatty Liver, Nonalcoholic,NAFLD,Nonalcoholic Fatty Liver Disease,Nonalcoholic Steatohepatitis,Fatty Livers, Nonalcoholic,Liver, Nonalcoholic Fatty,Livers, Nonalcoholic Fatty,Non alcoholic Fatty Liver Disease,Nonalcoholic Fatty Liver,Nonalcoholic Fatty Livers,Nonalcoholic Steatohepatitides,Steatohepatitides, Nonalcoholic,Steatohepatitis, Nonalcoholic

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