Clinical study of urinary sulfated bile acids in patients with hepatitis C virus.

BACKGROUND/AIMS Sulfation is considered to be a detoxifying mechanism for bile acids, which allows the sulfated bile acids to be eliminated in the urine (urinary sulfated bile acids: USBA) by enhancing renal clearance when serum bile acids increase due to hepatobiliary disease. We measured urinary sulfated bile acids in patients positive for hepatitis C virus and studied the relation between USBA and standard liver function tests. METHODOLOGY Seventy-eight outpatients could be followed for at least one year were enrolled in this study. Blood and urine samples were simultaneously obtained from the patients. The measured urinary sulfated bile acids levels were adjusted for the urinary creatinine concentration and the normal value was defined <8 micromol/g creatinine. RESULTS Among the 78 patients, the mean USBA level of 26 carriers, 37 patients with chronic hepatitis C, 9 with liver cirrhosis, and 6 with hepatocellular carcinoma were 6.0 +/- 6.1 micromol/g creatinine (mean +/- SD), 27.9 +/- 35.8, 33.1+/- 22.7, and 50.6 +/- 47.3, respectively. The mean urinary sulfated bile acids level was correlated with the clinical progression of these liver diseases. CONCLUSIONS Urinary sulfated bile acids are considered to be a useful diagnostic indicator of impaired liver function, and can also be used to assess the severity of hepatic disease.