SERUM 7-ALPHA-HYDROXY-4-CHOLESTEN-3-ONE CONCENTRATIONS IN THE EVALUATION OF BILE-ACID MALABSORPTION IN PATIENTS WITH DIARRHEA - CORRELATIONTO SEHCAT TEST

The synthesis of bile acids is regulated by a homeostatic mechanism in which bile acids returning to the liver from the intestine inhibit th eir own synthesis. Serum concentrations of the bile acid intermediate 7alpha-hydroxy-4-cholesten-3-one reflect the rate of bile acid synthes is whereas bile acid malabsorption can be determined by the SeHCAT tes t. This study was done to evaluate the correlation between the two tes ts in humans. Twenty eight patients with chronic diarrhoea were includ ed in the study. Fasting serum was collected for the determination of 7alpha-hydroxy-4-cholesten-3-one, and on the same day the gamma emitti ng bile acid analogue SeHCAT was given orally and its fractional catab olic rate assessed by repeated external counting over the upper abdome n during the next seven days. There was a highly significant positive correlation between the two tests (R(S) = 0.80, p < 0.001). The result s show a close relation between intestinal loss and hepatic synthesis of bile acids and imply that analysis of 7alpha-hydroxy-4-cholesten-3- one in serum should now be evaluated as a possible convenient method f or assessing bile acid malabsorption in patients with diarrhoea.