Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter March 14, 2015

Reference ranges of serum bile acids in children and adolescents

  • Jörg Jahnel , Evelyn Zöhrer , Hubert Scharnagl , Wolfgang Erwa , Günter Fauler and Tatjana Stojakovic EMAIL logo

Abstract

Background: Bile acids (BA) are found predominantly in bile but also in serum, where they can be used as markers for inborn and acquired hepatobiliary disorders. We measured serum BA levels by mass spectrometry to determine reference ranges for healthy children and adolescents in different age groups.

Methods: In 194 healthy children and adolescents (0–19 years) concentrations of serum BA and BA composition were determined using high-performance liquid chromatography high-resolution mass spectrometry. Individuals were classified by ages into five groups: 0–5 months, 6–24 months, 3–5 years, 6–11 years, and >11 years.

Results: The 95% confidence interval of serum total BA values in newborns was 3.85–6.32 μmol/L. In the cohort aged 6–24 months total BA values were significantly higher (6.61–9.43 μmol/L; p<0.001). During growth, values decreased (6–11 years; 3.61–5.41 μmol/L), and after 11 years (3.09–4.12 μmol/L) resembled those in adults (0.28–6.50 μmol/L). With respect to conjugation patterns, in neonates BA were primarily conjugated with taurine; however, after 6 months glycine conjugates clearly predominated.

Conclusions: Our data show that serum BA values vary substantially during the first years of life and that reference ranges for BA are age-dependent. The physiologic mechanisms underlying these variations remain to be determined.


Corresponding author: Tatjana Stojakovic, MD, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria, Phone: +43 316 38517816, Fax: +43 316 38513430, E-mail:
aGünter Fauler and Tatjana Stojakovic share senior authorship.

Acknowledgments

The excellent technical assistance of Maria Schäffer is gratefully acknowledged. We thank A.S. Knisely, Institute of Liver Studies, King’s College Hospital, London, UK, for helpful comments on the manuscript.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Financial support: None declared.

Employment or leadership: None declared.

Honorarium: J. Jahnel has received a grant.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Hofmann AF. Bile acids: the good, the bad, and the ugly. News Physiol Sci 1999;14:24–9.10.1152/physiologyonline.1999.14.1.24Search in Google Scholar

2. Colombo C, Okolicsanyi L, Strazzabosco M. Advances in familial and congenital cholestatic diseases. Clinical and diagnostic implications. Dig Liver Dis 2000;32:152–9.10.1016/S1590-8658(00)80403-XSearch in Google Scholar

3. Suzuki M, Muraji T, Obatake M, Nio M, Ito K, Suzuki K, et al. Urinary sulfated bile acid analysis for the early detection of biliary atresia in infants. Pediatr Int 2011;53:497–500.10.1111/j.1442-200X.2010.03268.xSearch in Google Scholar

4. Chiang JY. Bile acids: regulation of synthesis. J Lipid Res 2009;50:1955–66.10.1194/jlr.R900010-JLR200Search in Google Scholar

5. Brunner H, Northfield TC, Hofmann AF, Go VL, Summerskill WH. Gastric emptying and secretion of bile acids, cholesterol, and pancreatic enzymes during digestion. Duodenal perfusion studies in healthy subjects. Mayo Clin Proc 1974;49:851–60.Search in Google Scholar

6. Galatola G, Jazrawi RP, Bridges C, Joseph AE, Northfield TC. Direct measurement of first-pass ileal clearance of a bile acid in humans. Gastroenterology 1991;100:1100–5.10.1016/0016-5085(91)90288-VSearch in Google Scholar

7. Makishima M, Okamoto AY, Repa JJ, Tu H, Learned RM, Luk A, et al. Identification of a nuclear receptor for bile acids. Science 1999;284:1362–5.10.1126/science.284.5418.1362Search in Google Scholar PubMed

8. Tagliacozzi D, Mozzi AF, Casetta B, Bertucci P, Bernardini S, Di Ilio C, et al. Quantitative analysis of bile acids in human plasma by liquid chromatography-electrospray tandem mass spectrometry: a simple and rapid one-step method. Clin Chem Lab Med 2003;41:1633–41.10.1515/CCLM.2003.247Search in Google Scholar PubMed

9. Griffiths WJ, Sjovall J. Bile acids: analysis in biological fluids and tissues. J Lipid Res 2010;51:23–41.10.1194/jlr.R001941Search in Google Scholar

10. Polkowska G, Polkowski W, Kudlicka A, Wallner G, Chrzastek-Spruch H. Range of serum bile acid concentrations in neonates, infants, older children, and in adults. Med Sci Monit 2001;7:268–70.Search in Google Scholar

11. Niijima S. Studies on the conjugating activity of bile acids in children. Pediatr Res 1985;19:302–7.10.1203/00006450-198503000-00010Search in Google Scholar PubMed

12. Balistreri WF. Fetal and neonatal bile acid synthesis and metabolism – clinical implications. J Inherit Metab Dis 1991;14:459–77.10.1007/BF01797918Search in Google Scholar PubMed

13. Barbara L, Lazzari R, Roda A, Aldini R, Festi D, Sama C, et al. Serum bile acids in newborns and children. Pediatr Res 1980;14:1222–5.10.1203/00006450-198011000-00014Search in Google Scholar PubMed

14. Poley JR, Dower JC, Owen CA Jr, Stickler GB. Bile acids in infants and children. J Lab Clin Med 1964;63:838–46.Search in Google Scholar

15. Buffie CG, Bucci V, Stein RR, McKenney PT, Ling L, Gobourne A, et al. Precision microbiome reconstitution restores bile acid mediated resistance to Clostridium difficile. Nature 2015;517:205–8.10.1038/nature13828Search in Google Scholar PubMed PubMed Central

16. Weingarden AR, Chen C, Bobr A, Yao D, Lu Y, Nelson VM, et al. Microbiota transplantation restores normal fecal bile acid composition in recurrent Clostridium difficile infection. Am J Physiol Gastrointest Liver Physiol 2014;306:G310–9.10.1152/ajpgi.00282.2013Search in Google Scholar PubMed PubMed Central

Received: 2014-12-23
Accepted: 2015-2-10
Published Online: 2015-3-14
Published in Print: 2015-10-1

©2015 by De Gruyter

Downloaded on 29.4.2024 from https://www.degruyter.com/document/doi/10.1515/cclm-2014-1273/html
Scroll to top button