Clinical Significance of Measuring Urinary Sulfated Bile Acids in

Background/Aims: Measurement of urinary sulfated bile acid (USBA) level is a simple urine test that reflects the degree of cholestasis in newborns. The aim of this study was to clarify the clinical significances of this test for liver diseases in adults. Methodology: We examined the relationship between USBA level in a urine sample by enzymatic assay and clinical parameters and postoperative complications in 27 patients with hepatobiliary diseases who underwent surgical procedures between 2002 and 2007. Results: Mean USBA in all patients before surgery was 39.8 ± 64.0 μmol/L (median value was 6.6). USBA level was increased in patients with cholestasis. USBA level was significantly correlated with serum total bile acid, total bilirubin level and serum hyaluronic acid level (r=0.850, 0.602 and 0.504, respectively) (p<0.05) and, furthermore, tended to be correlated with liver-uptake ratio (LHL15) by technetium-99m galactosyl human serum albumin (Tc-GSA) scintigraphy and alanine aminotransferase level (r=-0.469 and 0.436, respectively but not significant). USBA level tended to be associated with postoperative uncontrolled ascites (p=0.050, not significant). Postoperative USBA level by day 7 was not changed; however, USBA level in patients with cholestatic diseases was decreased Conclusions: USBA is a simple and sensitive noninvasive test for cholestasis and also useful to predict postoperative uncontrolled ascites after hepatic resections.