Skip to main content

Advertisement

SpringerLink
Log in

The Bile Acid Turnover Rate Assessed with the 75SeHCAT Test Is Stable in Chronic Diarrhoea but Slightly Decreased in Healthy Subjects After a Long Period of Time

  • Original Paper
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

The stability of bile acid turnover rate was evaluated retrospectively using repeat SeHCAT tests in patients with chronic diarrhoea and prospectively for 16 years in healthy subjects. The SeHCAT values were stable in 39 patients with chronic diarrhoea, as shown by a comparison of the test results [data presented as median and (25th–75th percentile)]: 18% (8–23) in the first test versus 14% (9–21) in the second test [n = 39, P = 0.37, time interval 44 months (16–68), repeatability index >95%]. In contrast, they were reduced after 16 years in healthy subjects: 38% (30–49.5) in the first test versus 31% (21–49.5) in the second test (P < 0.03). In healthy subjects, the body mass index increased by 13% from 23.2 kg/m2 (21–24.6) to 26.2 kg/m2 (22.5–27.8) (P < 0.01) during the 16 years. There was a negative correlation between hepatic bile acid synthesis and the SeHCAT values (r = −0.615, P = 0.02, n = 14). In conclusion, the turnover rate of bile acids is stable over a long period of time in patients with chronic diarrhoea irrespective of bile acid malabsorption, suggesting that a repeat SeHCAT test is dispensable. There is a significant negative correlation between bile acid synthesis and SeHCAT test results in healthy subjects. The SeHCAT test values are slightly reduced in healthy subjects after 16 years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

ASBT:

Apical sodium-dependent bile salt transporter

BMI:

Body mass index

C4:

7α-Hydroxy-4-cholesten-3-one

75SeHCAT:

75Se-labeled homocholic acid-taurine

References

  1. Wong MH, Oelkers P, Dawson PA (1995) Identification of a mutation in the ileal sodium-dependent bile acid transporter gene that abolishes transport activity. J Biol Chem 270(45):27228–27234

    Article  PubMed  CAS  Google Scholar 

  2. Ung KA, Olofsson G, Fae A, Kilander A, Ohlsson C, Jonsson O (2002) In vitro determination of active bile acid absorption in small biopsy specimens obtained endoscopically or surgically from the human intestine. Eur J Clin Invest 32(2):115–121

    Article  PubMed  CAS  Google Scholar 

  3. Brydon WG, Nyhlin H, Eastwood MA, Merrick MV (1996) Serum 7 alpha-hydroxy-4-cholesten-3-one and selenohomocholyltaurine (SeHCAT) whole body retention in the assessment of bile acid induced diarrhoea. Eur J Gastroenterol Hepatol 8(2):117–123

    Article  PubMed  CAS  Google Scholar 

  4. Nyhlin H, Brydon G, Danielsson A, Westman S (1984) Clinical application of a selenium (75Se)-labelled bile acid for the investigation of terminal ileal function. Hepatogastroenterology 31(4):187–191

    PubMed  CAS  Google Scholar 

  5. Bajor A, Kilander A, Fae A, Galman C, Jonsson O, Ohman L et al (2006) Normal or increased bile acid uptake in isolated mucosa from patients with bile acid malabsorption. Eur J Gastroenterol Hepatol 18(4):397–403

    Article  PubMed  CAS  Google Scholar 

  6. Ung KA, Kilander AF, Lindgren A, Abrahamsson H (2000) Impact of bile acid malabsorption on steatorrhoea and symptoms in patients with chronic diarrhoea. Eur J Gastroenterol Hepatol 12(5):541–547

    Article  PubMed  CAS  Google Scholar 

  7. Galatola G (1992) The prevalence of bile acid malabsorption in irritable bowel syndrome and the effect of cholestyramine: an uncontrolled open multicentre study. Eur J Gastroenterol Hepatol 4:533–537

    Google Scholar 

  8. Galman C, Arvidsson I, Angelin B, Rudling M (2003) Monitoring hepatic cholesterol 7alpha-hydroxylase activity by assay of the stable bile acid intermediate 7 alpha-hydroxy-4-cholesten-3-one in peripheral blood. J Lipid Res 44(4):859–866

    Article  PubMed  CAS  Google Scholar 

  9. Fellous K, Jian R, Haniche M, Marteau P, Messing B, Rain JD et al (1994) Measurement of ileal absorption of bile salts with the selenium 75 labelled homotaurocholic acid test. Validation and clinical significance. Gastroenterol Clin Biol 18(10):865–872

    PubMed  CAS  Google Scholar 

  10. Rossel P, Sortsoe Jensen H, Qvist P, Arveschoug A (1999) Prognosis of adult-onset idiopathic bile acid malabsorption. Scand J Gastroenterol 34(6):587–590

    Article  PubMed  CAS  Google Scholar 

  11. Luman W, Williams AJ, Merrick MV, Eastwood MA (1995) Idiopathic bile acid malabsorption: long-term outcome. Eur J Gastroenterol Hepatol 7(7):641–645

    PubMed  CAS  Google Scholar 

  12. Einarsson K, Nilsell K, Leijd B, Angelin B (1985) Influence of age on secretion of cholesterol and synthesis of bile acids by the liver. N Engl J Med 313(5):277–282

    PubMed  CAS  Google Scholar 

  13. Eusufzai S, Ericsson S, Cederlund T, Einarsson K, Angelin B (1993) No influence of age on ileal absorption of bile acids in humans as determined by the SeHCAT test. Eur J Gastroenterol Hepatol 5:247–249

    Article  Google Scholar 

  14. Eastwood MA, Brydon WG, Baird JD, Elton RA, Helliwell S, Smith JH et al (1984) Fecal weight and composition, serum lipids, and diet among subjects aged 18 to 80 years not seeking health care. Am J Clin Nutr 40(3):628–634

    PubMed  CAS  Google Scholar 

  15. Bertolotti M, Gabbi C, Anzivino C, Crestani M, Mitro N, Del Puppo M et al (2007) Age-related changes in bile acid synthesis and hepatic nuclear receptor expression. Eur J Clin Invest 37(6):501–508

    Article  PubMed  CAS  Google Scholar 

  16. Honda A, Yoshida T, Xu G, Matsuzaki Y, Fukushima S, Tanaka N et al (2004) Significance of plasma 7alpha-hydroxy-4-cholesten-3-one and 27-hydroxycholesterol concentrations as markers for hepatic bile acid synthesis in cholesterol-fed rabbits. Metabolism 53(1):42–48

    Article  PubMed  CAS  Google Scholar 

  17. Thaysen EH, Orholm M, Arnefred T, Rodbro P (1982) Assessment of ileal function by abdominal counting of the retention of a gamma emitting bile acid analogue. Gut 23:862–865

    Article  PubMed  CAS  Google Scholar 

  18. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310

    PubMed  CAS  Google Scholar 

  19. Merrick MV, Eastwood MA, Anderson JR, Ross HM (1982) Enterohepatic circulation in man of a gamma-emitting bile-acid conjugate, 23-selena-25-homotaurocholic acid (SeHCAT). J Nucl Med 23(2):126–130

    PubMed  CAS  Google Scholar 

  20. Ferraris R, Jazrawi R, Bridges C, Northfield TC (1986) Use of a gamma-labeled bile acid (75SeHCAT) as a test of ileal function. Methods of improving accuracy. Gastroenterology 90(5 Pt 1):1129–1136

    PubMed  CAS  Google Scholar 

  21. Ferraris R, Galatola G, Barlotta A, Pellerito R, Fracchia M, Cottino F et al (1992) Measurement of bile acid half-life using [75Se]HCAT in health and intestinal diseases. Comparison with [75Se]HCAT abdominal retention methods. Dig Dis Sci 37(2):225–232

    Article  PubMed  CAS  Google Scholar 

  22. Smith T, Bjarnason I (1990) Experience with a gastrointestinal marker (51CrCl3) in a combined study of ileal function using 75SeHCAT and 58CoB12 measured by whole body counting. Gut 31(10):1120–1125

    Article  PubMed  CAS  Google Scholar 

  23. Gälman C (2004) Modulation of bile acid, cholesterol metabolism in health and disease. Karolinska Institutet, Stockholm

  24. Sadik R, Abrahamsson H, Ung KA, Stotzer PO (2004) Accelerated regional bowel transit and overweight shown in idiopathic bile acid malabsorption. Am J Gastroenterol 99(4):711–718

    Article  PubMed  Google Scholar 

  25. Sadik R, Abrahamsson H, Stotzer PO (2003) Gender differences in gut transit shown with a newly developed radiological procedure. Scand J Gastroenterol 38(1):36–42

    Article  PubMed  CAS  Google Scholar 

  26. Stahlberg D, Rudling M, Angelin B, Bjorkhem I, Forsell P, Nilsell K et al (1997) Hepatic cholesterol metabolism in human obesity. Hepatology 25(6):1447–1450

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by grants from the R&D Council, Skaraborg Hospital, and The Faculty of Medicine, Göteborg University, the Swedish Research Council, the Foundation of Old Female Servants, the Grönberg, Novo Nordisk and Swedish Heart-Lung Foundations and the Karolinska Institute. The data on the diarrhoea patients in this paper were presented as a poster at the 10th UEGW meeting in Geneva in 2002.

Author information

Authors and Affiliations

  1. Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, 41345, Gothenburg, Sweden

    Antal Bajor, Anders Kilander & Henrik Sjövall

  2. Metabolism Unit, Centre for Metabolism and Endocrinology, Department of Medicine and Molecular Nutrition Unit, Centre for Nutrition and Toxicology, NOVUM, Karolinska Institute at Huddinge University Hospital, 141 86, Stockholm, Sweden

    Mats Rudling

  3. Department of Internal Medicine, Skaraborg Hospital, Skovde, Sweden

    Kjell-Arne Ung

Authors
  1. Antal Bajor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anders Kilander
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Henrik Sjövall
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mats Rudling
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kjell-Arne Ung
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Antal Bajor.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bajor, A., Kilander, A., Sjövall, H. et al. The Bile Acid Turnover Rate Assessed with the 75SeHCAT Test Is Stable in Chronic Diarrhoea but Slightly Decreased in Healthy Subjects After a Long Period of Time. Dig Dis Sci 53, 2935–2940 (2008). https://doi.org/10.1007/s10620-008-0256-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-008-0256-4

Keywords

Search

Navigation