Predictive value of the concentration in serum of total 3 alpha-hydroxy bile acids in the diagnosis of hepatobiliary disease.

Fasting serum levels of total 3 alpha-hydroxy bile acids were measured in 163 consecutive patients, who clinically were suspected of having a hepatobiliary disorder. By means of routine biochemical liver tests and paraclinical investigations the clinical suspicion was confirmed in 95 patients and disproved in the other 68 patients. A comparison between this diagnostic grouping and the serum bile acids levels showed that the predictive value of serum concentrations above a discrimination value of 10 mumol/l--that is, the predictive value of a positive test--was 1.0 (0.94-1.0), whereas the corresponding predictive value of a negative test was 0.66 (0.56-0.75). Thus, fasting serum levels of total 3 alpha-hydroxy bile acids may be used as a highly specific and moderately sensitive diagnostic test for hepatobiliary disorders. Furthermore, the study showed that the nosographic sensitivity of total 3 alpha-hydroxy bile acids in patients with verified cirrhosis was significantly greater than that of serum bilirubins and not significantly different from those of the other routine biochemical liver tests.