elevated bile acids in newborns with biliary atresia (ba)胆汁酸升高在新生儿胆道闭锁(ba).pdfVIP

Elevated Bile Acids in Newborns with Biliary Atresia (BA) Kejun Zhou1,2,3., Na Lin3,4., Yongtao Xiao1,2,3, Yang Wang1,2,3, Jie Wen1,2,3, Gang-Ming Zou1,2,3, XueFan Gu3,4, Wei Cai1,2,3* 1 Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China, 2 Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China, 3 Shanghai Institute of Pediatric Research, Shanghai, China, 4 Department of Pediatrics, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China Abstract Biliary Atresia (BA), a result from inflammatory destruction of the intrahepatic and extrahepatic bile ducts, is a severe hepatobiliary disorder unique to infancy. Early diagnosis and Kasai operation greatly improve the outcome of BA patients, which encourages the development of early screening methods. Using HPLC coupled tandem mass spectrometry, we detected primary bile acids content in dried blood spots obtained from 8 BA infants, 17 neonatal jaundice and 292 comparison infants at 3–4 days of life. Taurocholate (TC) was significantly elevated in biliary atresia infants (0.98 60.62 mmol/ L) compared to neonatal jaundice (0.4760.30 mmol/L) and comparison infants (0.4360.40 mmol/L), with p = 0.0231 and p = 0.0016 respectively. The area under receiver operating characteristic (ROC) curve for TC to discriminate BA and comparison infants was 0.82 (95% confidence interval: 0.72–0.92). A cutoff of 0.63 mmol/L produced a sensitivity of 79.1% and specificity of 62.5%. The concentrations of total bile acids were also raised significantly in BA compared to comparison infants (6.6263.89 mmol/L vs 3.8163.06 mmol/L, p = 0.0162), with the area under ROC curve of 0.75 (95% confidence