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It is clear that microbial imbalance and dysregulated bile acid synthesis are inseparable, and they jointly contribute to hepatic inflammation via the gut-liver axis.
Additionally, results of a plasma biochemical panel revealed increased activities of lactate dehydrogenase (LDH) (305 U/L; reference range, 40-250 U/L), aspartate transaminase (AST) (1483 U/L; reference range, 90-180 U/L), alkaline phosphatase (ALP) (855 U/L; reference range, 290-750 U/L), and creatine kinase (238 U/L; reference range, 280-500) and increased concentration of bile acids (524 [micro]mol/ L; reference range, 6-35 [micro]mol/L).
For example, the gut microbiome modifies primary bile acids to secondary bile acids (Ridlon et al.
In search of a biomarker, "secondary bile acids clearly seem to be the winner, and for now, stool seems to make more sense than blood for samples," she stated.
20-22 Many studies have demonstrated a significant positive correlation between adverse fetal outcomes (including preterm delivery, meconium-stained amniotic fluid, and intrauterine fetal demise) and maternal fasting serum bile acid levels exceeding 40 mmol/L.
Also, there is need for making bile acid tests available for early and uniform diagnosis and making the process cost-effective.
Total and free bilirubins were also increased in HC fed animals since the first day of surgery, and a similar effect was observed in serum total bile acids (TBA).
investigated the long-term effect of oral CA for hereditary defects of primary bile acid synthesis and suggested it was safe and effective for 3[sz]-HSD-deficient patients.
Psyllium, which belongs to a class of gel-forming soluble fibers, disrupts the absorption or metabolizing of cholesterol by binding, entrapping, absorbing or otherwise interfering with the reabsorption of bile acids across the intestinal lumen.
In the study of 62 patients with bile acid synthesis disorders due to single enzyme defects, 64% of patients with evaluable data responded with improvements in baseline liver function tests and weight; two-thirds of patients survived longer than 3 years.
The drug, fexaramine, activates a protein called the farensoid X receptor (FXR) that plays a role in how the body releases bile acids from the liver, digests food and stores fats and sugars.