Clinical and Translational Research
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 27, 2021; 13(4): 433-455
Published online Apr 27, 2021. doi: 10.4254/wjh.v13.i4.433
Bile acid indices as biomarkers for liver diseases I: Diagnostic markers
Jawaher Abdullah Alamoudi, Wenkuan Li, Nagsen Gautam, Marco Olivera, Jane Meza, Sandeep Mukherjee, Yazen Alnouti
Jawaher Abdullah Alamoudi, Wenkuan Li, Nagsen Gautam, Yazen Alnouti, Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198, United States
Jawaher Abdullah Alamoudi, Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
Marco Olivera, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
Jane Meza, Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, United States
Sandeep Mukherjee, Department of Internal Medicine, College of Medicine, Creighton University Medical Center, Omaha, NE 68124, United States
Author contributions: Alamoudi JA is the primary researcher, collected and analyzed data, wrote the manuscript, prepared figures and formatted manuscript for publication; Li W and Gautam N helped in the liquid chromatography-tandem mass spectrometry sample analysis; Meza J supervised, reviewed, and approved all statistical analysis and provided intellectual input and feedback on manuscript; Olivera M and Mukherjee S helped in recruiting and consenting patients and sample collection as well as experimental design; Alnouti Y is the primary investigator who was responsible for the experimental design and supervising all aspects of this project and manuscript preparation.
Supported by University of Nebraska Medical Center-Clinical Research Center and Great Plains Health Research Consortium; and Society of American Gastrointestinal and Endoscopic Surgeons, No. 36-5360-2186-001.
Institutional review board statement: The study was reviewed and approved by the University of Nebraska Medical Center Institutional Review Board (approval No. 487-10-EP).
Clinical trial registration statement: This study is registered at ClinicalTrials.gov. The registration identification number is NCT01200082.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that there is no conflict of interests in this study.
Data sharing statement: Technical appendix, statistical code, and data set available from the corresponding author at yalnouti@unmc.edu. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yazen Alnouti, PhD, Professor, Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 557 S 42nd Street, Omaha, NE 68198, United States. yalnouti@unmc.edu
Received: January 5, 2021
Peer-review started: January 5, 2021
First decision: January 25, 2021
Revised: February 11, 2021
Accepted: March 22, 2021
Article in press: March 22, 2021
Published online: April 27, 2021
Processing time: 100 Days and 11.6 Hours
Core Tip

Core Tip: We have developed the concept of “bile acids (BA) indices” based on the detailed quantitative analysis of the urinary BA profile in patients with cholestatic liver diseases. We demonstrated the use of BA indices as diagnostic biomarkers for cholestatic liver diseases. BA indices had much lower inter- and intra-individual variability compared to absolute concentrations of the total and individual BA. In addition, BA indices demonstrated high area under the receiver operating characteristic curves, and changes of BA indices were associated with the risk of having a liver disease as determined by the logistic regression analysis.