Chemical structures and descriptions

Bile acids

Bile2

What is measured?

Bile acid precursor: 7α-hydroxy-cholesten-3-one (C4). Primary bile acids: cholic acid (CA), glycocholic acid (GCA), taurocholic acid (TCA), chenodeoxycholic acid (CDCA), glycochenodeoxycholic acid (GCDCA), taurochenodeoxycholic acid (TCDCA), hyocholic acid (HCA), glycohyocholic acid (GHCA), taurohyocholic acid (THCA), tauro-alfa-muricholic acid (TaMCA). Secondary bile acids: deoxycholic acid (DCA), glycodeoxycholic acid (GDCA), taurodeoxycholic acid (TDCA), lithocholic acid (LCA), glycolithocholic acid (GLCA), taurolithocholic acid (TLCA), lithocholic acid sulfate (LCAs), Iso-litocholic acid (iLCA), ursodeoxycholic acid (UDCA), glycoursodeoxycholic acid (GUDCA), tauroursodeoxycholic acid (TUDCA), hyodeoxycholic acid (HDCA), glycohyodeoxycholic acid (GHDCA), taurohyodeoxycholic acid (THDCA).
Method: LC-MS/MS

The bile acids

Bile acids are amphipathic molecules synthesized from cholesterol. They are categorized as primary (P) bile acids, synthesized in the liver, and secondary (S) bile acids, produced in the colon by bacterial modifications of other bile acids. Both types are subjected to conjugation (amidation) with glycine (Gly) or taurine (Tau) in the liver, and may also undergo hepatic isomerization, sulfation, and glucuronidation. Gut bacteria modify bile acids through several key pathways, including deconjugation, dehydroxylation, dehydrogenation, oxidation and epimerization, sulfation and esterification, as well as reconjugation with amino acids other than glycine and taurine, contributing to a large diversity of bile acid metabolites in the intestine. Most of these (≈95%) undergo enterohepatic circulation. Bile acids are essential for the digestion and absorption of dietary fats and fat-soluble vitamins, but have increasingly been recognized as signaling molecules across several tissues by serving as ligands for numerous receptors, including FXR, TGR5, PXR, VDR, and NR4A1.

Indication(s)

Circulating bile acids have been investigated in relation to (cholestatic) liver diseases, fatty liver disease, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), short bowel syndrome, clostridium difficile infection, obesity, and cardiometabolic, inflammatory, neoplastic (cancerous) and neurodegenerative diseases.

Specimen, collection and processing

Matrix: Serum or EDTA plasma.
Volume: Minimum volume is 60 µL, but 200 µL is optimal and allows reanalysis.
Preparation and stability: Samples should be put on ice immediately after collection and stored at −80 °C.

Transportation

Frozen, on dry ice. For general instruction on transportation, click here.

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Reported values, interpretation

Fasting serum/plasma total bile acid levels in healthy adults are typically 2–10 μmol/L. Cholic acid (CA) and chenodeoxycholic acid (CDCA) are present in roughly equal amounts, each typically less than 2–5 μmol/L. Deoxycholic acid (DCA) is the main secondary bile acid detected, with mean serum levels around 0.2 – 0.3 μmol/L. Conjugated primary bile acids (glycocholic and taurocholic acids) are the dominant forms measured in healthy controls, with mean total concentrations around 0.8–1.9 μmol/L.

Literature

1. Mohanty, I., Allaband, C., Mannochio-Russo, H., El Abiead, Y., Hagey, L. R., Knight, R. et al. (2024). The changing metabolic landscape of bile acids – keys to metabolism and immune regulation. Nat Rev Gastroenterol Hepatol, 21(7), 493-516.

 

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Per Christian Eriksen

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Per Magne Ueland has been Professor at the University of Bergen 1987-2018. He is one of the founders of Bevital AS and the scientific advisor in Bevital since 2023. His interests includes biomarkers related to nutrition, inflammation, ageing and life-style related chronic diseases. Per is committed to the development of precise, high-throughput mass spectrometry methods, tailored for metabolic profiling of biobank specimens from large cohorts.

Ove completed his education in Biomedical Science at the Western Norway University of Applied Sciences, supplemented by specialized training in Electrical Engineering and Electronics at the Royal Norwegian Naval Training Establishment and the National Institute of Technology. With many years of experience as a biomedical scientist in hospital laboratories—specializing primarily in microbiology—he brings a unique blend of clinical and technical expertise to his work. Ove focuses on the design and prototyping of electronics, as well as the service and maintenance of laboratory instrumentation, ensuring that technical equipment and workflows remain precise and reliable for research-focused activities.

Lena holds a master’s degree in biology from the University of Bergen, where her thesis focused on identifying whale skeletons using zooarchaeology by mass spectrometry (ZooMS). At Bevital, she works with LC‑MS/MS analyses and method development, focusing on accurate and reliable testing of biological samples. She is dedicated to ensuring precise and high‑quality results that contribute to reliable scientific outcomes and support ongoing research efforts.

Marit holds a degree in chemical engineering from Bergen Ingeniørhøyskole, which is now part of the Western Norway University of Applied Sciences. She works with quantitative analysis and method development on LC-MS/MS at the laboratory of Bevital AS.

Randi holds a Master of Science in Chemical Process Engineering from the Norwegian University of Science and Technology (NTNU). She has been part of Bevital since its very beginning, contributing her expertise primarily to the LC-MS/MS platforms, but also to the microbiological assays. In 2021, she stepped into the role of Manager/CEO, where she is dedicated to strengthening Bevital’s innovative profile and ensuring the company’s continued growth and success. She is especially motivated by advancing research that improves health insights and by fostering collaboration that drives scientific and technological progress.

Ove completed a bachelor’s degree in Biomedical Laboratory Sciences at the Western Norway University of Applied Sciences in Bergen. With extensive experience in method development and expertise in GC-MS/MS, he specializes in optimizing analytical techniques for research-focused studies. At Bevital, Ove is dedicated to advancing laboratory methods and workflows, contributing to innovative research through precise and reliable analytical solutions.

Lene holds a bachelor’s degree in Biomedical Laboratory Science from the Western Norway University of Applied Sciences, where she is also completing her master’s degree in Medical Laboratory Technology, expected to graduate in 2026. Her master’s thesis focuses on method validation in fatty acid analysis. At Bevital, she works with GC-MS/MS analyses, routinely performing SCFA measurements and emphasizing accurate and reliable testing of biological samples. With her strong laboratory background, Lene is committed to delivering high-quality results that support medical research.

Klaus earned his PhD in physics from the University of Münster in Germany. For more than thirty years he has specialized in Time‑of‑Flight mass spectrometry, contributing innovative approaches to SNP genotyping and protein quantification. Together with his colleague Lene Njåstad, he oversees Bevital’s Olink Proteomics service. He also leads Bevital’s website and media design efforts, ensuring a clear and informative public presence.

Adrian holds a PhD in diabetes research, along with bachelor’s and master’s degrees in biomedical science and public health, respectively. With over 20 years of experience in laboratory science, he leads high-precision metabolite analyses and method development at Bevital. His expertise centers on quantifying biomarkers, metabolite classes, and metabolic pathways related to nutrition, cardiovascular and neurodegenerative diseases, and cancer. Adrian is committed to advancing research quality and actively collaborates nationally and internationally, leveraging targeted metabolomics to support innovative, multidisciplinary research.

Statistical power is the probability that a statistical test will correctly reject a false null hypothesis (H0​) when a specific alternative hypothesis (H1​) is true. H0​ is the null hypothesis, which states there is no effect or no difference. H1​ is the alternative hypothesis, which states there is a real effect or difference. Alpha (α) is the probability of a Type I error (a false positive), which is the risk of incorrectly rejecting the H0​ when it is actually true. You set this value before the experiment, commonly at 0.05. Beta (β) is the probability of a Type II error (a false negative), which is the risk of failing to reject the H0​ when it is actually false.

Power is calculated as 1−β. Increasing power means you are decreasing the probability of making a Type II error.

Several factors can be adjusted to increase the power of a statistical test:

  • Effect Size: This is the magnitude of the difference you are trying to detect. A larger effect size is easier to detect, thus increasing power. 

  • Sample Size: The number of observations in a study. A larger sample size provides more information about the population, reducing the margin of error and increasing the power to detect a true effect.

  • Variation: Refers to the spread or standard deviation of the data within the population. Less variation makes it easier to distinguish a real effect from random noise, thereby increasing power.

  • Alpha (): Increasing the alpha level (e.g., from 0.05 to 0.10) also increases power, but at the cost of a higher risk of a Type I error. This trade-off is often undesirable.

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