ArticleAlimentary pharmacology & therapeutics2017
Performance characteristics of serum C4 and FGF19 measurements to exclude the diagnosis of bile acid diarrhoea in IBS-diarrhoea and functional diarrhoea.
Article in Alimentary pharmacology & therapeutics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Methods for diagnosing bile acid malabsorption: a systematic review.BMC gastroenterology · 2019Pooled it
- Analysis of C4 Concentrations to Predict Impact of Patient-Reported Diarrhea Associated With the Ileal Bile Acid Transporter Inhibitor Linerixibat.CPT: pharmacometrics & systems pharmacology · 2025Trial
- Bile Acid Malabsorption Panel in Patients with Treated Neuroendocrine Tumors.Digestive diseases and sciences · 2026Article
- Review
- Glucagon-Like Peptide-1 Receptor Agonists for Bile Acid Diarrhea: Emerging Evidence and Clinical Implications.Cureus · 2026Review
- [Bile Acid Diarrhea].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2024Review
- Bile Acid Diarrhea: From Molecular Mechanisms to Clinical Diagnosis and Treatment in the Era of Precision Medicine.International journal of molecular sciences · 2024Review
- Potential Value of Biomarker-Based Approaches for Evaluation and Management of Costly Functional Gastrointestinal Diseases.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Review
- Article
- New Developments in Bile Acid Diarrhea.Gastroenterology & hepatology · 2023Article
- Current and Future Therapeutic Options for Irritable Bowel Syndrome with Diarrhea and Functional Diarrhea.Digestive diseases and sciences · 2023Review
- The Impact of Confounders on Symptom-Endoscopic Discordances in Crohn's Disease.Crohn's & colitis 360 · 2023Article
- Review
- Fat Malabsorption and Ursodeoxycholic Acid Treatment in Children With Reduced Organic Solute Transporter-α (JPGN reports · 2022Article
- Review
- Pathophysiology and Clinical Management of Bile Acid Diarrhea.Journal of clinical medicine · 2022Review
- Bile Acid Diarrhea in Adults and Adolescents.Neurogastroenterology and motility · 2022Review
- BAD on the Runs: Improved Diagnosis of Idiopathic Bile Acid Diarrhea.Digestive diseases and sciences · 2022Article
- Downregulation of Serum and Distal Ileum Fibroblast Growth Factor19 in Bile Acid Diarrhoea Patients.Digestive diseases and sciences · 2022Article
- Functional, Diagnostic and Therapeutic Aspects of Bile.Clinical and experimental gastroenterology · 2022Article
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8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe serum biomarkers, elevated 7αC4 (C4) and decreased FGF19, have been proposed as screening tests for bile acid diarrhoea.
aimTo analyse prevalence, specificity and reproducibility of fasting C4 and FGF19 in identifying bile acid diarrhoea in patients with irritable bowel syndrome with predominant diarrhoea or functional diarrhoea (summarised as IBS-D).
methodsWe prospectively studied fasting serum C4 and FGF19 in 101 IBS-D patients; we reviewed data from 37 of the 101 patients with prior fasting serum C4 and FGF19 and from 30 of the 101 patients with prior faecal bile acids per 48 hours. We compared results with normal values (C4 ≥52.5 ng/mL [n=184], FGF-19 ≤61.7 pg/mL [n=50]). We used Spearman correlation and Bland-Altman plots to appraise reproducibility.
resultsAmong the 101 patients, there was a negative correlation between serum C4 and FGF19 (Rs=-.342, P=.0005). Bile acid diarrhoea was diagnosed in 10 patients based on elevated serum C4 levels (mean 23.5±23.1 [SD] ng/mL) and 21 patients based on decreased FGF19 levels (121.6±84.2 pg/mL). With replicate tests in patients with stable IBS-D, 78% of C4 and 70% of FGF19 measurements remained concordant, with 3% and 11% respectively consistently positive for bile acid diarrhoea in the 101 patients. Compared to 48 hours faecal bile acids, specificity for C4 and FGF19 was 83% and 78%, respectively. Bland-Altman plots demonstrated greater reliability of C4 than FGF19.
conclusionsAmong 101 patents with IBS-D, fasting FGF19 and C4 levels had good specificity and negative predictive value, suggesting utility as screening tests to exclude bile acid diarrhoea.
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