Cholenic acid is a monohydroxy bile acid. It is a cholesterol oxidation product formed by 7α-hydroxylation of 27-hydroxycholesterol (Item Nos. 14790 | 14791), as well as a precursor in the biosynthesis of chenodeoxycholic acid . Levels of cholenic acid are increased in patients with neonatal liver disease harboring mutations in CYP7A1, the gene encoding 7α-hydroxylase, as well as in patients with intrahepatic and extrahepatic cholestasis.