Skip to main content
SpringerLink
Log in

Comparison of biliary lipid secretion in non-obese cholesterol gallstone patients with normal, young, male volunteers

  • Originalien
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Summary

Measurements of biliary lipid secretion rates were performed in 14 non-obese patients with radiolucent gallstones (9 females, 5 males; mean age 48 years; mean body weight 65 kg) and in 14 healthy male volunteers (mean age 26 years, mean body weight 74 kg). The results in the gallstone patients differ in several respect from those obtained in the volunteers. Molar percentage of cholesterol was higher (5.8 versus 5.0 mol%;P<0.05) and molar percentage of bile acids lower (73.8 versus 76.9 mol%;P<0.05) in the gallstone patients. However, these changes were not followed by notable differences in cholesterol saturation of bile (94% vs 88%). Generally, hepatic secretion rates of cholesterol were significantly elevated in the gallstone patients (55 vs 46 mg/h;P<0.05) whereas outputs of bile acids and phospholipids did not differ between the two groups. Although patients with cholesterol gallstones tended to have a lower percentage of chenodeoxycholic acid (38 versus 42 mol%) and increased deoxycholic acid (23 versus 16 mol%) in their bile, these differences were not significant. Nevertheless, in patients with cholesterol gallstones a significant positive correlation between deoxycholic acid secretion and cholesterol output was observed. For the whole group of patients and volunteers a positive correlation between age and cholesterol secretion could be demonstrated. The higher hepatic cholesterol secretion in gallstone patients seems not be due to differences in body weight, but rather to the older age of the patients. These results suggest that age itself or age-related changes in deoxycholic acid metabolism contributes to biliary cholesterol output in non-obese patients with cholesterol gallstones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CA:

cholic acid

CDCA:

chenodeoxycholic acid

DCA:

deoxycholic acid

References

  1. Admirand WH, Small DM (1968) The physicochemical basis of cholesterol gallstone formation in man. J Clin Invest 47:1043–1052

    Google Scholar 

  2. Bartlett GR (1959) Phosphorous assay in column chromatography. J Biol Chem 234:466–468

    Google Scholar 

  3. Bateson MC, Maclean D, Ross PE, Bouchier IAD (1978) Clofibrate therapy and gallstone induction. Digestive Diseases 23:623–628

    Google Scholar 

  4. Bennion LJ, Grundy SM (1975) Effects of obesity and caloric intake on biliary lipid metabolism in man. J Clin Invest 56:996–1011

    Google Scholar 

  5. Bennion LJ, Grundy SM (1978) Risk factors for the development of cholelithiasis in man. N Engl J Med 299:1161–1167, 1221–1227

    Google Scholar 

  6. Bennion LJ, Mott DM, Howard BV (1980) Oral contraceptives raise the cholesterol saturation of bile by incresing biliary cholesterol secretion. Metabolism 29:18–22

    Google Scholar 

  7. Boston Collaborative Drug Surveillance Programme (1973) Oral contraceptives and venous thromboembolic disease, surgically confirmed gallbladder diesease, and breast tumors. Lancet I:1399–1404

    Google Scholar 

  8. Boston Collaborative Drug Surveillance Programme (1974) Surgically confirmed gallbladder disease, venous thromboembolic disease, and breast tumors in relation to post-menopausal estrogen therapy. New Engl J Med 290:15–19

    Google Scholar 

  9. Carulli N, Ponz de Leon M, Zironi F, Iori R, Loria P (1980) Bile-acid feeding and hepatic sterol metabolism: effect of deoxycholic acid. Gastroenterology 79:637–641

    Google Scholar 

  10. Coronary Drug Project Research Group (1977) Gallbladder disease as a side effect of drugs influencing lipid metabolism: Experience in the Coronary Drug Project. N Engl J Med 296:1185–1190

    Google Scholar 

  11. Einarsson K, Nilsell K, Leijd B, Angelin B (1985) Influence of age on secretion of cholesterol and synthesis of bile acids by the liver. N Engl J Med 313:277–282

    Google Scholar 

  12. Everson GT, Lawson MJ, McKinley C, Showalter R, Kern F Jr (1983) Gallbladder and small intestinal regulation of biliary lipid secretion during intraduodenal infusion of standard stimuli. J Clin Invest 71:596–603

    Google Scholar 

  13. Grundy SM, Ahrens EH jr, Salen G, Schreibman PH, Nestel PJ (1972) Mechanisms of action of clofibrate on cholesterol metabolism in patients with hyperlipidemia. J Lipid Res 13:531–551

    Google Scholar 

  14. Grundy SM, Metzger AL (1972) A physiological method for estimation of hepatic secretion of biliary lipids in man. Gastroenterology 62:1200–1217

    Google Scholar 

  15. Hegardt FG, Dam H (1971) The solubility of cholesterol in aqueous solutions of bile salts and lecithin. Z Ernährungswiss 10:223–233

    Google Scholar 

  16. Hofmann AF, Grundy SM, Lachin JM, Lan S-P, Baum RA, Hanson RF, Hesh T, Hightower NC, Marks JW, Mekhjian T, Shaefer RA, Soloway RD, Thistle JL, Thomas FB, Tyor MP and the National Cooperative Gallstone Study Group (1982) Pretreatment biliary lipid composition in white patients with radiolucent gallstones in the National Cooperative Gallstone Study. Gastroenterology 83:738–752

    Google Scholar 

  17. Holzbach RT, Marsh M, Olszewski M, Holan K (1973) Cholesterol solubility in bile. Evidence that supersaturated bile is frequent in healthy man. J Clin Invest 52:1467–1479

    Google Scholar 

  18. La Russo NF, Szczepanik PA, Hofmann AF (1977) Effect of deoxycholic acid ingestion on bile acid metabolism and biliary lipid secretion in normal subjects. Gastroenterology 72:132–140

    Google Scholar 

  19. Leiss O, von Bergmann K, Gnasso A, Augustin J (1985) Effect of gemfibrozil on biliary lipid metabolism in normolipemic subjects. Metabolism 34:74–82

    Google Scholar 

  20. Leiss O, von Bergmann K, Streicher U, Strotkoetter H (1984) Effect of three different dihydroxy bile acids on intestinal cholesterol absorption in normal volunteers. Gastroenterology 87:144–149

    Google Scholar 

  21. Low-Beer TS, Pomare EW (1975) Can colonic bacterial metabolites predispose to cholesterol gall stones? Br Med J 1:438–440

    Google Scholar 

  22. Mok HYI, von Bergmann K, Grundy SM (1979) Effects of continuous and intermittend feeding on biliary lipid outputs in man: application for measurements of intestinal absorption of cholesterol and bile acids. J Lipid Res 20:389–398

    Google Scholar 

  23. Northfield TC, Hofmann AF (1975) Biliary lipid output during three meals and overnight fast. I. Relationship to bile acid pool size and cholesterol saturation of bile in gallstone and control subjects. Gut 16:1–17

    Google Scholar 

  24. Paumgartner G, Horak W, Probst P, Grabner G (1971) Effect of phenobarbital on bile flow and bile salt excretion in the rat. Naunyn-Schmiedeberg's Arch Pharmakol 270:98–102

    Google Scholar 

  25. Pomare EW, Heaton KW (1973) Alteration of bile salt metabolism by dietary fibre (bran). Br Med J 4:262–264

    Google Scholar 

  26. Report from the Committee of Principal Investigators (1978) A co-operative trial in the primary prevention of ischaemic heart disease using clofibrate. Br Heart J 40:1069–1118

    Google Scholar 

  27. Shaffer EA, Small DM (1977) Biliary lipid secretion in cholesterol gallstone disease. J Clin Invest 59:828–840

    Google Scholar 

  28. Tarpila S, Miettinen TA, Metsaeranta L (1978) Effects of bran on serum cholesterol, faecal mass, fat, bile acids and neutral sterols, and biliary lipids in patients with diverticular disease of the colon. Gut 19:137–141

    Google Scholar 

  29. Thornton JR, Heaton KW (1981) Do colonic bacteria contribute to cholesterol gall-stone formation? Effects of lactulose on bile. Br Med J 282:1018–1020

    Google Scholar 

  30. van der Werf SDJ, Huiibregts AWM, Lamers HLM, van Berge Hengouwen GP, van Tongeren JHM (1981) Age dependent differences in human bile acid metabolism and 7a-dehydroxylation. Eur J Clin Invest 11:425–431

    Google Scholar 

  31. von Bergmann K, Epple-Gutsfeld M, Leiss O (1984) Differences in the effects of chenodeoxycholic and ursodeoxycholic acid on biliary lipid secretion and bile acid synthesis in patients with gallstones. Gastroenterology 87:136–143

    Google Scholar 

  32. von Bergmann K, Leiss O (1984) Effect of short-term treatment with bezafibrate and fenofibrate on biliary lipid metabolism in patients with hyperlipoproteinaemia. Eur J Clin Invest 14:150–154

    Google Scholar 

Download references

Author information

Author notes

  1. K. von Bergmann

    Present address: Department of Internal Medicine and Biochemistry, University of Texas Health Science Center at Dallas, 75235, Dallas, Texas

Authors and Affiliations

  1. Medizinische Klinik der Universität Bonn, Germany

    O. Leiß & K. von Bergmann

Authors
  1. O. Leiß
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. von Bergmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Dedicated to Professor Dr. Hans J. Dengler on the occasion of his 60th birthday

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leiß, O., von Bergmann, K. Comparison of biliary lipid secretion in non-obese cholesterol gallstone patients with normal, young, male volunteers. Klin Wochenschr 63, 1163–1169 (1985). https://doi.org/10.1007/BF01740592

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01740592

Key words

Search

Navigation