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Alterations of biliary lipid composition in patients with fatty liver and those with cholesterol gallstone disease

脂肪肝和胆固醇胆石病患者胆汁脂质成分的变化

基本信息

批准号：
06670519
负责人：
SHODA Junichi
金额：
$ 1.28万
依托单位：
University of Tsukuba
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1994
资助国家：
日本
起止时间：
1994 至 1995
项目状态：
已结题

项目摘要

Formation of cholesterol supersaturated bile is a prerequisite for cholesterol gallstone disease. In order to elucidate mechanisms responsible for cholesterol supersaturated bile formation in patients with cholesterol gallstone disease, we focused on the motility of the gallbladder and small intestine, both of which are important in maintaining enterohepatic circulation of bile acids, in addition to the hepatic cholesterogenesis and bile acid synthesis. In gallstone patients with intact gallbladder emptying, the small intestinal transit and absorption of bile acids were not prolonged and impaired, as compared with control subjects. Therfore, the patients may not exhibit the characteristics of a decrease in circulating pool of bile acids, and accordingly their gallbladder bile does not become supersaturated with cholesterol. However, in patients with impaired gallbladder emptying, the small intestinal transit and absorption of bile acids were significantly prolonged and impaired. In such cases, the supersaturation of gallbladder bile may be due to the reduced pool of circulating bile acids brought about by changes in bile acid distribution, e.g., a sequestration into the hypomotile gallbladder and intestine. In gallstone patients, hepatic de novo cholesterol synthesis was significantly decreased as compared with control subjects. it is further suggested that in the formation of cholesterol supersaturated bile a hypersecretion of cholesterol derived from an exogeneous source may play a significant role.

胆固醇过饱和胆汁的形成是胆固醇结石病的先决条件。为了阐明胆固醇结石患者胆固醇过饱和胆汁形成的机制，我们重点研究了胆囊和小肠的运动，这两者除了肝脏胆固醇生成和胆汁酸合成外，在维持胆汁酸的肝肠循环方面也很重要。与对照组相比，胆囊排空完整的胆石症患者的小肠转运和胆汁酸吸收没有延长和受损。因此，患者可能不会表现出循环胆汁酸池减少的特征，因此他们的胆囊胆汁不会变得胆固醇过饱和。然而，在胆囊排空障碍的患者中，胆汁酸的小肠转运和吸收显著延长和受损。在这种情况下，胆囊胆汁的过饱和可能是由于胆汁酸分布的变化引起的循环胆汁酸池减少，例如，胆囊和小肠的隔离与对照组相比，胆结石患者的肝脏从头胆固醇合成显著减少。进一步表明，在胆固醇过饱和胆汁的形成中，源自外源的胆固醇分泌过多可能起重要作用。