The cholesterol saturation index of human bile
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- Swell, L., Bell, C.C., Gregory, D.H. et al. Digest Dis Sci (1974) 19: 261. doi:10.1007/BF01072543
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A line of maximum cholesterol solubility was obtained by plotting the ratios of bile salt to cholesterolversus bile salt to phospholipid from model solutions simulating bile containing human biliary lecithin, human bile salts, and cholesterol. The sole factor responsible for the solubility of cholesterol (above the 3% total solid content) was found to be the proportion of bile salts to lecithin. This relationship could be expressed mathematically by a polynomial equation and the bile-salt-to-cholesterol ratio at maximum cholesterol holding capacity for a bile ascertained. From this information the percent cholesterol saturation of human bile could be determined. This method was applied to the bile obtained from 139 patients. The biles from 49 of 53 patients with known cholesterol gallstones had a cholesterol saturation index of 100% or greater, while 53 of 77 patients without evidence of cholesterol gallstones had a cholesterol-unsaturated bile. This method quantitates the exact degree of cholesterol saturation in human bile (cholesterol saturation index-CSI), and the availability of this index should be useful for diagnostic and therapeutic purposes.