Advertisement

Intestinal metabolism of bile acids and cholelithiasis

  • N. Carulli
  • P. Loria
  • D. Menozzi

Abstract

In 1969 Cleave1 proposed the term ‘the saccharine disease’ to include diverse conditions associated with overconsumption, such as obesity, diabetes and coronary heart disease, or attributed to colonic stasis such as constipation, haemorrhoids and diverticulosis. In the author’s view such diseases share a common aetiological factor represented by the consumption of refined carbohydrates which has two effects: it increases the caloric intake/weight of ingested food ratio, and alters the colonic function due to the diminished ingestion of roughage, lost during the refining procedures.

Keywords

Bile Acid Gallstone Disease Cholesterol Gallstone Lithocholic Acid Biliary Lipid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Cleave, T. L., Campbell, G. D. and Painter, N. S. (1969). Diabetes, Coronary Thrombosis and the Saccharine Disease. 2nd edn. ( Bristol: Wright )Google Scholar
  2. 2.
    Heaton, K. W. (1973). The epidemiology of gallstones and suggested aetiology. Clin. Gastroenterol., 2, 67–83PubMedGoogle Scholar
  3. 3.
    Sarles, H., Chalvet, H., Ambrosi, L., Gazeix, N. and D’Ortoli, A. (1957). Etude statistique des facteurs diététiques dans la pathologie de la lithiase biliaire humaine. Sem. Hôp. Paris, 33, 3424–3438PubMedGoogle Scholar
  4. 4.
    Sarles, H., Chabert, C., Pommeau, Y., Save, E., Mouret, H. and Gerolami, A. (1969). Diet and cholesterol gallstones. A study of 101 patients with cholelithiasis compared to 101 matched controls. Am. J. Dig. Dis., 14, 531–534PubMedCrossRefGoogle Scholar
  5. 5.
    Sarles, H., Hauton, J., Planche, N. E., Lafont, H. and Gerolami, A. (1970). Diet, cholesterol gallstones and composition of the bile. Am. J. Dig. Dis., 15, 251–260PubMedCrossRefGoogle Scholar
  6. 6.
    Sarles, H., Gerolami, A. and Bord, A. (1978). Diet and cholesterol gallstones. A further study. Digestion, 17, 128–134PubMedCrossRefGoogle Scholar
  7. 7.
    Reid, J. M., Fullmer, D. S., Pettigrew, K. D., Burch, T. A., Bennett, P. H., Miller, M. and Whedon, G. D. (1971). Nutrient intake of Pima Indian women: relationship to diabetes mellitus and gallbladder disease. Am. J. Clin. Nutr., 24, 1281–1289PubMedGoogle Scholar
  8. 8.
    Thornton, J. R., Emmett, P. M. and Heaton, K. W. (1983). Diet and gallstones: effects of refined and unrefined carbohydrate diets on bile cholesterol saturation and bile acid metabolism. Gut, 24, 2–6PubMedCrossRefGoogle Scholar
  9. 9.
    Williams, C. N., Johnston, J. L., McCarthy, S. and Field, C. A. (1981). Biliary lipid, bile acid composition and dietary correlations in Micmac Indian women. A population study. Dig. Dis. Sci., 26, 42–49PubMedCrossRefGoogle Scholar
  10. 10.
    Gross, H. M. B. (1929). A statistical study of cholelithiasis. J. Pathol. Bacteriol., 32, 503–526CrossRefGoogle Scholar
  11. 11.
    Marinović, I., Guerra, C. and Larach, G. (1972). Incidencia de litiasis biliar en material de autopsias y análisis de composición de los cálculos. Rev. Med. Chil., 100, 1320–1327PubMedGoogle Scholar
  12. 12.
    Van der Linden, W. (1961). Some biological traits in female gallstone disease patients: a study of body build, parity and serum cholesterol level with a discussion of some problems of selection in observational hospital data. Acta Chir. Scand. (Suppl.), 269, 1–94Google Scholar
  13. 13.
    Friedman, G. D., Kannel, W. B. and Dawber, T. R. (1966). The epidemiology of gallbladder disease: observations in the Framingham study. J. Chron. Dis., 19, 273–292PubMedCrossRefGoogle Scholar
  14. 14.
    Sturdevant, R. A. L., Pearce, M. L. and Dayton, S. (1973). Increased prevalence of cholelithiasis in men ingesting a serum-cholesterol-lowering diet. N. Engl. J. Med., 288, 24–27PubMedCrossRefGoogle Scholar
  15. 15.
    Bennion, L. J. and Grundy, S. M. (1975). Effects of obesity and caloric intake on biliary lipid metabolism in man. J. Clin. Invest., 56, 996–1011PubMedCrossRefGoogle Scholar
  16. 16.
    Shaffer, E. A. and Small, D. M. (1977). Biliary lipid secretion in cholesterol gallstone disease: the effect of cholecystectomy and obesity. J. Clin. Invest., 59, 828–840PubMedCrossRefGoogle Scholar
  17. 17.
    Mabee, T. M., Meyer, P., DenBesten, L. and Mason, E. E. (1976). The mechanism of increased gallstone formation in obese human subjects. Surgery, 79, 460–468PubMedGoogle Scholar
  18. 18.
    Low-Beer, T. S. and Pomare, E. W. (1975). Can colonie bacterial metabolites predispose to cholesterol gallstones? Br. Med. J., 1, 438–440PubMedCrossRefGoogle Scholar
  19. 19.
    Macdonald, I. A., Bokkenheuser, V. D., Winter, J., McLernon, A. M. and Mosbach, E. H. (1983). Degradation of steroids in the human gut. J. Lipid Res., 24, 675–700PubMedGoogle Scholar
  20. 20.
    Hepner, G. W., Hofmann, A. F., Malagelada, J. R., Szczepanik, A. P. and Klein, P. D. (1974). Increased bacterial degradation of bile acids in cholecystectomized patients. Gastroenterology, 66, 556–564PubMedGoogle Scholar
  21. 21.
    Pomare, E. W. and Heaton, K. W. (1973). The effect of cholecystectomy on bile salt metabolism. Gut, 14, 753–762PubMedCrossRefGoogle Scholar
  22. 22.
    Almond, H. R., Vlahcevic, Z. R., Bell, C. C., Gregory, D. H. and Swell, L. (1973). Bile acid pools, kinetics and biliary lipid composition before and after cholecystectomy. N. Engl. J. Med., 289, 1213–1216PubMedCrossRefGoogle Scholar
  23. 23.
    Heaton, K. W. (1977). Disturbances of bile acid metabolism in intestinal disease. Clin. Gastroenterol., 6, 69–89PubMedGoogle Scholar
  24. 24.
    Abaurre, R., Gordon, S. G., Mann, J. G. and Kern, F. Jr. (1969). Fasting bile salt pool size and composition after ileal resection. Gastroenterology, 57, 679–688PubMedGoogle Scholar
  25. 25.
    Van der Werf, S. D. J., Huijbregts, A. W. M., Lamers, H. L M., Van Berge-Henegouwen, G. P. and Van Tongeren, J. H. M. (1981). Age dependent differences in human bile acid metabolism and 7α-dehydroxylation. Eur. J. Clin. Invest., 11, 425–431PubMedCrossRefGoogle Scholar
  26. 26.
    Wynder, E. L. and Reddy, B. S. (1974). Metabolic epidemiology of colorectal cancer. Cancer (Suppl.), 34, 801–806PubMedCrossRefGoogle Scholar
  27. 27.
    Hepner, G. W. (1975). Altered bile acid metabolism in vegetarians. Am. J. Dig. Dis., 20, 935–940PubMedCrossRefGoogle Scholar
  28. 28.
    Huijbregts, A. W. M., Van Schaik, A., Van Berge-Henegouwen, G. P. and Van der Werf, S. D. J. (1980). Serum lipids, biliary lipid composition, and bile acid metabolism in vegetarians as compared to normal controls. Eur. J. Clin. Invest., 10, 443–449PubMedCrossRefGoogle Scholar
  29. 29.
    Pomare, E. W. and Heaton, K. W. (1973). Alteration of bile salt metabolism by dietary fibre (bran). Br. Med. J., 4, 262–264PubMedCrossRefGoogle Scholar
  30. 30.
    Pomare, E. W., Heaton, K. W., Low-Beer, T. S. and Espiner, H. J. (1976). The effect of wheat bran upon bile salt metabolism and upon the lipid composition of bile in gallstone patients. Am. J. Dig. Dis., 21, 521–526PubMedCrossRefGoogle Scholar
  31. 31.
    McDougall, R. M., Yakymyshyn, L., Walker, K. and Thurston, O. G. (1978). Effect of wheat bran on serum lipoproteins and biliary lipids. Can. J. Surg., 21, 433–435PubMedGoogle Scholar
  32. 32.
    Wicks, A. C. B., Yeates, J. and Heaton, K. W. (1978). Bran and bile: time-course of changes in normal young men given a standard dose. Scand. J. Gastroenterol., 13, 289–292PubMedCrossRefGoogle Scholar
  33. 33.
    Huijbregts, A. W. M., Van Berge-Henegouwen, G. P., Hectors, M. P. C., Van Schaik, A. and Van der Werf, S. D. J. (1980). Effects of a standardized wheat bran preparation on biliary lipid composition and bile acid metabolism in young healthy males. Eur. J. Clin. Invest., 10, 451–458PubMedCrossRefGoogle Scholar
  34. 34.
    Meyer, P. D., Den Besten, L. and Mason, E. E. (1979). The effects of a high-fiber diet on bile acid pool size, bile acid kinetics, and biliary lipid secretory rates in the morbidly obese. Surgery, 85, 311–316PubMedGoogle Scholar
  35. 35.
    Hepner, G. W. (1975). Effect of decreased gallbladder stimulation on enterohepatic cycling and kinetics of bile acids. Gastroenterology, 68, 1574–1581PubMedGoogle Scholar
  36. 36.
    Hofmann, A. F., Grundy, S. M., Lachin, J. M., Lan, S. P., Baum, R. A., Hanson, R. F., Hersh, T., Hightower, N. C. Jr., Marks, J. W., Mekhijan, H., Shaefer, R. A., Soloway, R. D., Thistle, J. L., Thomas, F. B., Tyor, M. P. 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, 738–752PubMedGoogle Scholar
  37. 37.
    Sjövall, J. (1960). Bile acids in man under normal and pathological conditions; bile acids and steroids. Clin. Chim. Acta, 5, 33–41CrossRefGoogle Scholar
  38. 38.
    Pomare, E. W. and Heaton, K. W. (1973). Bile salt metabolism in patients with gallstones in functioning gallbladder. Gut, 14, 885–890PubMedCrossRefGoogle Scholar
  39. 39.
    Van der Linden, W. and Bergman, F. (1977). An analysis of data on human hepatic bile. Relationship between main bile components, serum cholesterol and serum triglycerides. Scand. J. Clin. Lab. Invest., 37, 741–747PubMedCrossRefGoogle Scholar
  40. 40.
    Bennion, L. J., Mott, D. M. and Howard, B. V. (1980). Oral contraceptives raise the cholesterol saturation of bile increasing biliary cholesterol secretion. Metabolism, 29, 18–22PubMedCrossRefGoogle Scholar
  41. 41.
    Ahlberg, J., Angelin, B. and Einarsson, K. (1980). Biliary lipid composition in normo-and hyperlipoproteinemia. Gastroenterology, 79, 90–94PubMedGoogle Scholar
  42. 42.
    Ponz de Leon, M., Carulli, N., Iori, R., Loria, P. and Romani, M. (1983). Regulation of cholesterol absorption by bile acids: role of deoxycholic and cholic acid pool expansion on dietary cholesterol absorption. Ital. J. Gastroenterol., 15, 86–93Google Scholar
  43. 43.
    LaRusso, N. F., Szczepanic, P. A. and Hofmann, A. F. (1977). Effect of deoxycholic acid ingestion on bile acid metabolism and biliary lipid secretion in normal subjects. Gastroenterology, 72, 132–140PubMedGoogle Scholar
  44. 44.
    Ahlberg, J., Angelin, B., Einarsson, K., Hellström, K. and Leijd, B. (1977). Influence of deoxycholic acid on biliary lipids in man. Clin. Sci. Mol. Med., 53, 249–256PubMedGoogle Scholar
  45. 45.
    Carulli, N., Ponz de Leon, M., Zironi, F., Iori, R. and Loria, P. (1980). Bile acid feeding and hepatic sterol metabolism: effect of deoxycholic acid. Gastroenterology, 79, 637–641PubMedGoogle Scholar
  46. 46.
    Low-Beer, T. S. and Nutter, S. (1978). Colonic bacterial activity, biliary cholesterol saturation, and pathogenesis of gallstones. Lancet, 2, 1063–1064PubMedCrossRefGoogle Scholar
  47. 47.
    Carulli, N., Ponzde Leon, M., Loria, P., Iori, R., Rosi, A. and Romani, M. (1981). Effect of the selective expansion of cholic acid pool on bile lipid composition: possible mechanism of bile acid induced biliary cholesterol desaturation. Gastroenterology, 81, 539–546PubMedGoogle Scholar
  48. 48.
    Thornton, J. R. and Heaton, K. W. (1981). Effects of lactulose on bile composition. In Paumgartner, G., Stiehl, A. and Gerok, W. (eds.) Bile Acids and Lipids, pp. 181–188. ( Lancaster: MTP Press )Google Scholar
  49. 49.
    Salvioli, G., Salati, R., Bondi, M., Fratalocchi, A., Sala, B. M. and Gibertini, A. (1982). Bile acid transformation by the intestinal flora and cholesterol saturation in bile. Effects of Streptococcus faecium administration. Digestion, 23, 80–88PubMedCrossRefGoogle Scholar
  50. 50.
    Low-Beer, T. S., Pomare, E. W. and Morris, J. S. (1972). Control of bile salt synthesis. Nature: New Biol., 238, 215–216Google Scholar
  51. 51.
    Pomare, E. W. and Low-Beer, T. S. (1975). The selective inhibition of chenodeoxycholate synthesis by cholate metabolites in man. Clin. Sci. Mol. Med., 48, 315–321PubMedGoogle Scholar
  52. 52.
    Carui, N. and Ponz de Leon, M. (1982). How does bile acid pool composition regulate bile cholesterol saturation? ltd. J. Gastroenterol., 14, 179–183Google Scholar
  53. 53.
    Wagner, C. I., Trotman, B. V. and Soloway, R. D. (1976). Kinetic analysis of biliary lipid excretion in man and dog. J. Clin. Invest., 57, 473–477PubMedCrossRefGoogle Scholar
  54. 54.
    Armstrong, M. J. and Carey, M. C. (1982). The hydrophobic-hydrophilic balance of bile salts. Inverse correlation between reverse-phase high performance liquid Chromatographic mobilities and micellar cholesterol-solubilizing capacities. J. Lipid Res., 23, 70–80PubMedGoogle Scholar
  55. 55.
    Hegardt, F. G. and Dam, H. (1971). The solubility of cholesterol in aqueous solutions of bile salts and lecithin. Z. Ernährungswiss., 10, 223–233PubMedCrossRefGoogle Scholar
  56. 56.
    Neiderhiser, D. H. and Roth, H. P. (1968). Cholesterol solubilization by solutions of bile salts and bile salts plus lecithin. Proc. Soc. Exp. Biol. Med., 128, 221–225PubMedGoogle Scholar
  57. 57.
    Carulli, N., Loria, P., Bertolotti, M., Ponz de Leon, M., Salvioli, G. F. and Iori, R. (1983). Physicalchemical characteristics (detergency) of bile acids (BA) as determinant of bile lipid secretion. Gastroenterology, 84, 1367 (abstract)Google Scholar

Copyright information

© MTP Press Limited 1984

Authors and Affiliations

  • N. Carulli
  • P. Loria
  • D. Menozzi

There are no affiliations available

Personalised recommendations