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Effects of pravastatin and ursodeoxycholic acid on cholesterol and bile acid metabolism in patients with cholesterol gallstones

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Abstract

To investigate the effects of pravastatin and ursodeoxycholic acid (UDCA) on cholesterol and bile acid metabolism in humans, 41 patients with cholesterol gallstone disease were allocated to four groups and treated with pravastatin (20 mg/day), UDCA (600 mg/day), both pravastatin and UDCA, or neither drug (control) for 1–2 weeks prior to elective cholecystectomy. Cholesterol 7α-hydroxylase activity and serum levels of total 7α-hydroxycholesterol were significantly increased by pravastatin and unaffected by UDCA. 3-Hydroxy-3-methylglutaryl coenzyme A reductase activity was markedly increased by pravastatin and decreased by UDCA. UDCA significantly decreased biliary cholesterol concentration and the cholesterol saturation index and prolonged the nucleation time; however, pravastatin alone had little effect on biliary lithogenicity. Serum total and low-density lipoprotein (LDL)-cholesterol levels were reduced most by the combined administration of pravastatin and UDCA. In conclusion, at a dose of 20 mg/day, pravastatin increased bile acid synthesis but did not decrease biliary lithogenicity. UDCA had no significant effect on bile acid synthesis, but markedly decreased biliary lithogenicity.

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Authors and Affiliations

  1. First Department of Surgery, Kyushu University Faculty of Medicine, 3-1-1 Maidashi, Higashi-Ku, 812, Fukuoka, Japan

    Shuichiro Okamoto, Kenji Nakano, Keigo Kosahara, Masanori Kishinaka, Hitoshi Oda, Hitoshi Ichimiya, Kazuo Chijiiwa & Syoji Kuroki

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  1. Shuichiro Okamoto
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  2. Kenji Nakano
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  3. Keigo Kosahara
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  4. Masanori Kishinaka
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  5. Hitoshi Oda
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  6. Hitoshi Ichimiya
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  7. Kazuo Chijiiwa
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  8. Syoji Kuroki
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Additional information

This work was supported, in part, by Grants-in-Aid for Scientific Research (C) 03670632 (S. Kuroki) and 03670633 (K. Chijiiwa) from The Ministry of Education, Science and Culture, Japan.

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Okamoto, S., Nakano, K., Kosahara, K. et al. Effects of pravastatin and ursodeoxycholic acid on cholesterol and bile acid metabolism in patients with cholesterol gallstones. J Gastroenterol 29, 47–55 (1994). https://doi.org/10.1007/BF01229073

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  • DOI: https://doi.org/10.1007/BF01229073

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