Effect of the type of dietary fat on biliary lipid composition and bile lithogenicity in humans with cholesterol gallstone disease (original) (raw)
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Dietary N-3 polyunsaturated fatty acids decrease biliary cholesterol saturation in gallstone disease
Hepatology, 1992
Because fatty acid composition of biliary phospholipids Muences cholesterol secretion into bile, we investigated whether replacement of n-1 monounsaturated or n-6 polyunsaturated fatty acids with n-3 polyunsaturated fatty acids in biliary phosphatidylcholines reduces supersaturation with cholesterol and prevents precipitation of cholesterol crystals in bile of gallstone patients. Seven patients with radiolucent gallstones in functioning gallbladders were studied before (control) and after 5 wk of dietary supplementation with marine fish oil (11.3 &day = 3.75 gm 13-3 polyunsaturated fatty acids/day). Duodenal bile was collected for analysis during intravenous infusion of cholecystokinin. Gallbladder emptying in response to cholecystokinin was comparable before and during intake of n-3 polyunsaturated fatty acids. Intake of n-3 polyunsaturated fatty acids increased (p < 0.001) the fractions of eicosapentaenoic and docosahexaenoic acids and decreased the fractions of linoleic (p < 0.001) and arachidonic acids (p < 0.02) in biliary phospholipids. Concomitantly, the molar ratio of cholesterol to phospholipids decreased (-19%; p < 0.05). As a consequence, the cholesterol saturation index was reduced by-25% (p = O.Ol), from 1.60 f 0.44 to 1.24 f 0.38. However, in uitro nucleation time of duodenal bile was not prolonged. The decrease in cholesterol saturation was not sufficient to prevent nucleation of cholesterol crystals in bile of gallstone patients. In conclusion, our data suggest that cholesterol saturation can be influenced by the fatty acid composition of the phosphatidylcholines secreted in bile. (HEPATOLOGY 1992;16:960-967.) Formation of gallstones requires at least two stepssecretion of bile supersaturated with cholesterol and nucleation of cholesterol crystals (1). Saturation of bile with cholesterol can be decreased with intake of bile acids in use for gallstone dissolution; bile acids become enriched in bile and lower the secretory ratio of cholesterol to bile acids (2,3). No attempts have yet been
The role of dietary fats in the pathogenesis of gallstones
Frontiers in bioscience : a journal and virtual library, 2003
Gallstone disease is exceptionally common, occurring especially in Western populations, with cholesterol gallstones predominating. Currently, it is believed that one of the essential factors in the pathogenesis of cholesterol gallstones is a physical-chemical event that results primarily from alterations in the lipid composition of gallbladder bile. Cholesterol supersaturation is due principally to excessive secretion of cholesterol into the bile. Several biochemical defects, as well as diet, might cause hypersecretion of cholesterol. The precise effects of diet on cholesterol supersaturation of bile have not been clearly established, although epidemiological, clinical, and animal studies indicate that diet plays an important role in cholesterol gallstone formation. This review summarizes current information on the role of dietary fat in the modulation of cholesterol gallstone formation.
Liver International
A two-stage study was carried out to characterize the bile and plasma lipid composition in normolipidemic non-obese patients with and without cholesterol gallstones. The first stage involved 11 patients with cholesterol gallstones admitted for elective cholecystectomy and a control group of 16 patients without cholesterol gallstones undergoing elective laparotomy. Bile samples were obtained intraoperatively by aspiration from the gallbladder. The bile of all the gallstone patients was supersaturated with cholesterol and its nucleation time was much shorter than that of bile in the control group (2.5 days vs 22.5 days, respectively, P < 0.001). The biliary fatty acid profile of phosphatidylcholine (PC) and free fatty acids (FFA) of gallstone patients was similar to that of the control group. C-22 fatty acids were found in a higher concentration in the FFA than in the PC fatty acids (P < 0.05) in both groups of patients. Plasma triglyceride levels in the gallstone patients were ...
Journal of Agricultural and Food Chemistry, 2003
The mechanism of the hypocholesterolemic effect of olive oils was investigated in 60 Wistar rats adapted to cholesterol-containing and cholesterol-free diets. The rats were divided in six diet groups of 10. The control group was fed only basal diet (BD), which contained wheat starch, casein, cellulose, and mineral and vitamin mixtures. For the five other groups, 10 g/100 g virgin (virgin group) or lampante (lampante group) olive oils, 1 g/100 g cholesterol (chol group), or both cholesterol and oil (chol/virgin and chol/lampante groups) were added to the BD. The experiment lasted 4 weeks. Before and after the experiment the bile was collected, and its flow and biliary bile acids and cholesterol concentrations were registered. Plasma lipids, liver cholesterol, plasma antioxidative potential (TRAP), fecal output, fecal bile acids, and fecal cholesterol excretion were measured. Groups did not differ before the experiment. After the experiment significant hypocholesterolemic and antioxidant effects were registered mainly in groups of rats fed cholesterol-containing diets supplemented with both olive oils (chol/virgin and chol/lampante). Significant increases in the bile flow and in the bile cholesterol and bile acids concentrations were observed (19.2% and 16.9%, 30.5% and 18.2%, and 79.6% and 45.6% for the chol/virgin and chol/lampante groups, respectively). Also, significant increases of the fecal output and fecal excretion of bile acids and cholesterol in rats of these groups were found. In conclusion, olive oils positively affect plasma lipid metabolism. The hypocholesterolemic effect of olive oils is genuine and is most likely mediated through increases in bile flow and biliary cholesterol and bile acids concentrations and subsequent increases in their fecal excretion.
Lipid Profile in Bile and Serum of Cholelithiasis Patients– A Comparative Study
ABSTRACT The prevalence of cholesterol gallstones in Libya is very high depending on dietary patterns and ethnic background. It is now widely accepted that the primary event in the pathogenesis of cholesterol gallstones is an altered lipid metabolism giving rise to a greater proportion of cholesterol relative to other bile lipids secreted from the liver into bile. An abnormality in lipid metabolism may arise from a combination of various factors such as excess dietary cholesterol/fat, obesity, diabetes and genetic factors. The association of cholesterol super saturation of bile with cholesterol gallstones paved the way to a physical-chemical basis for gallstone formation. It however, soon became clear that other factors including nucleation of cholesterol crystal, binding together of these crystals with mucin, and hypomotility of the gall bladder played an equally important roles in gallstone formation. In the present study bile and serum were collected from 46 cholelithiasis patients during cholecystectomy at the 7th October Hospital of Al-Arab Medical University, Benghazi, Libya. Of the 46 bile samples collected, the male to female ratio was 1:6.67 (6 men and 40 women). Between 19 and 88 years of age, peak incidence of cholelithiasis was at age 40. Serum and biliary lipid profile was done by authenticated enzymatic methods. Serum lipid profile was done for 19 healthy controls of both sexes aged between 25 and 55 years. Results showed no statistically significant change in serum and biliary triglycerides. There was a significant elevation in both serum high density lipoprotein (HDL) and low density lipoprotein (LDL) when compared with controls (p<0.01). Biliary cholesterol (p<0.01), HDL (p<0.01) and LDL (p<0.01) was raised significantly when compared with serum samples. In male cholelithiasis patients, only biliary total cholesterol (p<0.05) and HDL (p<0.001) cholesterol showed a significant raise. Among females, cholelithiasis patients of ≤40 years showed highly significant levels of HDL (p<0.001) and LDL (p<0.001) in serum, and total cholesterol (p<0.001), HDL (p<0.001) and LDL (p<0.001) in bile. Among females, cholelithiasis patients aged >40 years, biliary cholesterol (p<0.001) and HDL (p<0.001) showed a statistically significant elevation but this was not the case with biliary LDL (p<0.05). As demonstrated in the present study, there is correlation between serum and biliary lipid profiles in causing gallstones in Libyan population. Both serum and biliary HDL consistently showed higher values in Libyan patients unlike in other studies.
Adaptation of biliary response to dietary olive oil and sunflower-seed oil in dogs
British Journal of Nutrition, 1992
The effects of adaptation to dietary fat of different degrees of unsaturation (olive oil and sunflower oil) on bile secretion were studied in dogs at rest and after food intake. The animals were prepared with a bidirectional biliary cannula and a duodenal cannula to provide bile return. The two experimental groups were fed on diets containing 150 g fat/kg in the form of either olive oil (O) or sunflower-seed oil (S). The flow-rate under resting conditions and the patterns of response to food were similar in both experimental groups, although postprandial hypersection were significantly greater in volume and more prolonged in group O. No appreciable differences in concentration and output of biliary cholesterol or phospholipids were noted between the two groups. In contrast, the concentration and output of bile acids differed significantly both at rest and after food: concentration and output of bile acids were greater at rest in group S. However, after food intake, these responses w...
Comparative study of Serum and Biliary Lipid Profile of Libyan Gallstone patients
The prevalence of cholesterol gallstones in Libya is very high depending on dietary patterns and ethnic background. It is now widely accepted that the primary event in the pathogenesis of cholesterol gallstones is an altered lipid metabolism giving rise to a greater proportion of cholesterol relative to other bile lipids secreted from the liver into bile. An abnormality in lipid metabolism may arise from a combination of various factors such as excess dietary cholesterol/fat, obesity, diabetes and genetic factors. The association of cholesterol super saturation of bile with cholesterol gallstones paved the way to a physical-chemical basis for gallstone formation. It however, soon became clear that other factors including nucleation of cholesterol crystal, binding together of these crystals with mucin, and hypomotility of the gall bladder played an equally important roles in gallstone formation. thanks to the staff of Department of Biochemistry, particularly Mr. Marai Mohammed, who helped in processing of samples. We also express our thanks to the staff and residents of the Department of Surgery, Seventh October Hospital, Benghazi, for providing samples and relevant information about patients.
Hepatology, 1998
In this study, we first developed and validated a new in vitro isolated, intra-arterially perfused, gallbladder model and then applied the method to investigate the absorption of biliary lipids by the gallbladder wall and the effect of this process on the composition of human bile. Oxygenated and glucose-added buffer was perfused through the cystic artery to maintain organ viability. A standard pooled natural bile, radiolabeled with H 3 -cholesterol and C 14 -palmitoyl-linoleoylphosphatidylcholine, was instilled in the lumen via a cystic duct catheter. Changes in bile volume and lipid concentrations were monitored at time intervals to evaluate the disappearance of lipids from bile caused by gallbladder absorptive function. Organ viability was demonstrated by stable lactate dehydrogenase (LDH) organ release and oxygen consumption throughout the experiments. In the pig, disappearance rates of lipids from bile were similar in vitro and in vivo, demonstrating the validity of the isolated in vitro model for functional studies. By applying our in vitro isolated preparation to the human gallbladder, we found that 23% of cholesterol and 32% of phosphatidylcholine, but only 9% of bile salts, disappeared from bile in 5 hours. As a consequence, at the end of the experiments, cholesterol (P F .05) and phospholipid (P F .05) molar percentages were significantly reduced, while the bile salt (P F .05) molar percentage was significantly increased with respect to values at the beginning of the studies. Our findings are of pathophysiological relevance and support the concept that the human gallbladder modifies the relative composition of biliary lipids in such a way as to increase cholesterol solubility in bile. (HEPATOLOGY 1998;28:314-322.)
British Journal of Nutrition, 2001
Bile acids derived from intestinal bacterial metabolism and transported to the breast in plasma may influence risk of breast cancer. The purpose of the present study was to test the hypothesis that fatty acid chain length and degree of unsaturation differ with regard to their influence on the postprandial release of cholecystokinin (CCK) and the subsequent increase in plasma bile acid concentrations that occur following a meal. A randomized crossover design was used to compare five high-fat test meals (50 g fat) with a low-fat test meal (15 g) on plasma bile acid and CCK concentrations in eighteen healthy premenopausal women. The high-fat meals were enriched in oleate or palmitate, or linoleate or medium-chain triacylglycerols (MCT) or a blend of oleate and long-chain n-3 fatty acids. The postprandial increase in plasma CCK concentration was lower on the MCT meal compared with all meals and was greater following the linoleate compared with the low-fat meal. Plasma bile acid concentr...