ascorbic-acid and Cholelithiasis

Topics: Adolescent; Arrhythmias, Cardiac; Ascorbic Acid; Blood Transfusion; Child; Cholelithiasis; Deferoxamine; Endocrine System Diseases; Female; Folic Acid; Growth Disorders; Heart Failure; Hematopoiesis; Humans; Iron; Leg Ulcer; Liver Diseases; Male; Pericarditis; Splenectomy; Thalassemia; Vitamin E

Topics: Animals; Arteriosclerosis; Ascorbic Acid; Ascorbic Acid Deficiency; Cholelithiasis; Cholesterol; Diet; Disease Models, Animal; Guinea Pigs; Humans; Lipids; Liver; Rats; Triglycerides

Topics: Ascorbic Acid; Chenodeoxycholic Acid; Cholelithiasis; Female; Fusidic Acid; Humans; Male; Middle Aged; Phenobarbital; Phosphatidylcholines

Vegetable and fruit consumption may have a protective effect against several types of cancers. However, the effect on biliary cancers is unclear. We investigated the association of vegetable/fruit consumption with the risks of gallbladder cancer (GBC), intrahepatic bile duct cancer (IHBDC) and extrahepatic bile duct cancer (EHBDC) in a population-based prospective cohort study in Japan. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazard model, and the exposure level was categorized into quartiles, with the lowest group used as the reference. A total of 80,371 people aged 45 to 74 years were enrolled between 1995 and 1999, and followed up for 1,158,632 person-years until 2012, during which 133 GBC, 99 IHBDC, and 161 EHBDC cases were identified. Increased consumption of total vegetable and fruit was significantly associated with a decreased risk of EHBDC (HR = 0.49; 95% CI: 0.29-0.81 for the highest group; p trend = 0.005). From the analysis of relevant nutrients, significantly decreased risk of EHBDC was associated with folate and insoluble fiber (HR = 0.48, 0.53; 95% CI: 0.28-0.85, 0.31-0.88 for the highest group; p trend = 0.010, 0.023; respectively), and a significant trend of decreased EHBDC risk associated with vitamin C was observed (p trend = 0.029). No decreased risk of GBC and IHBDC was found. Our findings suggest that increased vegetable/fruit consumption may decrease a risk of EHBDC, and folate, vitamin C, and insoluble fiber might be key contributors to the observed protective effect.

Topics: Adult; Alcohol Drinking; Ascorbic Acid; Bile Duct Neoplasms; Carcinoma; Cholelithiasis; Comorbidity; Diabetes Mellitus; Diet; Dietary Fiber; Female; Folic Acid; Follow-Up Studies; Fruit; Gallbladder Neoplasms; Hepatitis, Viral, Human; Humans; Japan; Life Style; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Smoking; Surveys and Questionnaires; Vegetables

Biliary cholesterol is transported by vesicles and micelles. Cholesterol microcrystals are derived from thermodynamically unstable vesicles. In experimental animals vitamin C deficiency leads to a super-saturation of biliary cholesterol and to the formation of gallstones.. To search for a possible relationship between serum levels of vitamin C and the formation of cholesterol gallstones in patients with cholelithiasis.. Thirteen patients with cholelithiasis and a programmed surgical intervention were treated with 2 g/day of vitamin C per os for two weeks before surgery. Forty nine patients subjected to a cholecystectomy not supplemented with vitamin C were studied as controls. Plasma concentrations of vitamin C and lipid profiles were measured. The cholesterol saturation index, crystallization time, cholesterol and phospholipid content in vesicles and micelles, separated by gel filtration chromatography, were studied in bile samples obtained from the gallbladder.. Vitamin C supplementation did not change significantly plasma lipids and bile lipid concentrations. However, in supplemented patients, significant reductions in vesicular cholesterol content (6.5 ± 4.8% compared to 17.9 ± 14.0% in the control group; p < 0.05) and vesicular cholesterol/phospholipid ratio (0.71 ± 0.53 compared to 1.36 ± 1.15 in controls; p < 0.05), were observed.. Vitamin C administration may modify bile cholesterol crystallization process, the first step in cholesterol gallstone formation.

Topics: Ascorbic Acid; Bile Acids and Salts; Case-Control Studies; Cholelithiasis; Cholesterol; Crystallization; Female; Humans; Lipid Metabolism; Lipids; Male; Micelles; Middle Aged

A hundred and fifty-two patients cholelithiasis were examined. Among them, 69 and 83 patients were operated on for acute destructive and chronic cholecystitis, respectively. In destructive cholecystitis, there is a high lipid oxidation rate accompanied by the elevated levels of nonenzymatic antioxidant ceruloplasmin. The low activity of catalase and ceruloplasmin and the decreased content of ascorbic acid suggest the depletion of antioxidative defense in patients with cholelithiasis with significant liver disease. The magnitude of changes in the activity of antioxidative enzymes and the level of the nonenzymatic antioxidant ascorbic acid depend on the state of the liver.

Topics: Antioxidants; Ascorbic Acid; Catalase; Ceruloplasmin; Cholecystitis, Acute; Cholelithiasis; Chronic Disease; Female; Humans; Liver Diseases; Male; Oxidation-Reduction

This study examined the correlates of clinical gallbladder disease among US adults and whether serum ascorbic acid levels are associated with a decreased prevalence of gallbladder disease.. Cross-sectional analyses of data from the Second National Health and Nutrition Examination Survey were conducted.. A total of 384 women (8%) and 107 men (3%) reported a history of gallstone disease, and 347 women (7%) and 81 men (2%) reported a history of cholecystectomy. An inverted U-shaped relation was found between serum ascorbic acid level and clinical gallbladder disease among women but not among men.. Ascorbic acid, which affects the catabolism of cholesterol to bile acids and, in turn, the development of gallbladder disease in experimental animals, may reduce the risk of clinical gallbladder disease in humans.

Topics: Adult; Aged; Ascorbic Acid; Causality; Cholecystectomy; Cholelithiasis; Cross-Sectional Studies; Female; Humans; Incidence; Male; Middle Aged; Sex Factors; United States

Results of examination and treatment of 157 patients with cholelithiasis against the background of a liver pathology were summed up. The antioxidant system in such patients was studied. The degree of a decrease of catalase activity in the liver and blood serum as well as the ascorbic acid content were found to depend on the liver state of patients with cholelithiasis. Greatest changes were found in patients with cirrhosis of the liver and chronic active hepatitis. The method of complex treatment of cholelithiasis patients with non-enzymatic antioxidants alpha-tocopherol and ascorbic acid is proposed. Activity of organ specific liver enzymes urokaninase and histidase was used for the estimation of treatment efficiency. Complex administration of ascorbic acid and alpha-tocopherol was shown to improve the liver function in patients operated upon for cholelithiasis.

Topics: Antioxidants; Ascorbic Acid; Bile; Biopsy; Catalase; Cholelithiasis; Combined Modality Therapy; Hepatitis, Chronic; Histidine Ammonia-Lyase; Humans; Liver; Liver Cirrhosis; Urocanate Hydratase

Vitamin C deficiency in guinea pigs leads to cholesterol supersaturation of bile and formation of cholesterol gallstones. It has been suggested that there may also exist an association between vitamin C and cholesterol gallstones in man, but such a relationship has not been studied in gallstone patients. In order to study the possible effects of vitamin C on gallstone disease in humans, plasma lipid levels, hepatic cholesterol metabolism, biliary lipid composition, cholesterol saturation and nucleation time of gallbladder bile were analysed in 16 consecutive gallstone patients, who were planned for laparoscopic cholecystectomy and were treated with vitamin C (500 mg, four times a day) for 2 weeks before surgery. The plasma concentration of vitamin C increased by 42% in the treatment group. The concentrations of plasma lipids did not differ before and after vitamin C treatment; nor did the plasma levels of lathosterol and 7 alpha-hydroxy-4-cholesten-3-one, reflecting cholesterol and bile acid synthesis respectively. The relative concentrations of cholesterol, bile acids and cholesterol concentration of bile did not differ significantly between the two groups, but the relative concentration of phospholipids was slightly higher in the treated group. The bile acid composition was changed; the percentage of cholic acid being lower and those of deoxycholic acid, ursodeoxycholic acid and lithocholic acid higher in the vitamin C-treated patients compared with the untreated group. The nucleation time was significantly longer in the treatment group (7 days) compared with the untreated group (2 days). Our findings indicate that vitamin C supplementation may also influence the conditions for cholesterol gallstone formation in humans.

Topics: Ascorbic Acid; Bile; Bile Acids and Salts; Cholelithiasis; Cholesterol; Female; Humans; Lipid Metabolism; Lipids; Lipoproteins, HDL; Lipoproteins, LDL; Male; Middle Aged; Triglycerides

In animal models of gallstone disease inflammatory alterations of the gallbladder mucosa are regularly found before the first appearance of cholesterol monohydrate crystals in bile. At sites of inflammation granulocytes generate reactive oxygen metabolites (ROM). The aim of our study was to investigate whether ROM may influence the cholesterol monohydrate crystal formation in supersaturated model bile. Superoxide anions (O2-), hydrogen peroxide (H2O2), and hydroxyl radicals (.OH) were generated by the interaction of Fe(3+)-EDTA with ascorbic acid (Asc). The influence of ROM on cholesterol crystal formation was studied by measurement of the nucleation time. To check whether lipid peroxidation was induced by the ROM generation, production of malondialdehyde equivalents was measured in bile with the thiobarbituric assay. Furthermore, the lipid pattern of bile after ROM exposure was analyzed by thin layer chromatography. Addition of Fe(3+)-EDTA/Asc to model bile markedly decreased the cholesterol nucleation time (NT) (p < 0.01), caused a significant increase in malonidialdehyde equivalents (p < 0.001) and induced the generation of 4-hydroxy-2,3-trans-nonenal (4-HNE). In an attempt to identify a specific oxygen metabolite responsible for the alterations in bile, the effects of various oxygen radical scavengers were tested. Desferal, which prevents -OH generation by chelation of ferrous iron, completely protected bile against Fe(3+)-EDTA/Asc-induced decrease in NT (p < 0.001), increase in lipid peroxidation (p < 0.001) and generation of 4-HNE. Our results indicate that formation of cholesterol crystals in model bile is enhanced by ROM. Hydroxyl radical induced lipid peroxidation appears to be the mechanism responsible for the crystallisation promoting activity of ROM.

Topics: Ascorbic Acid; Bile; Cholelithiasis; Cholesterol; Crystallization; Edetic Acid; Free Radical Scavengers; Iron Chelating Agents; Lipid Peroxidation; Malondialdehyde; Reactive Oxygen Species

After partial ligation of the common bile duct (CBD) of guinea pigs, 14 of 16 animals developed pigment gallstones within one week (S group). Intraperitoneal injection of Vit. E and C, each 10 mg/kg daily from 3 days before CBD ligation to one week after the operation (S+V group), decreased the gallstone incidence to 5/14 (exact probability < 0.01). The gallstone incidence in the control group, that only received laparotomy without ligation of the CBD, was 0/15. Biochemical analysis of the gallbladder bile showed that stricture of the CBD was associated with a significant increase in levels of unconjugated bilirubin (UCB) and Ca2+ (p < 0.05 and < 0.01). Simultaneously the scavenging rate (SR) of superoxide radical in bile significantly decreased (p < 0.05). Comparing S+V group with S group, the effect of Vit. E and C on the concentrations of UCB and Ca2+ in bile was not significant (both p > 0.05), but Vit. E and C normalized the SR, and the difference between S group and S+V group was significant (p < 0.05). These results suggested that Vit. E and C, known as antioxidants, enhanced the ability to scavenge oxygen radical in S+V group; and that in addition to the increases of UCB and Ca2+ concentrations, the participation of oxygen radicals might be of importance for pigment gallstone formation induced by bile duct obstruction.

Topics: Animals; Ascorbic Acid; Bile; Bile Pigments; Cholelithiasis; Common Bile Duct; Disease Models, Animal; Drug Evaluation, Preclinical; Free Radical Scavengers; Guinea Pigs; Incidence; Injections, Intraperitoneal; Ligation; Male; Oxidants; Vitamin E

Operative stenosis of common bile duct (CBD) (S group) induced pigment gallstones in 14 of 16 guinea pigs one week after operation. If Vit E and Vit C were given intraperitoneally 10 mg/kg daily from 3 days before to one week after the operation (S+V group), the gallstone incidence decreased to 5/14 (P < 0.01). In comparison with control group (C), unconjugated bilirubin (UCB) and Ca2+ concentration in gallbladder bile of S group increased significantly (P < 0.05 and P < 0.01 respectively), while the scavenge rate (SR) of superoxide radical (O2-.) in bile decreased significantly (P < 0.05). Comparing S+V group with S group showed that the differences of UCB and Ca2+ concentration were not significant (P < 0.05 both); only the SR rose significantly (P < 0.05) and reached the level of C group. It is suggested that besides the increase of UCB and Ca2+ concentration, the participation of oxygen radicals may be needed in formation of pigment gallstones induced by bile duct obstruction.

Topics: Animals; Ascorbic Acid; Bile; Bile Pigments; Bilirubin; Cholelithiasis; Cholestasis; Free Radical Scavengers; Guinea Pigs; Male; Oxygen; Vitamin E

Decreased activity of cholesterol 7 alpha-hydroxylase, the rate-limiting enzyme in the catabolism of cholesterol to bile acids, is known to result in increased biliary cholesterol concentration and supersaturation of bile. Supersaturation of bile by cholesterol is a necessary condition for cholesterol gallstone formation. In guinea pigs, the hepatic concentration of ascorbic acid affects the catabolism of cholesterol: hypovitaminosis C reduces cholesterol 7 alpha-hydroxylase activity. Cholesterol gallstones are frequently found in ascorbic acid-deficient guinea pigs. Risk factors for cholesterol gallstones in humans include obesity, aging, estrogen treatment, pregnancy and diabetes. Plasma ascorbic acid levels are reduced in these groups. Vegetarian diets, which typically have high ascorbic acid contents, protect against gallstones. Since ascorbic acid effects the rate-limiting step in the catabolism of cholesterol in the guinea pig and many human risk groups for cholesterol gallstones are associated with reduced ascorbic acid levels, ascorbic acid may play a contributory role in human gallbladder disease.

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Bile; Cholelithiasis; Cholesterol; Cholesterol 7-alpha-Hydroxylase; Diet, Vegetarian; Guinea Pigs; Humans

A method with isotopic 3H-CDCA was established to determine bile acid pool. Sixty male guinea pigs were divided randomly into two groups; 20 guinea pigs fed with standard chow served as control, and 40 with 10% low protein lithogenic chow were subdivided into 4 groups executed on 10,20,30 and 40 days (In the last subgroup, vitamin C was added to the chow), respectively. The bile acid pool of lithogenic animals decreased on the 10th days and significantly decreased on the 20th, 30th, 40th day (P < 0.01) when compared with controls in the same periods. The incidence of pigment gallstone was 90% on the 20th day, 100% on the 30th day, 40% on the 40th day in lithogenic animals. The pool size decreased slightly on the 40th day in lithogenic animals which were fed with supplement of Vitamin C. A significant positive correlation was noted between gallbladder volume and bile acid pool size (r = 0.842) in the 30th day lithogenic animals. We postulate that the decreased bile acid pool size occurs before the development of pigment gallstone and it may be an important factor in promoting the formation of gallstone.

Topics: Animals; Ascorbic Acid; Bile Acids and Salts; Cholelithiasis; Dietary Proteins; Guinea Pigs; Male; Time Factors

Topics: Ascorbic Acid; Cholecystitis; Cholelithiasis; Combined Modality Therapy; Humans; Postoperative Care; Sulfhydryl Compounds

Topics: Adult; Aged; Ascorbic Acid; Cholecystitis; Cholelithiasis; Female; Humans; Male; Middle Aged; Oxidation-Reduction; Sulfhydryl Compounds

Topics: Ascorbic Acid; Cholelithiasis; Dose-Response Relationship, Drug; Heparin; Humans; In Vitro Techniques; Solubility

Guinea pigs formed gallstones when fed chow supplemented with cholesterol and cholic acid. Although the stones contained little or no cholesterol the changes in biliary bile acid and lipid composition were similar to those observed in other rodents under conditions of cholesterol gallstone formation. Addition of cholestyramine to chow had a midly lithogenic effect. Hypovitaminosis C in animals given cholesterol and cholic acid resulted in an increase of the cholesterol content of the gallstones. The composition of biliary bile acids was markedly changed. Reductive formation of deoxycholic acid decreased and oxidative formation of ketonic bile acid increased. The results show that vitamin C may influence the redox state of the intestinal microorganisms microorganisms responsible for these conversions.

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Bile Acids and Salts; Cholelithiasis; Cholesterol; Cholesterol, Dietary; Cholestyramine Resin; Cholic Acid; Cholic Acids; Diet, Atherogenic; Female; Guinea Pigs; Hot Temperature; Male

1. Pregnant guinea-pigs receiving a low dose of L-ascorbic acid (0.2 mg/100 g body-weight per d) developed a hypercholesterolaemia in the third trimester of pregnancy, whereas no change in serum cholesterol levels was observed in pregnant animals receiving a higher dose of the vitamin (2 mg/100 g body-weight per d). 2. Pregnancy in the group of guinea-pigs receiving the higher dose of L-ascorbic acid was associated with an increased biliary secretion of bile acids. No change was observed in the biliary secretion of bile acids in pregnant animals receiving the lower dose of L-ascorbic acid, but these animals secreted significantly more cholesterol. 3. Changes in the biliary secretion of cholesterol and bile acids in the pregnant guinea-pig according to L-ascorbic acid intake were reflected in the composition of the gall-bladder bile. Thus, the gall-bladder bile of guinea-pigs receiving the lower dose of L-ascorbic acid contained more cholesterol, while the gall-bladder bile of those animals receiving the higher dose of the vitamin had a higher content of bile acids. 4. The increased cholesterol content of the gall-bladder of pregnant guinea-pigs receiving the lower dose of L-ascorbic acid resulted in decreased bile acid:cholesterol and phospholipid:cholesterol values, conditions predisposing to cholelithiasis.

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Bile; Bile Acids and Salts; Cholelithiasis; Cholesterol; Female; Guinea Pigs; Phospholipids; Pregnancy; Pregnancy, Animal

The addition of 0.5% of ascorbic acid to the lithogenic diet of golden hamsters whose body pool was labelled with 26-14C-cholesterol, lowered the formation of gallstones, the cholesterol concentration and half-life in blood plasma and in the liver, and accelerated cholesterol transformation to bile acids.

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Bile Acids and Salts; Cholelithiasis; Cholesterol; Cricetinae; Liver; Male; Mesocricetus

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Bile Acids and Salts; Cholelithiasis; Cholesterol; Cholesterol, Dietary; Gallbladder; Guinea Pigs; Male; Phospholipids

Topics: Administration, Oral; Animals; Ascorbic Acid; Chenodeoxycholic Acid; Cholelithiasis; Cricetinae; Drug Synergism; Guinea Pigs; Humans

Topics: Adult; Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Cholelithiasis; Cholesterol; Disease Models, Animal; Edema; Female; Gallbladder; Guinea Pigs; Humans; Liver

Topics: Alcohols; Animals; Ascorbic Acid; Cholelithiasis; Cholesterol; Cholesterol, Dietary; Cholic Acids; Fatty Liver; Female; Guanidines; Male; Mice; Neomycin; Pectins; Phosphatidylcholines; Sulfonamides

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Cholelithiasis; Cholesterol; Guinea Pigs; Liver

Topics: Adrenocorticotropic Hormone; Animals; Ascorbic Acid; Cholelithiasis; Female; Guinea Pigs; Hydrocortisone; Male; Scurvy