phytosterols and Cholelithiasis

Fifteen patients with gall stones who were taking chenodeoxycholic acid(CDCA) 15 mg/kg at bedtime participated in two separate experiments to investigate the effects of altering sterol intake on the cholesterol saturation index (SI) of fasting gall-bladder bile. In experiment I the 15 patients on an unrestricted diet had a SI of 0.87 +/- 0.04 (mean +/- SE of mean), which fell to 0.75 +/- 0.04 after one week in hospital on a diet of 100 mg cholesterol daily. In experiment II seven of the patients were given four different dietary regimens lasting one month each in random order as outpatients. On a diet of 600 mg of cholesterol daily the mean SI was 0.72 +/- 0.05, which fell to 0.67 +/- 0.05 when the patients were put on a 100 mg cholesterol diet. The addition of plant sterols (3 g daily) to both diets raised the mean SIs to 0.80 +/- 0.05 and 0.77 +/- 0.05 respectively. The percentage CDCA in bile was unaffected by alterations in the cholesterol and plant sterol intakes. We conclude that a low-cholesterol diet but not a high intake of plant sterols enhances the effect of CDCA in patients with gall stones.

Topics: Adult; Aged; Bile; Bile Acids and Salts; Chenodeoxycholic Acid; Cholelithiasis; Cholesterol; Cholesterol, Dietary; Female; Humans; Male; Middle Aged; Phytosterols

Topics: Aged; Arteriosclerosis; Autopsy; Body Weight; Cholecystectomy; Cholelithiasis; Cholesterol; Cholesterol, Dietary; Diet; Diet Therapy; Dietary Fats; Fats, Unsaturated; Fatty Acids, Unsaturated; Humans; Male; Middle Aged; Obesity; Phytosterols; Time Factors

Bile acid (BA) synthesis is essential in cholesterol and lipid homoeostasis.. Serum samples from 435 normal and 23 cholecystectomized subjects were obtained after overnight fasting and assayed for markers of BA and cholesterol synthesis, as well as cholesterol absorption. We determined whether BA synthesis was related to fibroblast growth factor 19 (FGF19; a circulating metabolic regulator that is thought to inhibit BA synthesis), gender, age and serum lipids.. Bile acid synthesis varied more than 9-fold in normal individuals and was 29% higher in men than in women. Whilst low-density lipoprotein cholesterol increased with age, BA and cholesterol synthesis were stable. BA production was positively correlated with serum triglycerides (TGs), and 35% of individuals with a high level (>95th percentile) of BA synthesis had hypertriglyceridaemia (HTG) (>95th percentile). Serum FGF19 levels varied by 7-fold in normal individuals and were related inversely to BA synthesis but were not related to gender, plasma lipids or history of cholecystectomy.. Bile acid synthesis has a wide inter-individual variation, is lower in women than in men and is correlated positively with serum TGs. High BA production is frequently linked to HTG. Age-related hypercholesterolaemia is not associated with changes in BA or cholesterol production, nor to an increase in cholesterol absorption. In humans, the circulating level of FGF19 may regulate hepatic BA production under fasting conditions.

Topics: Adult; Aged; Aged, 80 and over; Bile; Bile Acids and Salts; Case-Control Studies; Cholelithiasis; Cholestenones; Cholesterol; Female; Fibroblast Growth Factors; Humans; Hypertriglyceridemia; Male; Middle Aged; Phytosterols; Sex Factors; Young Adult

Quantitative analysis of the local distribution of four noncholesterol sterols, 24-methylene cholesterol, campesterol, stigmasterol, and beta-sitosterol, and of the local distribution of cholesterol in gallstones was performed by mass spectrometry, with D6-cholesterol as an internal standard. The role played by trace amounts of these four noncholesterol sterols in the formation of gallstones was investigated by comparing the amounts of these sterols in different parts of gallstones. It was found that the amounts of the noncholesterol sterols in the inside part were significant greater than the amounts in the outside part of various structural types of gallstones. However, the distribution of the cholesterol did not show such variation. The amounts of noncholesterol sterols distributed locally suggested that these sterols play a role in the formation of gallstones.

Topics: Cholelithiasis; Cholesterol; Female; Gas Chromatography-Mass Spectrometry; Humans; Male; Middle Aged; Phytosterols; Sitosterols; Sterols; Stigmasterol

Biliary and gallstone sterol compositions were analyzed in 20 consecutive cholecystectomized patients. The main intention was to identify and quantitate noncholesterol sterols and to compare the sterol patterns of the two sources. Cholesterol comprised approximately 97% of the stone and gallbladder bile sterols; the remainder were from plant sterols, cholestanol, and cholesterol precursors, mainly lathosterol and methylsterols (two methostenols, lanosterol, and two dimethylsterols). Desmosterol and delta 8-lathosterol were also identified in both the bile and the gallstones. The sterol patterns of the bile and gallstones differed markedly. Thus, the contents of the two lathosterols and the two methostenols were clearly higher in the gallstones, whereas lanosterol stayed almost totally, and other minor sterols were preferentially, in the bile. In fact, the gallstone methylsterols consisted mainly of the two methostenols, a pattern usually seen in esterified methylsterols in serum. The core and matrix of the stone, and large and small stones as well, had only a small variation in their sterol composition within each individual, suggesting that the pattern of the noncholesterol sterol precipitation remains the same during the growth of the stone. Centrifugation of the bile revealed sedimentation of methylsterols with the stonelike sterol pattern. It can be speculated that the soluble and poorly soluble bile sterols have different hepatic origins and that the similarity between (a) methylsterols in the stone and sediment and (b) esterified methylsterols in serum points to a common hepatic site of origin.

Topics: Bile; Cholelithiasis; Cholestanol; Cholesterol; Gallbladder; Humans; Phytosterols; Sterols

Topics: Animals; Bile; Bile Acids and Salts; Cholelithiasis; Cholesterol; Cricetinae; Female; Lipids; Mesocricetus; Phospholipids; Phytosterols

Topics: Arteriosclerosis; Bile; Bile Acids and Salts; Cholelithiasis; Cholesterol; Cholesterol, Dietary; Diet; Diet Therapy; Dietary Fats; Fasting; Fats, Unsaturated; Fatty Acids, Unsaturated; Humans; Male; Obesity; Phytosterols