Mamianetti A, Garrido D, Carducci C N, Vescina M C
Departamento de Medicina Interna, Hospital Aeronáutico Central, Buenos Aires, Argentina.
Medicina (B Aires). 1999;59(3):269-73.
Epidemiological studies have shown a positive association between cholesterol gallstones and colonic cancer. These two diseases may be somehow related with bile acids metabolic alterations. The aim of this study was to evaluate the profiles of fecal bile acid in gallstone patients, in order to estimate the quality and amount of fecal bile acids. A fecal bile acid profile of ten gallstone patients and ten controls was compared using high performance liquid chromatography. Total fecal bile acid excretion was significantly increased in gallstone patients compared with controls (692.7 mg/day (302.5-846.2) vs 165.7 mg/day (138.7-221.3), p < 0.01) as was the excretion of secondary free bile acids 562.9 mg/day (253.3-704.9) vs 99.9 mg/day (88.9-154.2), p < 0.01). Lithocholic and glycodeoxycholic acid percentages have also been found to show differences with controls of 55.4 (47.4-73.9) vs 24.6 (22.1-38.4) (p < 0.01) and 29.4 (3.3-41.7) vs 2.8 (1.0-3.8) (p < 0.03), respectively but deoxycholic acid has not shown differences between the two groups. Moreover, the percentage of ursodeoxycholic acid diminished significantly in gallstone patients (1.5 (1.0-2.8) vs 8.6 (6.0-10.39) (p < 0.001), and the decrease of chenodeoxycholic acid was also significant (20.0 (11.4-23.6) vs 8.9 (3.1-10.9) (p < 0.03) along with a rise in the ratios lithocholic/deoxycholic acids (1.8 (1.4-6.4) vs 0.9 (0.6-1.6) (p < 0.05) and glycine/taurine of deoxycholic acid (7.3 (4.1-46.6) vs 0.2 (0.1-0.5) (p < 0.01). In conclusion, we have observed a significant increase of total and secondary fecal bile acid excretion as well as a rise of LCA and GDCA percentages and a rise in the ratios of LCA/DCA and glycinet/taurine of DCA.
流行病学研究表明,胆固醇胆结石与结肠癌之间存在正相关。这两种疾病可能在某种程度上与胆汁酸代谢改变有关。本研究的目的是评估胆结石患者粪便胆汁酸的谱图,以估计粪便胆汁酸的质量和数量。使用高效液相色谱法比较了10名胆结石患者和10名对照者的粪便胆汁酸谱图。与对照组相比,胆结石患者的粪便胆汁酸总排泄量显著增加(692.7毫克/天(302.5 - 846.2)对165.7毫克/天(138.7 - 221.3),p < 0.01),次级游离胆汁酸的排泄量也是如此(562.9毫克/天(253.3 - 704.9)对99.9毫克/天(88.9 - 154.2),p < 0.01)。还发现石胆酸和甘氨脱氧胆酸的百分比与对照组存在差异,分别为55.4(47.4 - 73.9)对24.6(22.1 - 38.4)(p < 0.01)和29.4(3.3 - 41.7)对2.8(1.0 - 3.8)(p < 0.03),但脱氧胆酸在两组之间未显示出差异。此外,胆结石患者中熊去氧胆酸的百分比显著降低(1.5(1.0 - 2.8)对8.6(6.0 - 10.39)(p < 0.001),鹅去氧胆酸的降低也很显著(20.0(11.4 - 23.6)对8.9(3.1 - 10.9)(p < 0.03),同时石胆酸/脱氧胆酸的比值升高(1.8(1.4 - 6.4)对0.9(0.6 - 1.6)(p < 0.05)以及脱氧胆酸的甘氨酸/牛磺酸比值升高(7.3(4.1 - 46.6)对0.2(0.1 - 0.5)(p < 0.01)。总之,我们观察到粪便胆汁酸总排泄量和次级排泄量显著增加,以及石胆酸和甘氨脱氧胆酸百分比升高,石胆酸/脱氧胆酸和脱氧胆酸的甘氨酸/牛磺酸比值升高。