Tran Khoi Q, Graewin Shannon J, Swartz-Basile Deborah A, Nakeeb Attila, Svatek Carol L, Pitt Henry A
Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
Surgery. 2003 Aug;134(2):372-7. doi: 10.1067/msy.2003.234.
Human obesity is associated with leptin resistance, elevated serum glucose and lipids, hepatic steatosis, and cholesterol gallstone formation. These gallstones are thought to result from hypersecretion of biliary cholesterol as well as biliary stasis. Leptin-resistant Lep(db) obese mice, which are known to have elevated serum leptin, glucose, and lipids, as well as hepatic steatosis, should be an appropriate model for human gallstone formation. Therefore, we tested the hypothesis that leptin-resistant mice would have increased gallbladder volume, biliary cholesterol saturation, and cholesterol crystal formation.
Sixty lean control mice and 60 Lep(db) obese mice on a low cholesterol chow diet were studied. Gallbladder volumes were measured and bile was pooled to calculate cholesterol saturation index. Serum cholesterol, glucose, and leptin levels were determined from pooled serum. Hepatic fat vacuoles were counted. Bile from a second group of 90 lean control and 59 obese mice was observed microscopically for cholesterol crystal formation.
Leptin-resistant obese mice have significantly higher serum cholesterol, glucose, and leptin levels, hepatic fat vacuoles, and gallbladder volume than lean control mice. However, biliary cholesterol saturation index and cholesterol crystal formation were significantly diminished in the obese mice.
These data suggest that leptin-resistant Lep(db) obese mice have (1) increased gallbladder volume, (2) decreased biliary cholesterol saturation despite elevated serum cholesterol and hepatic steatosis, and (3) decreased in vitro cholesterol crystal formation. We conclude that the link between obesity and gallstone formation does not require hypersecretion of biliary cholesterol.
人类肥胖与瘦素抵抗、血清葡萄糖和脂质升高、肝脂肪变性以及胆固醇胆结石形成有关。这些胆结石被认为是由胆汁胆固醇分泌过多以及胆汁淤积导致的。已知瘦素抵抗的Lep(db)肥胖小鼠血清瘦素、葡萄糖和脂质升高,且存在肝脂肪变性,应是人类胆结石形成的合适模型。因此,我们检验了瘦素抵抗小鼠胆囊体积、胆汁胆固醇饱和度和胆固醇晶体形成会增加的假说。
研究了60只低脂饮食的瘦对照小鼠和60只Lep(db)肥胖小鼠。测量胆囊体积并收集胆汁以计算胆固醇饱和指数。从收集的血清中测定血清胆固醇、葡萄糖和瘦素水平。对第二组90只瘦对照小鼠和59只肥胖小鼠的胆汁进行显微镜观察以检测胆固醇晶体形成。
与瘦对照小鼠相比,瘦素抵抗的肥胖小鼠血清胆固醇、葡萄糖和瘦素水平、肝脂肪空泡和胆囊体积显著更高。然而,肥胖小鼠的胆汁胆固醇饱和指数和胆固醇晶体形成显著减少。
这些数据表明,瘦素抵抗的Lep(db)肥胖小鼠具有:(1)胆囊体积增加;(2)尽管血清胆固醇升高和存在肝脂肪变性,但胆汁胆固醇饱和度降低;(3)体外胆固醇晶体形成减少。我们得出结论,肥胖与胆结石形成之间的联系并不需要胆汁胆固醇分泌过多。