Reuben A, Qureshi Y, Murphy G M, Dowling R H
Eur J Clin Invest. 1986 Apr;16(2):133-42. doi: 10.1111/j.1365-2362.1986.tb01320.x.
Biliary cholesterol saturation indices (SI's) were measured in fasting duodenal bile from (i) obese and non-obese individuals with and without cholesterol gallstones, (ii) obese individuals undergoing weight reduction and (iii) obese gallstone patients receiving chenodeoxycholic acid (CDCA) therapy. Biliary lipid secretion rates were also measured in three obese subjects before and during 11 days starvation. The mean SI in fifteen non-obese controls (0.89 +/- SEM 0.06) was significantly lower than that in the twenty-four obese without (1.14 +/- 0.07; P less than 0.01), and in the twenty-nine non-obese with gallstones (1.30 +/- 0.05; P less than 0.001) while in sixteen obese gallstone patients, the mean SI of 1.55 +/- 0.06 was significantly higher than that seen in the other three groups (P less than 0.01-0.001). Although fifteen obese subjects lost 15% of their initial body weight during dieting, this did not change their SI's consistently. However in three obese individuals, total starvation did reduce the SI's and significantly lowered the biliary cholesterol secretion rate. Ten obese gallstone patients responded to 15.8 +/- 0.3 mg CDCA kg-1 day-1 by developing unsaturated fasting duodenal bile (SI 0.89 +/- 0.04). A further increase in CDCA dose to 19.0 +/- 0.7 mg kg-1 day-1, as a result of reducing body weight, was more effective in lowering SI's (0.75 +/- 0.06, range 0.51-1.0) than that achieved by increasing the dose to 18.9 +/- 0.46 mg kg-1 day-1 through more capsules per day (SI 0.89 +/- 0.03, range 0.67-1.25). These studies show that (i) biliary cholesterol SI's are greater when obesity and gallstones occur together than in either obesity or gallstones alone, and (ii) although weight loss in obese individuals does not consistently alter biliary cholesterol SI's, it may be beneficial in obese patients receiving CDCA therapy for gallstone dissolution.
在以下人群的空腹十二指肠胆汁中测量了胆汁胆固醇饱和指数（SI）：（i）有和没有胆固醇结石的肥胖和非肥胖个体；（ii）正在减肥的肥胖个体；（iii）接受鹅去氧胆酸（CDCA）治疗的肥胖胆结石患者。还在三名肥胖受试者饥饿11天之前和期间测量了胆汁脂质分泌率。15名非肥胖对照组的平均SI（0.89±标准误0.06）显著低于24名无结石的肥胖者（1.14±0.07；P<0.01）以及29名有结石的非肥胖者（1.30±0.05；P<0.001），而16名肥胖胆结石患者的平均SI为1.55±0.06，显著高于其他三组（P<0.01 - 0.001）。尽管15名肥胖受试者在节食期间体重减轻了初始体重的15%，但这并未持续改变他们的SI。然而，在三名肥胖个体中，完全饥饿确实降低了SI，并显著降低了胆汁胆固醇分泌率。10名肥胖胆结石患者对15.8±0.3mg CDCA·kg⁻¹·d⁻¹的反应是产生不饱和的空腹十二指肠胆汁（SI 0.89±0.04）。由于体重减轻，CDCA剂量进一步增加至19.0±0.7mg·kg⁻¹·d⁻¹，在降低SI方面（0.75±0.06，范围0.51 - 1.0）比通过每天增加胶囊数量使剂量增加至18.9±0.46mg·kg⁻¹·d⁻¹更有效（SI 0.89±0.03，范围0.67 - 1.25）。这些研究表明：（i）肥胖和胆结石同时存在时胆汁胆固醇SI高于单独存在肥胖或胆结石时；（ii）尽管肥胖个体体重减轻并不能持续改变胆汁胆固醇SI，但对接受CDCA治疗以溶解胆结石的肥胖患者可能有益。
