Faculty of Fundamental Problems of Technology, Department of Biomedical Engineering, Wroclaw University of Science and Technology, 50-370, Wroclaw, Poland.
Department of Pure and Applied Mathematics, Wroclaw University of Science and Technology, 50-372, Wroclaw, Poland.
Sci Rep. 2021 Apr 23;11(1):8868. doi: 10.1038/s41598-021-88249-w.
Obese people differ from the people of normal weight in gall bladder motility and have a higher risk of cholesterol stone formation. In this study, using a mathematical model of cholesterol homeostasis, which also considers the enterohepatic circulation of bile as well as cholesterol, we investigated the risk of cholesterol stone formation in obese and normal-weight groups who had normal blood cholesterol levels. We associated the risk of stone formation with the amount of cholesterol released into bile and the amount of de novo-synthesized cholic acid. For both groups, we determined the conditions of low and high risk. In addition, we analyzed the potential effects of changes in gall bladder motility with increased weight. The results showed that the obese group exhibited increased kinetics of enterohepatic circulation, leading to a significant increase in blood cholesterol levels, which can be reduced by increasing the amount of cholesterol in bile. Based on this finding, we suggest that for obese people, it is beneficial to reduce the amount and change the composition of circulating bile through the inhibition of cholic acid synthesis along with cholesterol synthesis. Furthermore, obese people should maintain a triglyceride-lowering diet and consume small meals containing fat, preferably in combination with agents that can reduce bile output from the gall bladder.
肥胖者的胆囊运动与正常体重者不同，胆固醇结石形成的风险更高。在这项研究中，我们使用了一种胆固醇动态平衡的数学模型，该模型还考虑了胆汁的肠肝循环以及胆固醇，研究了胆固醇水平正常的肥胖和正常体重组发生胆固醇结石形成的风险。我们将结石形成的风险与释放到胆汁中的胆固醇量和新合成的胆酸量联系起来。对于这两个组，我们确定了低风险和高风险的条件。此外，我们还分析了随着体重增加胆囊运动变化的潜在影响。结果表明，肥胖组的肠肝循环动力学增加，导致血液胆固醇水平显著升高，通过增加胆汁中的胆固醇量可以降低胆固醇水平。基于这一发现，我们建议肥胖者通过抑制胆酸合成和胆固醇合成来减少循环胆汁的量并改变其组成，这对肥胖者有益。此外，肥胖者应保持降低甘油三酯的饮食，并摄入含有脂肪的小餐，最好与能减少胆汁从胆囊排出的药物一起使用。
