Increase in serum total cholesterol and low-density lipoprotein cholesterol by high-dose chenodeoxycholic acid in patients with radiolucent gallstones significantly reversed during preventive low dose after gallstone dissolution.

This study examines the effects of high-dose chenodeoxycholic acid (CDCA) on serum lipids and lipoproteins in 25 patients who underwent a 12-month therapy with CDCA for the dissolution of cholesterol gallstones. All patients received a daily dose of CDCA of 15 mg/kg body weight. Complete dissolution of gallstones was achieved in 16 cases. After 6 months of therapy the mean total cholesterol levels and low-density lipoprotein cholesterol (C-LDL) significantly increased (p less than 0.001). The decrease of mean triglyceride levels was significant too (p less than 0.01), although it was greater among patients with effective gallstone dissolution than in patients with persistent gallstones. The effects of high-dose CDCA after 12 months of therapy were similar to those observed at 6 months. 12 patients of the gallstone dissolution group were treated with a continuous low dose of CDCA (250 mg/day) for preventing gallstone recurrence. 6 months after dissolution, the mean total cholesterol levels and C-LDL significantly decreased (p less than 0.01 and less than 0.05, respectively). High-dose administration of CDCA produced an increase in total cholesterol and C-LDL, but did not alter high-density lipoprotein cholesterol levels. These effects were significantly reversed when a preventive low dose of CDCA was given after gallstone dissolution.