Mok H Y, von Bergmann K, Crouse J R, Grundy S M
Gastroenterology. 1979 Mar;76(3):556-67.
Obese subjects are prone to supersaturated bile, which is maintained or increased during weight loss. In this report, two related studies were carried out on obese subjects to investigate effects of bile acid feeding on biliary lipid metabolism before and during weight reduction. In one study, chenodeoxycholic acid (CDCA), 750 mg/day, was given to 12 obese subjects during weight maintenance (1st mo) and during weight reduction (2nd mo). In the second study, effects of two bile acid preparations, CDCA and Bilron (containing mostly cholic acid and deoxycholic acid), randomly administered, were compared in another 12 obese subjects undergoing weight reduction. The results show that obese subjects had large pools of bile acids during weight maintenance which decreased on caloric restriction (1,000 kcal/day). CDCA increased pool size only modestly during weight maintenance, from 3,536 +/- 1,267 (SD) mg to 4,735 +/- 1,434 mg. Both CDCA and Bilron markedly reexpanded the contracted pool of bile acids in obese subjects on weight reduction. However, significantly reduced saturation of bile occurred only in those on CDCA and weight reductions, whereas supersaturation was unaltered when weight was maintained constant in these patients, or when Bilron was given. No significant side effects were noted during bile acid feeding for any of the subjects. Thus, CDCA given to obese subjects on weight reduction will reduce bile saturation and could protect against gallstones.
肥胖受试者易出现胆汁过饱和，且在体重减轻期间这种情况会持续存在或加重。在本报告中，对肥胖受试者进行了两项相关研究，以调查在体重减轻之前和期间给予胆汁酸对胆汁脂质代谢的影响。在一项研究中，在体重维持期（第1个月）和体重减轻期（第2个月），给12名肥胖受试者每天服用750毫克鹅去氧胆酸（CDCA）。在第二项研究中，比较了另外12名正在减肥的肥胖受试者随机服用两种胆汁酸制剂（CDCA和Bilron，后者主要含胆酸和脱氧胆酸）的效果。结果显示，肥胖受试者在体重维持期胆汁酸池较大，在热量限制（每天1000千卡）时会减小。在体重维持期，CDCA仅适度增加胆汁酸池大小，从3536±1267（标准差）毫克增至4735±1434毫克。在体重减轻的肥胖受试者中，CDCA和Bilron均显著使收缩的胆汁酸池重新扩大。然而，仅在服用CDCA且体重减轻的受试者中，胆汁饱和度显著降低，而在这些患者体重保持不变或服用Bilron时，过饱和度未改变。在给任何受试者服用胆汁酸期间均未观察到明显副作用。因此，给体重减轻的肥胖受试者服用CDCA会降低胆汁饱和度，并可预防胆结石。
