Vuoristo M, Miettinen T A
Eur J Clin Invest. 1982 Aug;12(4):285-91. doi: 10.1111/j.1365-2362.1982.tb02234.x.
Hypocholesterolaemia and high faecal elimination of cholesterol was explored by measuring the percentage of cholesterol absorbed, faecal steroids, serum cholesterol and dietary cholesterol in patients with coeliac disease before and after a gluten free diet. From these data, the total and endogenous flux of cholesterol into the gut and the amount of cholesterol absorbed could be calculated. The mean faecal bile acid excretion was normal, but faecal endogenous steroids and thus faecal total steroids, and the cholesterol synthesis, were increased in the patients. The percentage of cholesterol absorbed was quite low (15.1 +/- 2.1 (SEM) v. 34.1 +/- 2.5 in the controls), and it was attributable to a mucosal damage in the upper small intestine, suggesting that this played a primary role in the high faecal sterol loss. However, the influx of endogenous cholesterol into the gut had increased, so that in absolute terms the absorption of cholesterol was low only inconsistently. The gluten-free diet caused the opposite changes in the absorption percentage and influx of cholesterol into the gut, while the amount of cholesterol absorbed was only insignificantly increased. Serum cholesterol was significantly correlated with the cholesterol absorbed (r = 0.36; P less than 0.01), faecal endogenous steroids (r = -0.30; P less than 0.05), and cholesterol synthesis (r = -0.29; P less than 0.05). Furthermore, the rise in serum cholesterol during the gluten-free diet correlated negatively with the changes in cholesterol (r = -0.55; P less than 0.05) and bile acid (r = -0.77; P less than 0.01) synthesis. These associations and the lack of correlations between the amounts of cholesterol absorbed and synthesized suggest that the serum cholesterol level and regulation of cholesterol synthesis are interrelated in coeliac disease.
通过测量乳糜泻患者在无麸质饮食前后胆固醇吸收百分比、粪便类固醇、血清胆固醇和膳食胆固醇，探讨了低胆固醇血症和粪便中胆固醇的高排泄情况。根据这些数据，可以计算出进入肠道的胆固醇总量和内源性通量以及吸收的胆固醇量。患者粪便胆汁酸排泄均值正常，但粪便内源性类固醇以及粪便总类固醇和胆固醇合成增加。胆固醇吸收百分比相当低（15.1±2.1（标准误），而对照组为34.1±2.5），这归因于上段小肠的黏膜损伤，表明这在粪便固醇高丢失中起主要作用。然而，内源性胆固醇进入肠道的通量增加，因此就绝对量而言，胆固醇吸收仅不一致地低。无麸质饮食使胆固醇吸收百分比和进入肠道的通量发生相反变化，而吸收的胆固醇量仅略有增加。血清胆固醇与吸收的胆固醇（r = 0.36；P<0.01）、粪便内源性类固醇（r = -0.30；P<0.05）和胆固醇合成（r = -0.29；P<0.05）显著相关。此外，无麸质饮食期间血清胆固醇的升高与胆固醇（r = -0.55；P<0.05）和胆汁酸（r = -0.77；P<0.01）合成的变化呈负相关。这些关联以及吸收和合成的胆固醇量之间缺乏相关性表明，乳糜泻中血清胆固醇水平与胆固醇合成调节是相互关联的。
