Kesäniemi Y A, Salaspuro M P, Vuoristo M, Miettinen T A
Gut. 1982 Nov;23(11):931-8. doi: 10.1136/gut.23.11.931.
Biliary lipid secretion rates, faecal steroids, and serum lipids were studied in patients with chronic cholestatic liver disease mainly primary biliary cirrhosis. The biliary secretion of cholesterol, bile acids, and phospholipids was markedly decreased as compared with those in the control group and in general correlated negatively with the serum cholesterol and triglyceride values. The molar percentage of cholesterol was increased in the hepatic bile. This suggests that, in cholestatic liver disease, in contrast with the normal state, the hapatic bile may be supersaturated postprandially. Faecal bile acids and neutral sterols of cholesterol origin were decreased proportionately to the corresponding biliary lipid secretion rates. In fact, both biliary and faecal steroid outputs were only about a half or less than those in the controls, indicating that the fractional absorption was not changed but absolute absorption and faecal steroid excretion were low in patients with chronic cholestatic liver disease. Thus, despite low cholesterol and bile acid absorption, cholesterol and bile acid synthesis is low. A negative correlation between faecal steroids and serum cholesterol suggests that the high serum cholesterol level contributed to regulation of cholesterol synthesis.
对主要患有原发性胆汁性肝硬化的慢性胆汁淤积性肝病患者的胆汁脂质分泌率、粪便类固醇和血清脂质进行了研究。与对照组相比，胆固醇、胆汁酸和磷脂的胆汁分泌明显减少，并且总体上与血清胆固醇和甘油三酯值呈负相关。肝胆汁中胆固醇的摩尔百分比增加。这表明，与正常状态相比，在胆汁淤积性肝病中，餐后肝胆汁可能会过饱和。粪便胆汁酸和胆固醇来源的中性固醇与相应的胆汁脂质分泌率成比例降低。事实上，胆汁和粪便类固醇的输出量仅约为对照组的一半或更少，这表明慢性胆汁淤积性肝病患者的分数吸收没有改变，但绝对吸收和粪便类固醇排泄较低。因此，尽管胆固醇和胆汁酸吸收较低，但胆固醇和胆汁酸的合成也较低。粪便类固醇与血清胆固醇之间的负相关表明，高血清胆固醇水平有助于调节胆固醇的合成。
