Watanabe F, Hanai H, Kaneko E
First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu-City, Japan.
Am J Gastroenterol. 1998 Sep;93(9):1518-23. doi: 10.1111/j.1572-0241.1998.00473.x.
Although cholesterolosis of the human gallbladder is a relatively common disease, its etiology has not been fully understood. The aim of this study was to determine this etiology.
The lipid composition of the gallbladder mucosa and gallbladder bile and the enzyme activities (acylCoA-cholesterol ester acyltransferase [ACAT] and cholesterol ester hydrolase [CEH]) of the gallbladder mucosa were measured in control subjects, patients with cholesterolosis, and patients with cholesterol gallstone disease.
Levels of cholesterol ester in gallbladder mucosa in patients with cholesterolosis (n = 12) were higher than those in control subjects (n = 8). With regard to the lipid content in gallbladder bile, no differences were found in concentrations of cholesterol, phospholipids, and bile acids among control subjects (n = 11), patients with cholesterolosis (n = 13), and those with cholesterol gallstone disease (n = 15). In gallbladder mucosa, ACAT activity was significantly higher in patients with cholesterolosis (n = 10) than in control subjects (n = 8), whereas CEH activity did not differ between the two groups. As a result, the ACAT/CEH activity ratio was higher in patients with cholesterolosis than in control subjects.
It would be suggested that cholesterol ester synthesis of gallbladder mucosa might play an etiological role in the development of cholesterolosis.
尽管人类胆囊胆固醇沉着症是一种相对常见的疾病,但其病因尚未完全明确。本研究旨在确定其病因。
对对照组、胆固醇沉着症患者和胆固醇结石病患者测量胆囊黏膜和胆囊胆汁的脂质成分以及胆囊黏膜的酶活性(酰基辅酶A胆固醇酯酰基转移酶[ACAT]和胆固醇酯水解酶[CEH])。
胆固醇沉着症患者(n = 12)胆囊黏膜中的胆固醇酯水平高于对照组(n = 8)。关于胆囊胆汁中的脂质含量,对照组(n = 11)、胆固醇沉着症患者(n = 13)和胆固醇结石病患者(n = 15)之间的胆固醇、磷脂和胆汁酸浓度未发现差异。在胆囊黏膜中,胆固醇沉着症患者(n = 10)的ACAT活性显著高于对照组(n = 8),而两组之间的CEH活性无差异。因此,胆固醇沉着症患者的ACAT/CEH活性比值高于对照组。
提示胆囊黏膜胆固醇酯合成可能在胆固醇沉着症的发生中起病因学作用。