Gallbladder bile supersaturated with cholesterol in gallstone patients preferentially develops from shortage of bile acids
Gallstone (GS) formation requires that bile is supersaturated with cholesterol, which is estimated by a cholesterol saturation index (CSI) calculated from gallbladder (GB) total lipids and the mol% (mole percent) of bile acids (BAs), cholesterol, and phospholipids (PLs). Whereas CSI indicates GS ris...
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2019-03-01
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doaj-0deeee3d7cf346bcac71a0ab644166e92021-04-29T04:35:49ZengElsevierJournal of Lipid Research0022-22752019-03-01603498505Gallbladder bile supersaturated with cholesterol in gallstone patients preferentially develops from shortage of bile acidsMats Rudling0Amit Laskar1Sara Straniero2To whom correspondence should be addressed.; Metabolism Unit, Endocrinology, Metabolism and Diabetes, and Integrated CardioMetabolic Center (ICMC), Department of Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, S-141 86 Stockholm, SwedenMetabolism Unit, Endocrinology, Metabolism and Diabetes, and Integrated CardioMetabolic Center (ICMC), Department of Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, S-141 86 Stockholm, SwedenMetabolism Unit, Endocrinology, Metabolism and Diabetes, and Integrated CardioMetabolic Center (ICMC), Department of Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, S-141 86 Stockholm, SwedenGallstone (GS) formation requires that bile is supersaturated with cholesterol, which is estimated by a cholesterol saturation index (CSI) calculated from gallbladder (GB) total lipids and the mol% (mole percent) of bile acids (BAs), cholesterol, and phospholipids (PLs). Whereas CSI indicates GS risk, we hypothesized that additional comparisons of GB lipid mol% data are inappropriate to identify why CSI is increased in GS disease. We anticipated that GB lipid mmol/l (millimole per liter) levels should instead identify that, and therefore retrieved GB mmol/l data for BAs, cholesterol, and PLs from a study on 145 GS and 87 GS-free patients and compared them with the corresponding mol% data. BA and PL mmol/l levels were 33% and 31% lower in GS patients, while cholesterol was unaltered. CSI was higher in GS patients and correlated inversely with GB levels of BAs and PLs, but not with cholesterol. A literature search confirmed, in 13 studies from 11 countries, that GB BA levels and, to a certain extent, PLs are strongly reduced in GS patients, while cholesterol levels are not elevated. Our findings show that a shortage of BAs is a major reason why GB bile is supersaturated with cholesterol in GS patients. These results are sustainable because they are also valid from a global perspective.http://www.sciencedirect.com/science/article/pii/S0022227520326134bile acid metabolismbile physical chemistry/gallstone formationcholesterol metabolismgallstone formationobesity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mats Rudling Amit Laskar Sara Straniero |
spellingShingle |
Mats Rudling Amit Laskar Sara Straniero Gallbladder bile supersaturated with cholesterol in gallstone patients preferentially develops from shortage of bile acids Journal of Lipid Research bile acid metabolism bile physical chemistry/gallstone formation cholesterol metabolism gallstone formation obesity |
author_facet |
Mats Rudling Amit Laskar Sara Straniero |
author_sort |
Mats Rudling |
title |
Gallbladder bile supersaturated with cholesterol in gallstone patients preferentially develops from shortage of bile acids |
title_short |
Gallbladder bile supersaturated with cholesterol in gallstone patients preferentially develops from shortage of bile acids |
title_full |
Gallbladder bile supersaturated with cholesterol in gallstone patients preferentially develops from shortage of bile acids |
title_fullStr |
Gallbladder bile supersaturated with cholesterol in gallstone patients preferentially develops from shortage of bile acids |
title_full_unstemmed |
Gallbladder bile supersaturated with cholesterol in gallstone patients preferentially develops from shortage of bile acids |
title_sort |
gallbladder bile supersaturated with cholesterol in gallstone patients preferentially develops from shortage of bile acids |
publisher |
Elsevier |
series |
Journal of Lipid Research |
issn |
0022-2275 |
publishDate |
2019-03-01 |
description |
Gallstone (GS) formation requires that bile is supersaturated with cholesterol, which is estimated by a cholesterol saturation index (CSI) calculated from gallbladder (GB) total lipids and the mol% (mole percent) of bile acids (BAs), cholesterol, and phospholipids (PLs). Whereas CSI indicates GS risk, we hypothesized that additional comparisons of GB lipid mol% data are inappropriate to identify why CSI is increased in GS disease. We anticipated that GB lipid mmol/l (millimole per liter) levels should instead identify that, and therefore retrieved GB mmol/l data for BAs, cholesterol, and PLs from a study on 145 GS and 87 GS-free patients and compared them with the corresponding mol% data. BA and PL mmol/l levels were 33% and 31% lower in GS patients, while cholesterol was unaltered. CSI was higher in GS patients and correlated inversely with GB levels of BAs and PLs, but not with cholesterol. A literature search confirmed, in 13 studies from 11 countries, that GB BA levels and, to a certain extent, PLs are strongly reduced in GS patients, while cholesterol levels are not elevated. Our findings show that a shortage of BAs is a major reason why GB bile is supersaturated with cholesterol in GS patients. These results are sustainable because they are also valid from a global perspective. |
topic |
bile acid metabolism bile physical chemistry/gallstone formation cholesterol metabolism gallstone formation obesity |
url |
http://www.sciencedirect.com/science/article/pii/S0022227520326134 |
work_keys_str_mv |
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