Factors affecting the measurement of cholesterol nucleation in human gallbladder and duodenal bile

Marks, Jay W.; Broomfield, Paul; Bonorris, George; Schoenfield, Leslie J.

doi:10.1016/0016-5085(91)90480-9

Cited by 27 publications

(8 citation statements)

References 20 publications

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“…Nucleation is the critical step in gallstone formation in supersaturated bile [20][21][22]. This is an aggregation process by which crystals of cholesterol are formed.…”

Section: Cholesterol Stonesmentioning

confidence: 99%

Gender and Gallstone Disease

Novacek

2006

Wien Med Wochenschr

124

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Gallstone disease is a common disorder all over the world. In the Western societies about 80 % of the gallstones are composed primarily of cholesterol. Several risk factors for gallstone formation have been identified. One of the most important risk factors is female gender. Rates of gallstones are two to three times higher among women than men. But this is primarily a phenomenon of the childbearing age. Pregnancy is also a major risk factor for gallstone formation. The risk is related to the number of pregnancies. Sex hormones are most likely to be responsible for the increased risk. Estrogen increases biliary cholesterol secretion causing cholesterol supersaturation of bile. Thus, hormone replacement therapy in postmenopausal women and oral contraceptives have also been described to be associated with an increased risk for gallstone disease. However, the effect of estrogen is dose-dependent and new oral contraceptives with a low estrogen dose do not seem to increase the rate of gallstone formation. The present article focuses on the mentioned risk factors associated with female sex hormones.

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“…Nucleation is the critical step in gallstone formation in supersaturated bile [20][21][22]. This is an aggregation process by which crystals of cholesterol are formed.…”

Section: Cholesterol Stonesmentioning

confidence: 99%

Gender and Gallstone Disease

Novacek

2006

Wien Med Wochenschr

124

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“…Alternatively, bile-rich fluid can be aspirated from the duodenum of fasting subjects after stimulating gallbladder emptying with either cholecystokinin or caerulein [4], but samples obtained in this way may be contaminated with saliva, gastric and pancreatic secretions. With few exceptions [5], most investigators believe that duodenal bile is unsuitable for studies of physical chemistry. A third possible way of sampling bile is at endoscopic retrograde cholangiopancreatography (ERCP) [6,7] but these specimens contain variable mixtures of hepatic and gallbladder bile, with or without contrast media.…”

mentioning

confidence: 99%

Ultrasound-guided percutaneous fine needle puncture of the gallbladder for studies of bile composition

Hussaini¹,

Kennedy²,

Pereira³

et al. 1995

The British Journal of Radiology

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Ultrasound-guided percutaneous fine needle puncture of the gallbladder (PFNP-GB) is invaluable for diagnostic and research purposes, but there are few reports about its safety. We therefore describe the efficacy and side-effects of 43 consecutive gallbladder punctures in 39 patients. PFNP-GB was successful in 40/43 (93%), but failed in three. Bile was completely aspirated in 28 of the 40 (70%) successful procedures. After 36 of the 43 punctures (84%), the patients remained asymptomatic, although on seven occasions (16%) the patients complained of right upper quadrant pain 0.5-12 h after the procedure. In six of these, the pain resolved in 2-24 h, although one developed a leucocytosis (22 x 10(9) 1(-1)). The seventh patient developed pyrexia and signs of generalized peritonism, which settled with conservative therapy. Ultrasonographic abnormalities of the gallbladder wall were seen in five of the seven symptomatic patients, consisting of: (i) an increase in the thickness of the gallbladder wall (n = 5) from less than 2 mm to 4-14 mm; (ii) peri-cholecystic collections (n = 2) measuring 5 and 11 mm in diameter; (iii) an intraluminal mucosal flap (n = 1); (iv) an intraluminal echogenic layer (n = 1); and (v) a 12 cm intraabdominal haematoma in the patient with generalized peritonism. Predictors of pain were: (i) the number of needle "passes" (3.7 +/- 0.8, range 2-8, in patients with pain vs 2.0 +/- 0.2, range 1-6, in pain-free patients, p < 0.02); (ii) the absence of gallbladder stones (p < 0.03); and (iii) incomplete aspiration of bile from the gallbladder (p < 0.02). PFNP-GB is an effective way of sampling fresh gallbladder bile, although there is a 16% risk of inducing pain and/or ultrasonographic changes in the gallbladder.

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“…Our data confirm that increased bile cholesterol saturation gallbladder emptying from subjects' specific diet meals (õ1-g fat meal for the 520-kcal group, 10-g fat meal for the 900-kcal group) before treatment and index can occur during rapid weight loss. 1,6,7 The reason for at weeks 2, 4, and 8 during weight loss formula. Values are mean { SE.…”

Section: Discussionmentioning

confidence: 99%

“…Shortened kcal diet provided poor gallbladder emptying (35%), crystal nucleation time has been observed during very-lowwhereas the 10-g fat meal of the 900-kcal diet provided calorie liquid diets. 7 Mucin and calcium increased in gallbladmaximal emptying. Gallstones developed in four of six der bile of obese subjects forming gallstones after gastric by-520-kcal subjects and none of seven 900-kcal subjects (P pass.…”

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confidence: 96%

“…Obese subjects were randomized to one of two loss. 1,6,7 In one study, 10 subjects losing weight on a 1,000-low-calorie liquid diets for rapid weight loss: a 520-kcal kcal diet showed reduced output of all bile lipids, but 6 of the diet with less than 2 g fat/d, and a 900-kcal diet with 30 10 increased their bile saturation index. 6 On the other hand, g fat/d (including one 10-g fat meal to stimulate maximal several studies have reported decreased bile saturation index gallbladder emptying).…”

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The Role of Gallbladder Emptying in Gallstone Formation During Diet–Induced Rapid Weight Loss

et al. 1996

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nized factors in cholesterol gallstone formation; bile which is Obese persons are at risk for cholesterol gallstones saturated with cholesterol is essential for crystals to form, because their bile is saturated with cholesterol. The risk nucleation factors can influence whether crystals form in satincreases during rapid weight loss by means of certain urated bile, and gallbladder stasis can allow crystal growth. very-low-calorie diets or gastric bypass surgery. GallObesity is associated with increased bile cholesterol secrestone risk factors during rapid weight loss include intion and saturation index. 6 Several studies suggest that bile creased bile cholesterol saturation index and gallbladsaturation index increases further during rapid weight der stasis. Obese subjects were randomized to one of two loss. 1,6,7 In one study, 10 subjects losing weight on a 1,000-low-calorie liquid diets for rapid weight loss: a 520-kcal kcal diet showed reduced output of all bile lipids, but 6 of the diet with less than 2 g fat/d, and a 900-kcal diet with 30 10 increased their bile saturation index. 6 On the other hand, g fat/d (including one 10-g fat meal to stimulate maximal several studies have reported decreased bile saturation index gallbladder emptying). Bile and blood lipids, saturation after 6 to 20 days of fasting. 8,9 Cholesterol may be mobilized index, leukocyte 3-hydroxy-3-methylglutaryl coenzyme from tissue stores to be secreted into bile during rapid weight A (HMG CoA) reductase activity, and ultrasonographic loss. 6 Decreased bile acid synthesis has also been detected gallbladder emptying were measured repeatedly during during diet-induced weight loss and fasting. 6,9,10 Thus, rapid dietary treatment. Both diets produced comparable weight loss may alter secretion of cholesterol and bile acids weight loss of 22%. Bile cholesterol saturation index inin a manner conducive to gallstone formation. creased during both diets (26%), but fell to 15% below Pro-and antinucleating proteins and mucins are described prediet level after weight loss. Compared with subjects' in gallbladder bile, and may predispose to gallstones. These maximal gallbladder emptying fraction of 66%, the 520-factors could change during rapid weight loss. Shortened kcal diet provided poor gallbladder emptying (35%), crystal nucleation time has been observed during very-lowwhereas the 10-g fat meal of the 900-kcal diet provided calorie liquid diets. 7 Mucin and calcium increased in gallbladmaximal emptying. Gallstones developed in four of six der bile of obese subjects forming gallstones after gastric by-520-kcal subjects and none of seven 900-kcal subjects (P pass. 11,12 Å .021), an unanticipated difference that resulted in preGallbladder emptying may also participate in gallstone formature study termination for ethical reasons. Blood lipmation. 13 Studies of meal-stimulated gallbladder emptying in ids and HMG CoA reductase activity in mononuclear leuobese subjects have given variable results. [14][15][16][17] We and others kocytes fell at week 8 durin...

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Factors affecting the measurement of cholesterol nucleation in human gallbladder and duodenal bile

Cited by 27 publications

References 20 publications

Gender and Gallstone Disease

Gender and Gallstone Disease

Ultrasound-guided percutaneous fine needle puncture of the gallbladder for studies of bile composition

The Role of Gallbladder Emptying in Gallstone Formation During Diet–Induced Rapid Weight Loss

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