The relationship between serum lipids, nucleation time, and biliary lipids in patients with gallstones

Janowitz, P; Wechsler, J. G.; Kuhn, Klaus A.; Kratzer, Wolfgang; Tudyka, J; Swobodnik, W; Ditschuneit, H.

doi:10.1007/bf00235527

Cited by 19 publications

(16 citation statements)

References 31 publications

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“…Because we found no considerable evidence for disease effects due to biliary stones, it is possible that high levels of triglycerides, and low levels of HDL and apo A, may affect the risk of biliary stones through their involvement in several key processes of gallstone pathogenesis. For example, high serum triglyceride levels are associated with increased cholesterol saturation of the bile 7,30,31 and rapid nucleation of cholesterol crystals, 32 important precursors to gallstones. Similarly, low serum levels of apo A have been linked to decreased cholesterol crystallization in the bile, 33 and low serum levels of HDL have been associated with increased biliary cholesterol saturation and bile acid hyposecretion, 8,[30][31][32] which reduces cholesterol solubility in the bile and leads to gallstone formation.…”

Section: Discussionmentioning

confidence: 99%

“…For example, high serum triglyceride levels are associated with increased cholesterol saturation of the bile 7,30,31 and rapid nucleation of cholesterol crystals, 32 important precursors to gallstones. Similarly, low serum levels of apo A have been linked to decreased cholesterol crystallization in the bile, 33 and low serum levels of HDL have been associated with increased biliary cholesterol saturation and bile acid hyposecretion, 8,[30][31][32] which reduces cholesterol solubility in the bile and leads to gallstone formation. 34 Although the exact role of low levels of total cholesterol and/or LDL in gallstone formation is unclear, a number of indirect observations suggest a possible inverse association between total cholesterol and gallstone pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

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Serum lipid levels and the risk of biliary tract cancers and biliary stones: A population‐based study in China

Andreotti

Chen

Gao

et al. 2007

Intl Journal of Cancer

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Biliary tract cancers, encompassing the gallbladder, extrahepatic bile ducts and ampulla of Vater, are rare but highly fatal malignancies. Gallstones, the predominant risk factor for biliary cancers, are linked with hyperlipidemia. As part of a populationbased case-control study conducted in Shanghai, China, we examined the associations of serum lipid levels with biliary stones and cancers. We included 460 biliary cancer cases (264 gallbladder, 141 extrahepatic bile duct, and 55 ampulla of Vater), 981 biliary stone cases and 858 healthy individuals randomly selected from the population. Participants completed an in-person interview and gave overnight fasting blood samples. Participants in the highest quintile of triglycerides (≥160 mg/dl) had a 1.4-fold risk of biliary stones (95% CI 5 1.1-1.9), a 1.9-fold risk of gallbladder cancer (95% CI 5 1.3-2.8), and a 4.8-fold risk of bile duct cancer (95% CI 5 2.8-8.1), compared to the reference group (third quintile: 90-124 mg/dl). Participants in the lowest quintile of high-density lipoprotein (HDL) (<30 mg/dl) had a 4.2-fold risk of biliary stones (95% CI 5 3.0-6.0), an 11.6-fold risk of gallbladder cancer (95% CI 5 7.3-18.5), and a 16.8-fold risk of bile duct cancer (95% CI 5 9.1-30.9), relative to the reference group (third quintile: 40-49 mg/dl). In addition, total cholesterol, low-density lipoprotein (LDL) and apolipoprotein A (apo A) were inversely associated with biliary stones; whereas low levels as well as high levels of total cholesterol, LDL, apo A and apolipoprotein B (apo B) were associated with excess risks of biliary tract cancers. Our findings support a role for serum lipids in gallstone development and biliary carcinogenesis. ' 2007 Wiley-Liss, Inc.Key words: serum lipid levels; gallstones; biliary tract cancer Biliary tract cancers, consisting of tumors of the gallbladder, extrahepatic bile ducts and ampulla of Vater, are rare but highly fatal malignancies. 1,2 Gallstones are the most important known risk factor for all three biliary tract cancer subsites. Specifically, cholesterol gallstones (composed mainly of cholesterol) and mixed gallstones (composed of both cholesterol and bilirubin) are most strongly associated with gallbladder cancer. 2,3 Furthermore, cholesterol gallstones and gallbladder cancer share a number of putative risk factors, including obesity, high fat diet and hyperlipidemia. 2,4 Hyperlipidemia is generally characterized by high serum levels of total cholesterol, triglycerides, low-density-lipoprotein (LDL), and low levels of high-density-lipoprotein (HDL). High triglycerides and low HDL have been most consistently associated with gallstones, whereas the associations of total cholesterol and LDL with gallstones are less consistent. [5][6][7] Cholesterol gallstone pathogenesis involves cholesterol saturation of the bile duct due to the hypersecretion of cholesterol from the liver 8 ; however, the exact role of individual lipids, lipoproteins and apolipoproteins is less clear.Given the relationship between hyperlipidemia and gallsto...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Serum lipid levels and the risk of biliary tract cancers and biliary stones: A population‐based study in China

Andreotti

Chen

Gao

et al. 2007

Intl Journal of Cancer

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“…Many different studies of plasma lipids in various ChGS-prone population groups have produced results that are not uniform (7,(26)(27)(28)(29)(30)(31). There are studies that identified a strong correlation between low plasma HDL-C and increased risk of ChGS, but Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Because low plasma HDL-C concentration has been linked epidemiologically to ChGS disease in humans and in mice (7,(26)(27)(28)(29)(30)(31), we quantified the effects of obesity mutations on plasma total, HDL, and non-HDL choles- terol levels ( Table 4). The values display that none of the obesity mutations results in a significant decline in HDL-C concentrations.…”

Section: Hepatic and Plasma Cholesterol Concentrationsmentioning

confidence: 99%

Cholesterol gallstone formation in overweight mice establishes that obesity per se is not linked directly to cholelithiasis risk

Bouchard

Johnson

Carver

et al. 2002

Journal of Lipid Research

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The relationship between obesity and cholesterol cholelithiasis is not well understood at physiologic or genetic levels. To clarify whether obesity per se leads to increased prevalence of cholelithiasis, we examined cholesterol gallstone susceptibility in three polygenic (KK/H1J, NON/LtJ, NOD/LtJ) and five monogenic [carboxypeptidase E ( Cpe fat ), agouti yellow (A y ) , tubby ( tub ), leptin ( Lep ob ), leptin receptor ( Lepr db )] murine models of obesity during ingestion of a lithogenic diet containing dairy fat, cholesterol, and cholic acid. At 8 weeks on the diet, one strain of polygenic obese mice was resistant whereas the others revealed low or intermediate prevalence rates of cholelithiasis. Monogenic obese mice showed distinct patterns with either high or low gallstone prevalence rates depending upon the mutation. Dysfunction of the leptin axis, as evidenced by the Lep ob and the Lepr db mutations, markedly reduced gallstone formation in a genetically susceptible background strain, indicating that in mice with this genetic background, physiologic leptin homeostasis is a requisite for cholesterol cholelithogenesis. In contrast, the Cpe fat mutation enhanced the prevalence of cholelithiasis markedly when compared with the background strain. Since CPE converts many prohormones to hormones, a deficiency of biologically active cholecystokinin is a likely contributor to enhanced susceptibility to cholelithiasis through compromising gallbladder contractility and small intestinal motility. Because some murine models of obesity increased, whereas others decreased cholesterol gallstone susceptibility, we establish that cholesterol cholelithiasis in mice is not simply a secondary consequence of obesity per se. Rather, specific genes and distinct pathophysiological pathways are responsible for the shared susceptibility to both of these common diseases. -Bouchard, G., D. Johnson, T. Carver, B. Paigen, and M. C. Carey. Cholesterol gallstone formation in overweight mice establishes that obesity per se is not linked directly to cholelithiasis risk.

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“…Bile is rich in phospholipids, phosphates, cholesterine, chenodesoxycholic acid, and bilirubin. The enzymatic activity of bile is poor [19]. Nevertheless it is regarded as an 'aggressive juice' in surgery once it leaks out of the biliary and digestive tract.…”

Section: Discussionmentioning

confidence: 99%

Biodegradation of Absorbable Sutures in Body Fluids and pH Buffers

Freudenberg¹,

Rewerk²,

Kaess³

et al. 2004

Eur Surg Res

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Objective: This study measures the influence of body fluids on the loss of tensile strength of absorbable sutures in vitro. Methods: Nine synthetic absorbable sutures were incubated in different gastrointestinal fluids, as well as in blood and three buffers. Stretch tests were performed after days 0, 7, 14, and 21. Results: Tensile strength varied from 18.5 to 32.8 N, and elasticity varied from 9.5 to 51% of the initial length. The influence of pH, blood, and gastric juice was negligible on all sutures except PDS II^®. Except for Monocryl^®, all sutures, especially Polysorb^® and Vicryl^®, lost tensile strength much faster in bile, jejunal and pancreatic juices than in the corresponding buffers. Conclusion: The biodegradation of sutures varies greatly in different body fluids independent of differences in pH.

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The relationship between serum lipids, nucleation time, and biliary lipids in patients with gallstones

Cited by 19 publications

References 31 publications

Serum lipid levels and the risk of biliary tract cancers and biliary stones: A population‐based study in China

Serum lipid levels and the risk of biliary tract cancers and biliary stones: A population‐based study in China

Cholesterol gallstone formation in overweight mice establishes that obesity per se is not linked directly to cholelithiasis risk

Biodegradation of Absorbable Sutures in Body Fluids and pH Buffers

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