The effects of short term lipid infusion on plasma and hepatic bile lipids in humans
| Autor: | Ronit Pakula, Moshe Rubin, A. Tietz, Tuvia Gilat, Fred M. Konikoff, F Greif, A. Moser |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Fat Emulsions Intravenous medicine.medical_specialty Linoleic acid medicine.medical_treatment Biology Article chemistry.chemical_compound Cholelithiasis Internal medicine Blood plasma medicine Bile Humans Cholecystectomy Biliary sludge Enterohepatic circulation Phospholipids Triglycerides Aged Cholesterol Gastroenterology Middle Aged medicine.disease Endocrinology Parenteral nutrition chemistry Cholecystitis lipids (amino acids peptides and proteins) Female |
| Zdroj: | Gut. 45:453-458 |
| ISSN: | 1468-3288 0017-5749 |
| DOI: | 10.1136/gut.45.3.453 |
| Popis: | BACKGROUNDPatients on parenteral nutrition have an increased incidence of gall bladder sludge and gallstone disease, thought to be related to bile stasis. Intravenous lipid emulsions, especially those containing medium chain triglycerides, have also been shown to have a lithogenic effect on the composition of bile in the gall bladder.AIMSTo determine whether lipid infusion influences hepatic bile composition in patients with an indwelling T tube following cholecystectomy and choledochotomy.METHODSIn eight patients undergoing the above surgical procedure, the time at which effects of the interrupted enterohepatic circulation were minimal was determined. Twenty two cholesterol gallstone patients with bile fistula were then randomised to receive an infusion of a lipid emulsion containing either long chain triglycerides or a mixture of long and medium chain triglycerides.RESULTSLipid infusion resulted in a significant increase in plasma levels of triglycerides and phospholipids. Both lipid emulsions caused an increase in hepatic biliary cholesterol level and cholesterol saturation index, but this effect was more pronounced with medium chain triglycerides. The fatty acid composition of biliary phospholipids showed a significant enrichment of linoleic acid by both lipid infusions.CONCLUSIONSInfusion of triglycerides causes lithogenic changes in hepatic bile composition in humans, the lithogenic effect of infusion of medium chain triglycerides being more pronounced than that of long chain triglycerides. This effect, coupled with gall bladder stasis, may be responsible for the increased risk of biliary sludge and gallstone formation in patients on long term lipid infusion. |
| Databáze: | OpenAIRE |
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