STUDIES ON BILE ACID AND LIPID COMPOSITION OF BILE IN PATIENTS WITH GALLSTONES:Especially on the Disorder in Bile Acid Metabolism

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Bile acid and lipid composition of bile was estimated in 39 patients with gallstones and 8 controls. Twenty four patients with pigment stones in the biliary ducts and/or the gallbladder showed normal lipid composition of bile. In their bile acid composition, relative proportion of cholic acid significantly decreased, chenodeoxycholic acid increased and among many of them, ursodeoxycholic acid was detected. Many of them, including 4 old patients showed markedly elevated glycine/taurine-conjugated bile acid ratio, perhaps by proliferation of bacterial floras in the intestine.Meanwhile, 15 patients with cholesterol stones in the gallbladder showed significantly low bile acid/cholesterol ratio of bile, indicating supersaturation of bile with cholesterol. In their bile acid composition, relative proportion of cholic acid and deoxycholic acid elevated and chenodeoxycholic acid significantly decreased. Considering the relationship of biliary lipid composition to glycine/taurine-conjugated bile acid ratio, decrease of bile acid synthesis was suspected.In 6 patients with acute obstructive jaundice, proportion of cholic acid markedly elevated.
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