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Citations to this article

Effects of obesity and caloric intake on biliary lipid metabolism in man.
L J Bennion, S M Grundy
L J Bennion, S M Grundy
Published October 1, 1975
Citation Information: J Clin Invest. 1975;56(4):996-1011. https://doi.org/10.1172/JCI108180.
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Research Article Article has an altmetric score of 6

Effects of obesity and caloric intake on biliary lipid metabolism in man.

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Abstract

The effects of obesity and caloric intake on biliary lipid metabolism were investigated in a series of related studies. The degree of saturation of gallbladder bile with cholesterol was found to be significantly higher in a group of 23 obese healthy subjects than in a group of 23 nonobese controls matched for age, sex, and race. Bile was also significantly more saturated in 11 obese subjects before than after weight reduction. To determine whether supersaturated bile in obesity is due to excessive secretion of cholesterol or to deficient secretion of bile acids and phospholipids, the hepatic outputs of these three lipids were measured during constant duodenal infusion of formula in the same 11 subjects before and after weight reduction. Weight reduction resulted in significant reduction of cholesterol output but not of bile acid or phospholipid output. Moreover, very obese subjects were found to have cholesterol secretion rates markedly higher than less obese subjects previously studied by the same method. In obese subjects, bile was supersaturated with cholesterol despite increased bile acid pool sizes and increased secretion rates of bile acids and phospholipids. Supersaturated bile in the obese could therefore be attributed to a single defect in lipid secretion, namely, an excessive output of cholesterol. To determine whether the rate of caloric intake can account for the effects of obesity on biliary lipid composition and secretion, nine obese white men were studied on a weight maintenance diet and then during weight reduction on a 1,000 cal diet. As compared to weight maintenance, chronic caloric restriction resulted in reduced outputs of cholesterol, bile acids, and phospholipids, reduced bile acid pool size, and reduced synthesis and fecal excretion of cholesterol. Saturation of bile with cholesterol did not decrease during weight reduction, evidently because of the mobilization of cholesterol from adipose stores and the marked reduction in bile acid and phospholipid output observed during chronic caloric restriction. Acute alterations in caloric infusion rates did not fully reproduce the effects of chronic administration of high and low calorie diets. Likewise, chronic intake of hypercaloric diets by nonobese subjects did not reproduce the cholesterol hypersecretion characteristic of the obese. Thus, increased cholesterol secretion in obese subjects could not be fully explained by the amount of calories they ingested to maintain stable weight. It is concluded that obesity is characterized by excessive hepatic secretion of cholesterol which results in supersaturated bile.

Authors

L J Bennion, S M Grundy

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Citations to this article in year 2011 (3)

Title and authors Publication Year
Abnormalities of lipid metabolism, gallstone disease and gallbladder function
S Zanlungo, A Rigotti, JF Miquel, F Nervi
Clinical Lipidology 2011
The aetiology of symptomatic gallstones quantification of the effects of obesity, alcohol and serum lipids on risk. Epidemiological and biomarker data from a UK prospective cohort study (EPIC-Norfolk)
PJ Banim, RN Luben, H Bulluck, SJ Sharp, NJ Wareham, KT Khaw, AR Hart
European Journal of Gastroenterology & Hepatology 2011
Role of nuclear receptors for bile acid metabolism, bile secretion, cholestasis, and gallstone disease
T Claudel, G Zollner, M Wagner, M Trauner
Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease 2011

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