Document Detail


Comparative evaluation of chenodeoxycholic and ursodeoxycholic acids in obese patients. Effects on biliary lipid metabolism during weight maintenance and weight reduction.
MedLine Citation:
PMID:  2065925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Obesity is a condition associated with an increased frequency of gallstone disease. This study attempted to evaluate the comparative effects of two gallstone-dissolving agents, chenodeoxycholic acid and ursodeoxycholic acid, on bile acid metabolism and biliary lipid secretion in obese subjects in order to identify the bile acid of choice in preventing and treating gallstone disease in obesity. Twenty obese subjects (greater than 120% ideal body wt) were randomly treated with ursodeoxycholic acid (10 mg.kg-1.day-1.1 mo-1) and then with chenodeoxycholic acid (15 mg.kg-1.day-1.1 mo-1) or with chenodeoxycholic acid first and then with ursodeoxycholic acid. Patients 1-10 were studied while eating an unrestricted weight-maintenance diet, whereas patients 11-20 were eating a 1080-kcal/d hypocaloric diet. Biliary lipid composition, cholesterol saturation index, and biliary bile acid pattern were evaluated in all subjects before and after each treatment period; in subjects 6-10 and 16-20, biliary lipid secretion rates and bile acid pool size were also evaluated. Both ursodeoxycholic acid and chenodeoxycholic acid decreased cholesterol outputs and cholesterol saturation index. However, during the weight-maintenance period the decrease induced by chenodeoxycholic acid was not significant. Biliary cholesterol outputs and cholesterol saturation index were always lower during ursodeoxycholic acid administration than during chenodeoxycholic acid therapy. Ursodeoxycholic acid levels during ursodeoxycholic acid administration and chenodeoxycholic acid levels during chenodeoxycholic acid administration increased in bile to 50% and 77%, respectively, of total bile acid levels. Bile acid pool size remained unchanged during chenodeoxycholic acid administration and was significantly reduced by ursodeoxycholic acid administration during the weight-reduction period. In conclusion, ursodeoxycholic acid in obese subjects seems more effective than chenodeoxycholic acid, at least during weight maintenance, in reducing cholesterol saturation of bile. This effect is related to a significant decrease of biliary cholesterol output.
Authors:
G Mazzella; F Bazzoli; D Festi; M Ronchi; R Aldini; A Roda; B Grigolo; P Simoni; N Villanova; E Roda
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Gastroenterology     Volume:  101     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-08-15     Completed Date:  1991-08-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  490-6     Citation Subset:  AIM; IM    
Affiliation:
Cattedra di Gastroenterologia, Universitía di Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bile / chemistry,  drug effects*,  secretion
Bile Acids and Salts / chemistry,  secretion
Chenodeoxycholic Acid / pharmacology,  therapeutic use*
Cholelithiasis / etiology,  prevention & control*
Cholesterol / analysis,  secretion
Drug Evaluation
Female
Humans
Male
Middle Aged
Obesity / complications*
Phospholipids / analysis,  secretion
Ursodeoxycholic Acid / pharmacology,  therapeutic use*
Weight Loss / physiology
Chemical
Reg. No./Substance:
0/Bile Acids and Salts; 0/Phospholipids; 128-13-2/Ursodeoxycholic Acid; 474-25-9/Chenodeoxycholic Acid; 57-88-5/Cholesterol

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