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Bilirubin monoglucuronide promotes cholesterol gallstone formation
H S Kaufman1, T H Magnuson, T H Webb
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The Journal of Surgical Research
|May 1, 1991
Summary
High carbohydrate diets increase bilirubin monoglucuronide, promoting cholesterol gallstone formation even without cholesterol supersaturation in prairie dog bile.
Area of Science:
- Biliary lipid metabolism
- Gastroenterology
- Biochemistry
Background:
- Bile composition, including cholesterol, mixed micelles, and lecithin-cholesterol vesicles, influences gallstone formation.
- Bilirubin monoglucuronide (BMG) may displace cholesterol from micelles, potentially leading to crystal precipitation.
Purpose of the Study:
- To test if bilirubin monoglucuronide enhances cholesterol gallstone formation without causing cholesterol supersaturation.
- To investigate the role of high carbohydrate diets in gallstone pathogenesis.
Main Methods:
- Prairie dogs were fed control, high carbohydrate (CHO), or CHO plus trace cholesterol diets for 8 weeks.
- Bile was analyzed for gallstones, crystals, BMG, and lipids post-cholecystectomy.
- Cholesterol saturation index was calculated.
Main Results:
- No gallstones formed in control animals.
- 13% of CHO-fed animals developed gallstones; 88% developed gallstones when trace cholesterol was added (P < 0.001).
- Gallbladder bile remained unsaturated with cholesterol across all groups, but BMG, phospholipid, and cholesterol concentrations increased with CHO diets.
Conclusions:
- High carbohydrate diets, even with minimal cholesterol, increase BMG in bile.
- This leads to cholesterol gallstone formation in prairie dogs without inducing cholesterol supersaturation.
- BMG appears to be a key factor in diet-induced cholesterol gallstone formation.