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Deoxycholate metabolism in alcoholic cirrhosis
Gastroenterology
|August 1, 1976
Summary
Patients with alcoholic cirrhosis often lack deoxycholate in bile. Reduced fecal bacterial conversion of cholate to deoxycholate, due to decreased 7 alpha-dehydroxylase activity, explains this bile acid metabolism abnormality.
Area of Science:
- Gastroenterology
- Hepatology
- Microbiology
Background:
- Bile acid metabolism is crucial for digestion and liver function.
- Alcoholic cirrhosis is associated with altered bile composition, including deoxycholate deficiency.
Purpose of the Study:
- To elucidate the mechanism behind deoxycholate deficiency in the bile of patients with alcoholic cirrhosis.
- To investigate abnormalities in bile acid metabolism in alcoholic cirrhosis.
Main Methods:
- Quantitative and qualitative analysis of fecal bile acids.
- Measurement of fecal bacterial metabolism of cholate to deoxycholate in vitro.
- Assessment of exogenous [14C]deoxycholate excretion and hepatic metabolism.
Main Results:
- No evidence of deoxycholate malabsorption or rehydroxylation was found.
- Cirrhotic patients with biliary deoxycholate deficiency showed significantly decreased fecal deoxycholate and lithocholate levels.
- In vitro fecal bacterial conversion of cholate to deoxycholate was significantly reduced in cirrhotic patients.
Conclusions:
- Reduced 7 alpha-dehydroxylase activity in fecal bacteria of some alcoholic cirrhosis patients impairs cholate to deoxycholate conversion.
- This impaired bacterial conversion explains the absence of deoxycholate in the bile of these patients.
- The study identifies a key mechanism in bile acid metabolism disruption in alcoholic cirrhosis.
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