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Low-dose ursodeoxycholic acid prolongs cholesterol nucleation time in gallbladder bile of patients with cholesterol gallstones.

Abstract
The high rate of stone recurrence represents a drawback of non-surgical therapy of cholesterol gallstone disease. Although most studies report that long-term bile acid treatment does not have protective effects, preliminary results suggest that low-dose ursodeoxycholic acid decreases the rate of gallstone recurrence in a subgroup of younger patients. To clarify the underlying mechanism we investigated whether low-dose ursodeoxycholic acid treatment influences biliary cholesterol saturation and/or nucleation time of cholesterol. Ten patients with cholesterol gallstones and functioning gallbladder received 250 mg ursodeoxycholic acid/day at bedtime 6-10 days prior to cholecystectomy. Eleven patients with cholesterol gallstones without treatment served as controls. Cholesterol crystals were present in the gallbladder bile of 7 out of the 10 patients receiving ursodeoxycholic acid and in all control biles. Ursodeoxycholic acid treatment significantly (P less than 0.02) decreased the cholesterol saturation index (mean +/- S.E.: 0.94 +/- 0.05 vs. 1.43 +/- 0.18) and led to an approximately 5-fold prolongation (P less than 0.005) of the cholesterol nucleation time (mean +/- S.E.: 12.0 +/- 2.4 vs. 2.3 +/- 0.7 days). We conclude that low-dose ursodeoxycholic acid might be effective in the prevention of post-dissolution gallstone recurrence by both decreasing cholesterol saturation and prolonging cholesterol nucleation time.
AuthorsD Jüngst, G Brenner, E Pratschke, G Paumgartner
JournalJournal of hepatology (J Hepatol) Vol. 8 Issue 1 Pg. 1-6 (Jan 1989) ISSN: 0168-8278 [Print] Netherlands
PMID2921499 (Publication Type: Journal Article)
Chemical References
  • Bile Acids and Salts
  • Deoxycholic Acid
  • Ursodeoxycholic Acid
  • Cholesterol
Topics
  • Adult
  • Aged
  • Bile (metabolism)
  • Bile Acids and Salts (metabolism)
  • Cholelithiasis (metabolism, prevention & control)
  • Cholesterol (metabolism)
  • Crystallization
  • Deoxycholic Acid (analogs & derivatives)
  • Drug Administration Schedule
  • Female
  • Gallbladder (metabolism)
  • Humans
  • Lipid Metabolism
  • Male
  • Middle Aged
  • Time Factors
  • Ursodeoxycholic Acid (administration & dosage, therapeutic use)

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