scholarly journals Gallstone Formation Follows a Different Trajectory in Bariatric Patients Compared to Nonbariatric Patients

Metabolites ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 682
Author(s):  
Sylke Haal ◽  
Maimoena S. S. Guman ◽  
Yair I. Z. Acherman ◽  
Johannes P. G. Jansen ◽  
Michel van Weeghel ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Saturation Index ◽  
Gallstone Formation ◽  
Gallbladder Bile ◽  
Gallbladder Emptying ◽  
Cholesterol Gallstones ◽  
Interesting Pattern ◽  
Lipid Species ◽  
Cholesterol Saturation Index ◽  
Bariatric Patients

Since obese patients form cholesterol gallstones very rapidly after bariatric surgery, in patients who did not form gallstones during preceding years, we hypothesized that gallstone formation follows a different trajectory in bariatric patients compared to nonbariatric patients. We therefore analyzed the lipid composition of gallbladder bile derived from 18 bariatric gallstone patients and 17 nonbariatric gallstone patients (median (IQR) age, 46.0 (28.0–54.0) years; 33 (94%) female) during laparoscopic cholecystectomy using an enzymatic and lipidomics approach. We observed a higher concentration of total lipids (9.9 vs. 5.8 g/dL), bile acids (157.7 vs. 81.5 mM), cholesterol (10.6 vs. 5.4 mM), and phospholipids (30.4 vs. 21.8 mM) in bariatric gallstone patients compared to nonbariatric gallstone patients. The cholesterol saturation index did not significantly differ between the two groups. Lipidomics analysis revealed an interesting pattern. Enhanced amounts of a number of lipid species were found in the gallbladder bile of nonbariatric gallstone patients. Most striking was a fivefold higher amount of triglyceride. A concomitant ninefold increase of apolipoprotein B was found, suggesting secretion of triglyceride-rich lipoproteins (TRLs) at the canalicular pole of the hepatocyte in livers from nonbariatric gallstone patients. These findings suggest that gallstone formation follows a different trajectory in bariatric patients compared to nonbariatric patients. Impaired gallbladder emptying might explain the rapid gallstone formation after bariatric surgery, while biliary TRL secretion might contribute to gallstone formation in nonbariatric patients.

Fenugreek seeds reduce atherogenic diet-induced cholesterol gallstone formation in experimental mice

2009 ◽  
Vol 87 (11) ◽  
pp. 933-943 ◽  
Author(s):  
R.L.R. Reddy ◽  
K. Srinivasan
Keyword(s):  
Cholesterol Metabolism ◽  
Cholesterol Gallstone ◽  
Saturation Index ◽  
Gallstone Formation ◽  
Atherogenic Diet ◽  
High Cholesterol ◽  
Cholesterol Gallstones ◽  
Lithogenic Diet ◽  
Fenugreek Seed ◽  
Cholesterol Saturation Index

Dietary hypocholesterolemic adjuncts may have a beneficial role in the prevention and treatment of cholesterol gallstones (CGS). In this investigation, fenugreek (Trigonella foenum-graecum) seed was evaluated for this potential on the experimental induction of CGS in laboratory mice. CGS was induced by maintaining mice on a lithogenic diet (0.5% cholesterol) for 10 weeks. Fenugreek seed powder was included at 5%, 10%, and 15% of this lithogenic diet. Dietary fenugreek significantly lowered the incidence of CGS in these mice; the incidence was 63%, 40%, and 10% in the 5%, 10%, and 15% fenugreek groups, respectively, compared with 100% in the lithogenic control. The antilithogenic influence of fenugreek is attributable to its hypocholesterolemic effect. Serum cholesterol level was decreased by 26%–31% by dietary fenugreek, while hepatic cholesterol was lowered by 47%–64% in these high cholesterol-fed animals. Biliary cholesterol was 8.73–11.2 mmol/L as a result of dietary fenugreek, compared with 33.6 mmol/L in high-cholesterol feeding without fenugreek. Cholesterol saturation index in bile was reduced to 0.77–0.99 in fenugreek treatments compared with 2.57 in the high-cholesterol group. Thus, fenugreek seed offers health-beneficial antilithogenic potential by virtue of its favourable influence on cholesterol metabolism.

Anti-cholelithogenic effect of dietary tender cluster beans (Cyamopsis tetragonoloba) on the formation of cholesterol gallstones in mice

2014 ◽  
Vol 39 (2) ◽  
pp. 152-157 ◽  
Author(s):  
Chikkanna K. Raghavendra ◽  
Krihnapura Srinivasan
Keyword(s):  
Cholesterol Gallstone ◽  
Saturation Index ◽  
Liver Cholesterol ◽  
Cyamopsis Tetragonoloba ◽  
Cholesterol Gallstones ◽  
Lithogenic Diet ◽  
Cholesterol Saturation ◽  
Freeze Dried ◽  
Phospholipid Ratio ◽  
Cholesterol Saturation Index

Providing a lithogenic diet that contains 0.5% cholesterol to experimental mice for 10 weeks resulted in cholesterol supersaturation in gallbladder bile, which induced the formation of cholesterol gallstones. In this study, to evaluate the anti-cholelithogenic potential of dietary tender cluster bean, a freeze-dried powder of the test legume was included in the lithogenic diet at 5%, 10%, and 15%. Dietary cluster beans reduced the cholesterol gallstone incidence by 43%, 46%, and 58% at the respective doses. Dietary cluster beans markedly reduced biliary cholesterol and, hence, the cholesterol saturation index. This was corroborated by the beneficial modification of the cholesterol/phospholipid ratio and the cholesterol/bile acid ratio in the bile. Dietary cluster beans countered the alterations in serum and liver cholesterol and lipid profiles caused by the lithogenic diet. Thus, dietary tender cluster beans exerted an anti-cholelithogenic influence by decreasing cholesterol hypersecretion into bile and, hence, the cholesterol saturation index, decreasing the formation of lithogenic bile in experimental mice.

scholarly journals Protective Effects of Yinchenhao Decoction on Cholesterol Gallstone in Mice Fed a Lithogenic Diet by Regulating LXR, CYP7A1, CYP7B1, and HMGCR Pathways

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Yong Meng ◽  
Ke Meng ◽  
Xin Zhao ◽  
Donghua Li ◽  
Qiaoying Gao ◽  
...  
Keyword(s):  
Cholesterol Gallstone ◽  
Saturation Index ◽  
Gallstone Formation ◽  
Intragastric Administration ◽  
Protective Effects ◽  
Biochemical Tests ◽  
Lithogenic Diet ◽  
Preventive Drug ◽  
Cholesterol Saturation Index ◽  
Bile Cholesterol

The study attempted to elucidate whether lipid genes are closely associated with lipid metabolic abnormalities during the lithogenic time and how Yinchenhao Decoction (YCHD) works on the transcriptions of lipid genes against cholesterol gallstone model. C57BL/6J mice fed on lithogenic diet (LD) were used for model establishment and randomized into 5 groups. All groups received LD for different weeks with isometrically intragastric administration of YCHD or NS. Biochemical tests were measured and liver tissues were harvested for histological and genetic detection. It was found that all groups with increasing LD showed a following tendency of gallstone incidence, bile cholesterol, phospholipids, total bile acid, and cholesterol saturation index (CSI). Conversely, YCHD could significantly normalize the levels of gallstone incidence, bile lipids, and CSI (CSI<1). As lithogenic time progressed, ABCG5, ABCG8, PPAR-α, and ABCB4 were upregulated, and SREBP2, CYP7A1, and CYP7B1 were downregulated, while CYP7A1, CYP7B1, LXR, and HMGCR mRNA were increased 3-fold under the administration of YCHD. It was concluded that abnormal expressions of the mentioned genes may eventually progress to cholesterol gallstone. CYP7A1, CYP7B1, LXR, and HMGCR mRNA may be efficient targets of YCHD, which may be a preventive drug to reverse liver injury, normalize bile lipids, facilitate gallstone dissolution, and attenuate gallstone formation.

scholarly journals Stability of Human Gallbladder Bile: Effect of Freezing

2001 ◽  
Vol 15 (6) ◽  
pp. 363-366 ◽  
Author(s):  
Paul Janowitz ◽  
Richard Mason ◽  
Wolfgang Kratzer
Keyword(s):  
Saturation Index ◽  
Gallbladder Bile ◽  
Needle Puncture ◽  
Nucleation Time ◽  
Human Gallbladder ◽  
Fine Needle ◽  
Cholesterol Saturation ◽  
Before And After ◽  
Cholesterol Saturation Index ◽  
Fine Needle Puncture

In the present study, the stability of the most essential biliary parameters of human gallbladder bile at -18°C was examined over several months. In 12 patients with gallstone disease (10 female, two male; 52.1±13.3 years of age), bile was obtained through fine needle puncture of the gallbladder under local anesthetic. The concentrations of total lipids, cholesterol, phospholipids and bile acids, and the cholesterol saturation index and crystal appearance time were determined before and after freezing over a mean period of 4.38±2.9 months. Gallbladder bile obtained by fine needle puncture has proved to be of excellent quality. The total lipid concentration was unchanged before (8.30±4.16 g/dL) and after freezing (9.16±4.54 g/dL, P=0.6027). The biliary cholesterol, phospholipids and bile acid concentrations, and cholesterol saturation index showed no statistically significant differences before and after freezing. A significant difference arises in the context of subdivision of the group to the nucleation time. Before freezing, most patients had a nucleation time between five and eight days, which shortened to between one and four days after thawing (P=0.0100). The authors conclude that, with the exception of the nucleation time, human gallbladder bile can be stored at -18°C for four months with stability of major lipid components.

Simvastatin, a competitive inhibitor of HMG-CoA reductase, lowers cholesterol saturation index of gallbladder bile

Hepatology ◽  
1988 ◽  
Vol 8 (5) ◽  
pp. 1147-1150 ◽  
Author(s):  
William C. Duane ◽  
Donald B. Hunninghake ◽  
Martin L. Freeman ◽  
Pete A. Pooler ◽  
Linda A. Schlasner ◽  
...  
Keyword(s):  
Saturation Index ◽  
Competitive Inhibitor ◽  
Gallbladder Bile ◽  
Hmg Coa Reductase ◽  
Cholesterol Saturation ◽  
Cholesterol Saturation Index ◽  
Coa Reductase

Partial characterization of a nonmicellar system of cholesterol solubilization in bile

1987 ◽  
Vol 252 (3) ◽  
pp. G374-G383 ◽  
Author(s):  
S. P. Lee ◽  
H. Z. Park ◽  
H. Madani ◽  
E. W. Kaler
Keyword(s):  
Bile Salts ◽  
Saturation Index ◽  
Buoyant Density ◽  
Gallbladder Bile ◽  
Elastic Light Scattering ◽  
Cholesterol Solubilization ◽  
Cholesterol Saturation Index

We have shown that there were two distinctly separate cholesterol-containing fractions in human hepatic and gallbladder bile. In addition to mixed micelles that were composed of bile salts, cholesterol, and phospholipids and measured at approximately 25 A by quasi-elastic light scattering spectroscopy, there was a nonmicellar fraction made up of cholesterol and phospholipids with no, or only trace amount of bile salts. This fraction had a mean hydrodynamic radius of 600 A. When studied with electron microscopy, the fraction consisted of particle spherical in shape that measured 900–1,300 A in diameter and were monodisperse. This form of cholesterol had a low buoyant density of less than 1.05 g/ml by density gradient ultracentrifugation and eluted as a macromolecular aggregate (mol wt greater than 200,000) employing Sephadex G-75 chromatography. The quantity of nonmicellar cholesterol in bile correlated positively with the cholesterol saturation index (r = 0.649; P less than 0.001) and inversely with relative bile salt concentration (r = -0.572, P less than or equal to 0.03) and total lipid concentration (r = -0.844, P less than 0.0001). In vitro and in vivo addition of bile salts resulted in a shift of nonmicellar cholesterol to micellar cholesterol. In hepatic bile, nonmicellar cholesterol was the predominant and sometimes the exclusive form of cholesterol transport. When nucleation experiments were performed on gallbladder bile samples, the cholesterol that had nucleated were almost exclusively derived from the nonmicellar fraction.

Bile concentration is a key factor for nucleation of cholesterol crystals and cholesterol saturation index in gallbladder bile of gallstone patients

Hepatology ◽  
1990 ◽  
Vol 11 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Karel J. Van Erpecum ◽  
Gerard P. Berge Van Henegouwen ◽  
Bregt Stoelwinder ◽  
Yvonne M. G. Schmidt ◽  
Frans L. H. Willekens
Keyword(s):  
Saturation Index ◽  
Gallbladder Bile ◽  
Cholesterol Crystals ◽  
Bile Concentration ◽  
Cholesterol Saturation ◽  
Key Factor ◽  
Cholesterol Saturation Index

POSTOPERATIVE COMPLIANCE OF BARIATRIC SURGERY PATIENTS REGARDING THE ASSESSMENT OF SERUM LEPTIN LEVELS AND INSULIN RESISTANCE

2019 ◽  
Vol 49 (1/2019) ◽  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Serum Levels ◽  
Medical Laboratory ◽  
Leptin Resistance ◽  
Obese Patients ◽  
Laboratory Assessment ◽  
Serum Leptin ◽  
Before And After ◽  
Bariatric Patients

Background and aims: Overweight and obese patients who undergo bariatric surgery require a rigorous clinical and paraclinical assessment both before and after the surgery at 3, 6, and 12 months.The present study aims the assessment of serum leptin levels and insulin resistance status in compliant bariatric patients to scheduled medical laboratory assessment at 6 months after surgery. Material and Method: The study included 109 eligible patients selected for bariatric surgery, 48 of whom attended the scheduled visit at 6 months after the surgery. Laboratory assessing regarded the insulin resistance by determining before meal the serum levels of leptin, glucose and insulin, as well as HOMA 1 and HOMA 2 indexes. Results: Patients who underwent bariatric treatment experienced a significant decrease in insulin resistance status. A higher percentage in the preoperative group was recorded in women, feature which was also recorded in the postoperative group that attended the scheduled visit at 6 months after surgery. Age is also an important factor that significantly influences the behavioral adherence to postoperative visits. Conclusions: Insulin resistance status improved significantly in 6 months after bariatric surgery among the fully compliant patients. The percentage of attendance at scheduled visits is higher among women, and decreases with age. Keywords: obesity surgery, leptin resistance, insulin resistance, HOMA index, compliance

scholarly journals Preoperative Cardiac Diagnostics in Bariatric Patients with Diabetes and Perioperative Morbidity: Results of a Cohort of 258 Patients

2021 ◽  
Author(s):  
Benjamin Stillhard ◽  
B. T. Truc Ngo ◽  
Ralph Peterli ◽  
Thomas Peters ◽  
Romano Schneider ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Myocardial Perfusion ◽  
Cardiac Catheterization ◽  
Myocardial Perfusion Scintigraphy ◽  
Perfusion Scintigraphy ◽  
Perioperative Morbidity ◽  
Obesity And Diabetes ◽  
Patients With Diabetes ◽  
Cardiac Assessment ◽  
Bariatric Patients

Abstract Purpose The combination of obesity and diabetes mellitus are well-known risk factors for cardiovascular complications and perioperative morbidity in metabolic surgery. The aim of this study was to evaluate effectivity and reliability of the cardiac assessment in patients with diabetes prior to bariatric surgery. Setting Private, university-affiliated teaching hospital, Switzerland Material and Methods Retrospective analysis of prospectively collected data on results and consequences of cardiac assessments in 258 patients with obesity and diabetes scheduled for primary bariatric surgery at our institution between January 2010 and December 2018. Results Out of 258 patients, 246 (95.3%) received cardiac diagnostics: 173 (67.1%) underwent stress-rest myocardial perfusion scintigraphy (MPS), 15 (5.8%) patients had other cardiac imaging including cardiac catheterization, 58 (22.5%) patients had echocardiography and/or stress electrocardiography, and 12 (4.7%) patients received no cardiac evaluation. Subsequently, cardiac catheterization was performed in 28 patients (10.9%), and coronary heart disease was detected and treated in 15 subjects (5.8%). Of these 15 individuals, 5 (33.3%) patients had diffuse vascular sclerosis, 8 (53.3%) patients underwent coronary angioplasty and stenting, and 2 (13.3%) patients coronary artery bypass surgery. Bariatric surgery was performed without perioperative cardiovascular events in all 258 patients. Conclusion Our data suggest that a detailed cardiac assessment is mandatory in bariatric patients with diabetes to identify those with yet unknown cardiovascular disease before performing bariatric surgery. We recommend carrying out myocardial perfusion scintigraphy as a reliable diagnostic tool in this vulnerable population. If not viable, stress echocardiography should be performed as a minimum.

scholarly journals Impact of the COVID-19 Pandemic on the Patient’s Decision about Bariatric Surgery: Results of a National Survey

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 756
Author(s):  
Maciej Walędziak ◽  
Anna Różańska-Walędziak ◽  
Paweł Bartnik ◽  
Joanna Kacperczyk-Bartnik ◽  
Andrzej Kwiatkowski ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Online Survey ◽  
Negative Impact ◽  
Weight Loss Surgery ◽  
General Information ◽  
Open Questions ◽  
Increased Risk ◽  
Bariatric Patients ◽  
The Moment ◽  
The Impact

Background: the COVID-19 pandemic and the implemented restrictions have changed the functioning of healthcare systems worldwide. The purpose of the study was to evaluate the impact of the present epidemiological situation on patients’ decisions about undergoing weight loss surgery. Methods: data were collected from 906 bariatric patients by the means of a national online survey, the majority of whom were women (87.9%). The survey started on 9 April 2020 and was open until 28 April 2020. The questionnaire included multiple choice and open questions, divided into three chapters: general information about the patient, life during the COVID-19 pandemic, and bariatric care during the COVID-19 pandemic. Results: despite the pandemic and the associated risk of COVID-19 infection, 443 responders (48.9%) would have decided to undergo bariatric surgery. Awareness of the negative impact of obesity on the course of COVID-19 illness had only marginable impact on patients’ decision-making (76.6% vs. 75.3%; p < 0.80). Contact with COVID-19 prior to the survey had a negative impact on the willingness to undergo bariatric surgery (3.0% vs. 4.4%; p < 0.55). There was a positive correlation between the BMI and preference for bariatric surgery in the time of the pandemic (37.4 ± 9.0 vs. 34.9 ± 8.7; p < 0.001). Conclusions: the level of awareness about the advantages of operative treatment of obesity is high among bariatric patients. The majority of patients awaiting bariatric surgery at the moment of the survey were positive about undergoing bariatric surgery despite the increased risk of a serious course of COVID-19 infection. Therefore, a large proportion of patients was determined to have bariatric treatment even during the pandemic, being aware of the increased risk of worse pace of COVID-19 disease in case of obesity and related diseases.

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