Cholesterol Solubility in Bile. EVIDENCE THAT SUPERSATURATED BILE IS FREQUENT IN HEALTHY MAN

R. Thomas Holzbach; Mitsuko Marsh; Monica Olszewski; Keith Holan

doi:10.1172/JCI107321

^{Gastrointestinal Research Unit, Department of Medicine, St. Luke's Hospital, Cleveland, Ohio 44104}

^{Department of Medicine, Case Western Reserve University, School of Medicine, Cleveland, Ohio 44104}

Find articles by Holzbach, R. in: PubMed | Google Scholar

^{Gastrointestinal Research Unit, Department of Medicine, St. Luke's Hospital, Cleveland, Ohio 44104}

^{Department of Medicine, Case Western Reserve University, School of Medicine, Cleveland, Ohio 44104}

Find articles by Marsh, M. in: PubMed | Google Scholar

^{Gastrointestinal Research Unit, Department of Medicine, St. Luke's Hospital, Cleveland, Ohio 44104}

^{Department of Medicine, Case Western Reserve University, School of Medicine, Cleveland, Ohio 44104}

Find articles by Olszewski, M. in: PubMed | Google Scholar

^{Gastrointestinal Research Unit, Department of Medicine, St. Luke's Hospital, Cleveland, Ohio 44104}

^{Department of Medicine, Case Western Reserve University, School of Medicine, Cleveland, Ohio 44104}

Find articles by Holan, K. in: PubMed | Google Scholar

Published in Volume 52, Issue 6 on June 1, 1973
J Clin Invest. 1973;52(6):1467–1479. https://doi.org/10.1172/JCI107321.
© 1973 The American Society for Clinical Investigation

Published June 1, 1973 - Version history

The development and validation of a direct method for measuring maximum cholesterol solubility in bile is described. Application of this method to five large mammalian species, including man, produced a micellar zone significantly smaller than that previously reported. Further studies on in vitro model solutions patterned after bile confirmed this new micellar zone. Thus, direct evidence demonstrates that the micellar zone boundary derived in vitro from model solutions is applicable to human gallbladder bile. Using the present criteria, normal human bile, in contrast to bile from other mammalian species, is commonly supersaturated with cholesterol. A male-female difference in bile composition is not demonstrable despite the well-established female preponderance of cholelithiasis. Bile from patients with cholesterol cholelithiasis has a micellar zone similar to normals but differs compositionally in that there is a greater excess of cholesterol above saturation. We conclude that cholesterol supersaturation may be a necessary but not solely sufficient cause for gallstone formation.