Abstract

PIP: The effects of clofibrate and of the combined administration of estrogen plus progestin on the concentration of fasting hepatic bile lipids and on pool sizes and turnover rates of cholic acid were studied. 8 women with normal serum lipids, 1 male with beta-lipoproteinemia, and 1 female with pre-beta-lipoproteinemia were studied after recovery from cholecystecomy. Hepatic bile was collected periodically as long as 4 1/2 months through a closed indwelling cystic duct catheter. Clofibrate lowered serum cholesterol by 15-25% in 3 of the normolipidemic patients. In a patient with hypertriglyceridemia, serum cholesterol fell from 306 to 171 and triglycerides from 520 to 179. Estrogen plus progestin produced a 7% rise in serum cholesterol in 1 patient. Biliary cholesterol increased during clofibrate (7 patients) and hormone (3 patients) administration while bile acid levels were decreased. Cholic acid kinetics in 3 patients showed decreased synthesis rates and pool sizes with both drugs. It is suggested that increased cholesterol saturation of bile during administration of a natural estrogen with progestin to cholecystectomized patients relects an increased propensity to cholesterol formation.