The influence of chenodeoxycholic acid on cholesterol and bile acid turnover in humans with cholelithiasis.

The in vivo dynamics of cholesterol were determined in 8 individuals who were part of a national double-blind study testing the efficacy of chenodeoxycholic acid ingestion on the dissolution of gallstones. Despite the ingestion of this bile acid in amounts in excess of its normal endogenous flux, the conversion of neutral sterol to chenodeoxycholic acid continued. The flux of neutral sterol to endogenous chenodeoxycholate was lower for the patients ingesting bile acid than for one of the patients on placebo, but was similar to that of the other control and similar to previously published chenodeoxycholate flux in patients with cholesterol cholelithiasis. The remaining flux was on the basis of the very efficiently absorbed dietary chenodeoxycholate. The total cholesterol fractional catabolic rate and flux were not appreciably diminished by the administration of either high or low dose chenodeoxycholate to these individuals with cholesterol cholelithiasis.