Effects of cholic acid on the metabolism of endogenous plasma triglyceride and on biliary lipid composition in hyperlipoproteinemia.

Plasma lipids, endogenous triglyceride kinetics, and biliary lipid composition were determined in 13 patients with primary hyperlipoproteinemia (HLP) before and during treatment with cholic acid (15 mg/kg body weight/day for 3 months). In patients with type IIa HLP (n = 5), no consistent effects were seen on fasting plasma lipids or triglyceride turnover determined over a 10-hour period. Plasma triglyceride concentration was decreased in six of the eight patients with type IV HLP. Apparent triglyceride production rate was not significantly changed with initially elevated triglyceride synthesis. Treatment with cholic acid resulted in an increased proportion of bile acids and a decreased proportion of cholesterol and phospholipids in fasting duodenal bile; bile saturation with cholesterol was not significantly reduced. The results ,re discussed in relation to previous studies on the integrated regulation of bile acid and triglyceride metabolism, and it is concluded that cholic acid and chenodeoxycholic acid exert different effects on plasma triglyceride metabolism and on biliary lipid composition in HLP.