Effect of gemfibrozil on biliary lipid metabolism in normolipemic subjects

Abstract

The mechanisms of the lipid-lowering agent gemfibrozil on biliary lipid metabolism were studied in eight normolipemic male volunteers. These measurements were performed before and after 3 months of administration. During administration of gemfibrozil, plasma cholesterol decreased by 19% ( P < 0.01) and triglycerides by 46% ( P < 0.01), and HDL cholesterol increased by 10% ( P < 0.01). The lithogenic index in gallbladder bile increased from 0.73 to 1.37 ( P < 0.05) and in hepatic bile from 0.86 to 1.42 ( P < 0.01). The increase in lithogenicity of gallbladder bile and hepatic bile was due to an increased biliary output of cholesterol from 47 to 70 mg/h ( P < 0.01) and a decreased output of bile acids from 943 to 694 mg/hr ( P < 0.01), whereas phospholipid output was not altered. The reduction in bile acid output was a result of a significant decrease in chenodeoxycholic acid secretion (r = 0.852; P < 0.01). Cholic acid output was not effected by gemfibrozil. These results suggest that administration of gemifbrozil enhances the possible risk of gallstone formation like clofibrate.