Journal of Lipid Research, Vol 34, 859-863, Copyright © 1993 by Lipid Research, Inc.
Facilitated method for measurement of biliary secretion rates in healthy humans
WC Duane, MD Levitt and MK Elson
Department of Medicine, Veterans Affairs Medical Center, Minneapolis, MN.
We have developed a facilitated method for determining secretion of
constituents into bile. The ratio of constituent/bilirubin was measured in
gallbladder bile and multiplied by bilirubin secretion rate, estimated by
measuring endogenous production of carbon monoxide (VCO) by breath
sampling. Accuracy of this method was assessed by measuring secretion rate
of 99mTechnetium-labeled disofenin during steady-state constant intravenous
infusion. In nine subjects, mean (+/- SEM) secretion of disofenin by the CO
method was 104.2 +/- 7.2% of expected and by standard marker perfusion was
97.8 +/- 13.1% of expected. In ten subjects, secretion rate of cholesterol
by the CO method averaged 103 mumol/h by the CO method compared to 113 by
marker perfusion (NS). Compared to marker perfusion (which is believed to
reflect 24-h secretion rate), the CO method significantly underestimated
secretion rate of bile acid (1110 vs. 1332 mumol/h, P = 0.076) and lecithin
(295 vs. 413 mumol/h, P = 0.01), probably because gallbladder bile
contained a disproportionate amount of fasting versus postprandial bile.
Thus, this new method provides an accurate secretion rate for biliary
constituents secreted at a relatively constant rate, including cholesterol,
with less variability than marker perfusion. However, it can be used to
estimate secretion of bile acid and lecithin only when a 20-30%
underestimation of 24-h secretion is acceptable.
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