Bile acid, neutral sterol and faecal fat excretion in subjects treated with fenfluramine and its relationship to fenfluramine-induced diarrhoea

Abstract

SummaryBile acid, neutral sterol and faecal fat excretion was studied over a period of 9 weeks in a group of 16 healthy subjects before, during and after administration of fenfluramine. Statistical analysis revealed a significant increase in bile acid excretion during the drug phase (P<0.02); and during recovery period of 3 weeks (P< 0-05). Faecal neutral sterol, as the total of coprostanol and cholesterol elimination was also enhanced after fenfluramine. Coprostanol was replaced by cholesterol in 12 subjects. Faecal fat was studied in 6 subjects, the excretion increased during the drug phase (P< 005), and remained elevated during the post-drug period (P< 001). The composition of the bile acids remained unaltered in all the subjects except 3 who had a fenfluramine-induced watery diarrhoea; and these excreted chenodeoxy and cholic together with smaller amounts of secondary bile acids. A higher excretion of bile acids was found in the 8 overweight subjects (P<0.01) before ministration of fenfluramine.These results are discussed in an attempt to correlate the effect of fenfluramine with changes in bile acid and neutral sterol excretion, and its relationship to fenfluramine-induced diarrhoea.

Effects of a standardized wheat bran preparation on biliary lipid composition and bile acid metabolism in young healthy males

“…This will give similar results, but will prevent the potential formation ofbile acid ethyl-esters [30]. Rigorous saponification of bile acids, as described by Grundy et al [31], was not necessary because in healthy subjects no conjugated bile acids are detectable in faeces [32]. Further, Lepage et al [33] found that rigorous alkaline hydrolysis of keto bile acids gives low recoveries and formation of bile acid artefacts to a high degree.…”