Background and aims:
Octreotide treatment of acromegalic patients induces cholesterol gallstone formation, in part by impairing cholecystokinin release and gall‐bladder contraction. However, there are few data on the effect of octreotide on biliary arachidonic acid‐rich phospholipids or mucin glycoprotein, factors which also influence cholesterol gallstone formation.
Methods:
In acromegalic patients studied before and during 3 months of octreotide treatment, we measured mucin glycoprotein concentrations and the molecular species of phosphatidylcholine, and related the results to the cholesterol saturation and percentage of deoxycholic acid in gall‐bladder bile.
Results:
The relative proportions of the major arachidonic acid‐rich phosphatidylcholine species, PC 16:0–20:4 and PC 18:0–20:4, increased significantly during octreotide treatment. These changes were associated with a rise in the cholesterol saturation index and a non‐significant twofold increase in mucin glycoprotein concentration. There were significant correlations between PC 16:0–20:4 and the cholesterol saturation index, percentage of vesicular cholesterol and percentage of deoxycholic acid in gall‐bladder bile.
Conclusions:
In acromegalic patients, octreotide increases the proportions of arachidonic acid‐rich phospholipids, with associated rises in: (a) the cholesterol saturation index and percentage of vesicular cholesterol, and (b) the percentage of deoxycholic acid in gall‐bladder bile—changes similar to those found in patients with cholesterol‐rich gall‐bladder stones.