Octreotide increases the proportions of arachidonic acid-rich phospholipids in gall-bladder bile.
OBJECTIVE
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.
Pereira
S P
SP
Gastroenterology Unit, Division of Medicine, Guy's Hospital Campus, GKT School of Medicine, King's College London, UK. steve.pereira@uclh.org
Hussaini
S H
SH
Murphy
G M
GM
Wass
J A
JA
Dowling
R H
RH
D000172:Acromegaly / Q000188:drug therapy* / Q000378:metabolism; D000328:Adult; D001095:Arachidonic Acids / Q000378:metabolism; D016022:Case-Control Studies; D002769:Cholelithiasis / Q000139:chemically induced; D003840:Deoxycholic Acid / Q000378:metabolism; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000302:isolation & purification; D015282:Octreotide / Q000009:adverse effects / Q000627:therapeutic use*; D010713:Phosphatidylcholines / Q000378:metabolism*; D010743:Phospholipids / Q000378:metabolism*
D001095:Arachidonic Acids; D005765:Gastrointestinal Agents; D009077:Mucins; D010713:Phosphatidylcholines; D010743:Phospholipids; D003840:Deoxycholic Acid; D015282:Octreotide