Lithogenic Bile among Young Indian Women

Chippewa Indian women have a high prevalence of symptomatic gallstones. Lithogenic bile is characterized by a low ratio of bile acids plus lecithin to cholesterol. The ratios of bile acid plus lecithin to cholesterol in duodenal bile among 12 young Indian women without gallstones were significantly lower, 9.4 ± 0.82 (mean ± S.E.), than among white controls, 16.4 ± 1.0 (p less than 0.001), and Indian men, 14.8 ± 2.2 (p less than 0.02), and not different from those previously reported among white women with gallstones: 11.3 ± 1.3. Administration of chenodeoxycholic acid resulted in a bile acid composition of 96 per cent chenodeoxycholic acid and significantly increased the ratio of bile acid plus lecithin to cholesterol to 14.2 ± 1.9, without adverse reactions. These observations suggest that lithogenic bile precedes gallstone formation in Chippewa women and that administration of chenodeoxycholic acid decreases this lithogenic potential.