Micellar Solubilization of Intestinal Lipids and Sterols in Gluten Enteropathy and Liver Cirrhosis

In gluten enteropathy (I) the transfer of hydrolyzed lipids and sitosterol from the increased oil phase to the micellar phase of the diluted jejunal contents was decreased during fat digestion. The concentrations of conjugated bile salts and micellar cholesterol were normal in almost all cases. Jejunal bile salt concentrations tended to be subnormal in unicteric cirrhosis (II), yet micellar lipids and sitosterol were normal, so that at each bile salt concentration their levels were higher than in I. In icteric cirrhosis (III) the micellar lipid and bile salt levels were low, augmented quantities of hydrolyzed lipids remaining in the increased oil phase of diluted intestinal contents. The intestinal cholesterol pool of II and particularly of III was reduced. In contrast to controls, micellar lipids and exogenous sterols correlated in I-III with the micellar bile salt concentration, micellar solubilization of sterols being facilitated by the presence of monoglycerides and free fatty acids.