Bile Salt Metabolism:I. The Physiology of Bile Salts

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Abstract
Bile salts are synthesized in the human liver from cholesterol, conjugated with glycine or taurine and secreted in bile with cholesterol and lecithin. Molar concentrations of these 3 lipids determine solubility of cholesterol in bile. Within the gastrointestinal lumen bile salts play an essential role in lipid absorption and fat transport. An efficient entero-hepatic circulation maintains hepatic bile salt secretion and provides a feed-back control of bile salt and cholesterol metabolism. Potentially hepatotoxic lithocholic acid formed in the intestinal lumen by bacterial action on chenodeoxycholic acid is sulfated in the liver thus decreasing intestinal reabsorption. Total fecal excretion of bile salts balances hepatic synthesis and represents a major catabolic path in cholesterol metabolism.