ROLE OF SERUM LIPIDS IN GALLSTONE PATHOGENESIS: A CASE–CONTROL STUDY FROM PUNJAB


Apinder Kaur, Amandeep Kaur, Satbir Kaur

Abstract


 

 Objective: Pathogenesis of gallstone (GS) disease is multifactorial, involving both genetic and environmental factors. The main pathogenic factor responsible for the hypersecretion of cholesterol into bile is the impaired lipid metabolism, which actually reflects the likelihood of GS formation. The study aims to determine the significance of serum lipids in the etiology of GS disease and to identify the possible confounding effects of age, gender, and body mass index (BMI) on GS disease.

Methods: A case–control study was conducted on 97 ultrasonically confirmed GS cases and 92 healthy controls which were further divided on the basis of gender, age group (≥40 and <40 (y)), BMI (obese and non-obese), and number of stones (single and multiple). The serum lipid parameters were estimated using the enzymatic kit assay. The statistical analysis of the lipid parameters in relation to age, gender, obesity, and stone number was done using the Student’s t-test, Chi-square test, and Mann–Whitney U-test. p<0.05 was considered statistically significant.

Results: The mean serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were significantly higher in cases as compared to controls (p=0.0001 [95% confidence interval [CI]: 33.3–61.2] and p=0.0001 [95% CI: 36.6–64.2], respectively). The serum high-density lipoprotein cholesterol (HDL-C) level was non-significantly lower in GS patients as compared to controls (p=0.4). Obese female patients of age group ≥40 (y) had an abnormal lipid profile with a significant rise in mean TC, LDL-C, and triglycerides (TG) (p<0.05) and were at higher risk of developing the GS disease as compared to controls. However, no probable effect of abnormal lipid profile, age, gender, and BMI on increasing the number of stones was found (p>0.05).

Conclusion: Abnormal lipid parameters, especially high TC and LDL-C, were found to be significantly associated with GS disease. Increased age, obesity, and female gender along with dyslipidemia altogether elevate the risk of formation of GS. The formation of single/multiple stones was not influenced by the abnormal lipid profile, age, gender, and BMI.


Keywords


Gallstone disease, Serum lipids, Cholesterol, Total cholesterol, Low-density lipoprotein, High-density lipoprotein.

| PDF |

References


Batajoo H, Hazra NK. Analysis of serum lipid profile in cholelithiasis patients. J Nepal Health Res Counc 2013;11:53-5.

Celika S, Doganb S, Arslanc H. Is the presence of single or multiple gallstones a matter of chance? What is the relationship between the number of stones and lipid profile, age, gender, and stone type? J Univ Surg 2015;3:13.

Friedman GD. Natural history of asymptomatic and symptomatic gallstones. Am J Surg 1993;165:399-404.

Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: Cholelithiasis and cancer. Gut Liver 2012;6:172-87.

Sachdeva S, Khan Z, Ansari MA, Khalique N, Anees A. Lifestyle and gallstone disease: Scope for primary prevention. Indian J Community Med 2011;36:263-7.

Di Ciaula A, Wang DQ, Bonfrate L, Portincasa P. Current views on genetics and epigenetics of cholesterol gallstone disease. Cholesterol 2013;2013:298421.

Heaton KW, Braddon FE, Mountford RA, Hughes AO, Emmett PM. Symptomatic and silent gall stones in the community. Gut 1991;32:316 20.

Méndez-Sánchez N, Chavez-Tapia NC, Motola-Kuba D, Sanchez-Lara K, Ponciano-Rodríguez G, Baptista H, et al. Metabolic syndrome as a risk factor for gallstone disease. World J Gastroenterol 2005;11:1653-7.

Ata N, Kucukazman M, Yavuz B, Bulus H, Dal K, Ertugrul DT, et al. The metabolic syndrome is associated with complicated gallstone disease. Can J Gastroenterol 2011;25:274-6.

Shaffer EA. Epidemiology and risk factors for gallstone disease: Has the paradigm changed in the 21st century? Curr Gastroenterol Rep 2005;7:132-40.

Cuevas A, Miquel JF, Reyes MS, Zanlungo S, Nervi F. Diet as a risk factor for cholesterol gallstone disease. J Am Coll Nutr 2004;23:187 96.

Ghadir MR, Riahin AA, Havaspour A, Nooranipour M, Habibinejad AA. The relationship between lipid profile and severity of liver damage in cirrhotic patients. Hepat Mon 2010;10:285-8.

Coelho VG, Caetano LF, Liberatore Júnior Rdel R, Cordeiro JA, Souza DR. Lipid profile and risk factors for cardiovascular diseases in medicine students. Arq Bras Cardiol 2005;85:57-62.

Lambou-Gianoukos S, Heller SJ. Lithogenesis and bile metabolism. Surg Clin North Am 2008;88:1175-94, vii.

Van Erpecum KJ. Pathogenesis of cholesterol and pigment gallstones: An update. Clin Res Hepatol Gastroenterol 2011;35:281-7.

Weerakoon HT, Ranasinghe S, Navaratne A, Sivakanesan R, Galketiya KB, Rosairo S. Serum lipid concentrations in patients with

cholesterol and pigment gallstones. BMC Res Notes 2014;7:548.

Abdullah UY, Jassim HM, Baig AA, Khorsheed RM, Al-Khayat AH, Sulong AF, et al. Gallstones in patients with inherited hemolytic diseases. Int J Pharm Pharm Sci 2015;7:9-15.

Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. Lancet 2006;368:230-9.

Sama C, Labate AM, Taroni F, Barbara L. Epidemiology and natural history of gallstone disease. Semin Liver Dis 1990;10:149-58.

Channa NA, Khand F, Ghanghro AB, Soomro AM. Quantitative analysis of serum lipid profile in gallstone patients and controls. Pak J Anal Environ Chem 2010;11:59-65.

Lin IC, Yang YW, Wu MF, Yeh YH, Liou JC, Lin YL, et al. The association of metabolic syndrome and its factors with gallstone disease. BMC Fam Pract 2014;15:138.

Gururaja GM, Mundkinajeddu D, Kumar SA, Allan JJ, Dethe SM, Agarwal A. Cholesterol lowering potentials of a blend of standardized methanol extracts of Moringa oleifera leaves and fruits in Albino Wistar rats. Int J Pharm Pharm Sci 2016;8:262-8.

Chapman BA, Wilson IR, Frampton CM, Chisholm RJ, Stewart NR, Eagar GM, et al. Prevalence of gallbladder disease in diabetes mellitus. Dig Dis Sci 1996;41:2222-8.

Dwivedi S, Singh S, Singh D, Tiwari S. Association of non clinical characteristics and lipid profile with gall bladder stone patients; a case control study. Panacea J Med Sci 2014;4:62-4.

Scragg RK, Calvert GD, Oliver JR. Plasma lipids and insulin in gall stone disease: A case-control study. Br Med J (Clin Res Ed) 1984;289:521-5.

Koebnick C, Smith N, Black MH, Porter AH, Richie BA, Hudson S. Pediatric obesity and gallstone disease: Results from a crosssectional study of over 510,000 youth. J Pediatr Gastroenterol Nutr 2012;55:328-33.

Chen CY, Lu CL, Lee PC, Wang SS, Chang FY, Lee SD. The risk factors for gall stone disease among senior citizens: An oriental study. Hepato Gastroenterol 1999;46:1067-612.

Yoo EH, Lee SY. The prevalence and risk factors for gallstone disease. Clin Chem Lab Med 2009;47:795-807.

Rizk NM, Yousef M. Association of lipid profile and waist circumference as cardiovascular risk factors for overweight and obesity among school children in Qatar. Diabetes Metab Syndr Obes 2012;5:425-32.

Domeyer PJ, Sergentanis TN, Zagouri F, Tzilalis B, Mouzakioti E, Parasi A. Chronic cholecystitis in elderly patients. Correlation of the severity of inflammation with the number and size of the stones. In Vivo 2008;28:269-72.

Csendes A, Becerra M, Rojas J, Medina E. Number and size of stones in patients with asymptomatic and symptomatic gallstones and gallbladder carcinoma: A prospective study of 592 cases. J Gastrointest Surg 2000;4:481-5.




About this article

Title

ROLE OF SERUM LIPIDS IN GALLSTONE PATHOGENESIS: A CASE–CONTROL STUDY FROM PUNJAB

Keywords

Gallstone disease, Serum lipids, Cholesterol, Total cholesterol, Low-density lipoprotein, High-density lipoprotein.

DOI

10.22159/ajpcr.2018.v11i2.22846

Date

01-02-2018

Additional Links

Manuscript Submission

Journal

Asian Journal of Pharmaceutical and Clinical Research
Vol 11 Issue 2 February 2018 Page: 284-288

Print ISSN

0974-2441

Online ISSN

2455-3891

Authors & Affiliations

Apinder Kaur
Department of Human Genetics, Punjabi University, Patiala - 147 002, Punjab, India.
India

Amandeep Kaur
Department of Human Genetics, Punjabi University, Patiala - 147 002, Punjab, India.
India

Satbir Kaur
Department of Human Genetics, Punjabi University, Patiala - 147 002, Punjab, India.
India


Article Tools


Email this article (Login required)
Email the author (Login required)

Refbacks