Abstract
BackgroundPathogenesis of gallstones (GS) is multifactorial and multiple genetic and environmental factors have been identified in different populations for different types of GS with varying prevalence. However the role of the each aetiological factor on the formation of mixed cholesterol and black pigment GS has not being addressed adequately. Hence in this study we attempted to compare known possible risk factors for mixed cholesterol and black pigment GS among two groups of patients with two types of GS.MethodsThe study was done on a cohort of patients with symptomatic GS admitted to the Teaching Hospital Peradeniya, Sri Lanka over a period of 18 months. Clinical and epidemiological data and physical parameters of the patients were recorded and surgically removed GS were analyzed chemically and physically to identify the type of GS. In addition lipid profile was done in all the patients with normal serum bilirubin levels.ResultsA total of 86 patients were included in the study. Mixed cholesterol GS was significantly common among females than males (χ2 test, p = 0.029). Mixed cholesterol GS was commonly seen among patients belonging to Moor ethnicity (χ2 test, p = 0.009). Majority of patients with mixed cholesterol GS had body mass index above 25 kg/m2 (χ2 test, p = 0.018). Black pigment GS were significantly common among patients with type II diabetes mellitus (Fisher’s exact test, p = 0.035). Further all the patients with chronic haemolytic anaemia and alcoholic cirrhosis had black pigment GS. Age, family history, Fasting Blood Glucose, dyslipidaemia, lipid profile, parity and use of oral contraceptive pills in females, smoking and alcohol intake in males did not differ significantly among patients in the two groups.ConclusionGender, ethnicity and body mass index can be used to predict the formation of mixed cholesterol GS and black pigment GS.
Highlights
Pathogenesis of gallstones (GS) is multifactorial and multiple genetic and environmental factors have been identified in different populations for different types of GS with varying prevalence
Cholesterol is the main chemical constituent in mixed cholesterol GS whereas calcium bilirubinate is the main constituent in black pigment GS [7]
Development of mixed cholesterol GS was significantly common among females (χ2 test, df = 1, p = 0.029)
Summary
Pathogenesis of gallstones (GS) is multifactorial and multiple genetic and environmental factors have been identified in different populations for different types of GS with varying prevalence. Compare to Western and East Asian countries black pigment GS are prevalent in South Asian population [3]. The identification of aetiopathogenesis of GS with special reference to both mixed cholesterol and black pigment GS is important in implementing preventive measures for GS among South Asians. Both mixed cholesterol and black pigment stones are composed of same chemical constituents namely cholesterol, calcium bilirubinate, calcium phosphate and calcium carbonate [7]. Further in mixed cholesterol GS, cholesterol is concentrated mainly in peripheral zones and pigments are mainly seen in the core [7] Though these two types of GS are described separately existence of common aetiological factors for both types of GS is a possibility
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
