Abstract
Objective: As no studies were reported from Bangladesh, the present study was conducted on serum lipid profile, i.e. triglyceride TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) and high density lipoproteincholesterol (HDL-C) in Bangladeshi patients with cholelithiasis Patients and methods: A total of 44 adult patients with cholelithiasis and 30 healthy subjects as normal controls (NC) were included in the study. The blood samples were taken from fasting patients at diagnosis before cholecystectomy (Serum-I0), gall bladder bile during cholecystectomy (Bile- I0) and blood sample again after 2-3 months at follow-up (Serum-II0) and from fasting NC subjects. TG, TC, LDL-C and HDL-C were quantitated in serum and bile by standard methods using research kits from reputed companies. The results were compared statistically by ANOVA and Student’s t-test using SPSS propramme Results: TG level was elevated in Serum- I0 , Bile- I0 and Serum- II0 of patients, being highest in Bile- I0 compared to controls (NC) (p 0.05) among NC, Serum- I0 and Serum- II0, but it was higher in Bile- I0 significantly (p<0.001). Conclusion: Alterations in lipid profile in cholelithiasis were significant but complex and cholecystectomy had profound impact suggesting a crucial role of gall bladder. The results were discussed accordingly.
Highlights
Cholelithiasis is one of the most common gastrointestinal disorders being prevalent in about 10-15% of adults in the developing countries [1,2]
total cholesterol (TC) was elevated in Serum- II0 after cholecystectomy, no significant difference was observed between normal controls (NC) and patients Serum- I0 (p=0.835)
lowdensity lipoprotein cholesterol (LDL-C) levels in NC, Serum- I0 and Serum- II0 were similar (p=0.126, p=0.138), Serum-II0 levels was elevated compared to Serum- I0 (p
Summary
Cholelithiasis (gallstone disease) is one of the most common gastrointestinal disorders being prevalent in about 10-15% of adults in the developing countries [1,2]. Most of the patients are asymptomatic, about 20% of them become symptomatic They require treatment currently involving the surgical removal of the gallbladder and gallstones, that is cholecystectomy [2,3]. There are three stages of gallstone formation: super saturation, nucleation and aggregation. The association of cholesterol super saturation of bile with cholesterol gallstones paved the way for the physical-chemical basis for gallstone formation [4,5]. It soon became evident that other factors including nucleation of cholesterol crystals, binding together of these crystal with mucin and hypomotility of the gallbladder plays an important role in gallstone formation [1,3,4]. It is reported that an increase in biliary arachidony -1- lecithin may lead to increased prostanoid synthesis, which may be responsible for increased mucin secretion as well as gallbladder hypomotility [4,5]
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