Interrelation of fibroblast growth factor 19 with the bile acids’ levels and lipid profile parameters in patients with chronic non-calculous cholecystitis with and without type 2 diabetes mellitus

Abstract

Objective — to study changes in the levels of fibroblast growth factor 19 (FGF‑19), bile acids (BAs) and lipid profile parameters in patients with a combined course of type 2 diabetes mellitus (DM2) and chronic non‑calculous cholecystitis (CNC) and with isolated CNC, as well as to investigate the nature of these relationships between the indicators.Materials and methods. Examinations involved 93 patients with CNC, from them CNC was combined with DM2 in 62 cases (the main group). The comparison group consisted of 31 patients with isolated CNC. The age of patients ranged between 44 and 75 years. The DM2 duration varied 1 to 19 years. The control group consisted of 20 practically healthy age‑ and gender‑matching subjects. The assessments included the lipid metabolism status (total cholesterol, high, low and very low density lipoprotein cholesterol («Dac spectrum med reagent» kits, Moldova), triglycerides («Dac spectrum med reagent» kits, Moldova). «Dialab» reagent kit (Austria) was used to determine the blood serum BAs levels. The FRF‑19 level was studied by the enzyme immune method («BioVendor» reagent kit, Czech Republic).Results. It has been established that RFF‑19 levels in the groups of combined CNC‑DM2 pathology and isolated CNC were significantly lower than in patients from the control group, with more pronounced decrease was masked in patients with comorbid pathology. In patients with CNC‑DM2 comorbidity, the serum BAs level was in 4.8 times higher, and in patients with isolated CNC in 2.6 times higher than in subjects from control group (p < 0.05). The comparison of the studied parameters in patients with comorbidity of type 2 diabetes and CNC and patients with isolated CNC showed differences. In patients with CNC‑DM2 comorbidity vs isolated CNC, the BAs levels were higher by 82 % and FGF‑19 levels were lower by 39.6 % (p < 0.05). The changes in lipid profile vs norm were determined in all investigated patients, the most pronounced they were in case of the CNC and DM2 comorbidity. The levels of total cholesterol, triglycerides and low density lipoproteins levels were higher at CNC and DM2 comorbidity by 46.1 %, in 1.4 times and by 29.8 %, respectively (p < 0.05). The levels of high density lipoproteins were significantly lower at the combined course of CNC and DM2 when compared with patients who had isolated CNC (p < 0.05).Conclusions. In patients with comorbidity of type 2 diabetes mellitus and CNC and with isolated cholecystitis, an increase in the serum BAs levels have been established against the background of the low serum levels of their regulator FRF‑19 along with the changes in lipid profile of atherogenic nature when compared with the control group. Dysregulation of BAs homeostasis and proatherogenic activity of lipid profile markers are more profound in cases with the simultaneous course of DM2 and CNC compared to the cases with isolated CNC.