The role of routine thyroid assay in the management of gallstones

Abstract

Cholelithiasis is a type of biliary stone disease, with a high prevalence. Along with classic risk factors like obesity, weight loss, female sex hormones, age, an association with thyroid dysfunction has been established.To evaluate the importance of thyroid profile as a diagnostic/therapeutic workup of gallstones.The study included 200 subjects, above 18 years. 100 subjects (50 males+50 females) had cholelithiasis confirmed by ultrasonography and remaining as 100 subjects(50males+50females) control group without gallstones. After a detailed history and clinical examination, blood samples were analyzed for TSH, T3 and T4, using Chemiluminescence-Immunoassay. Subjects with history of thyroid dysfunction or on thyroid replacement therapy, diabetes mellitus, pregnancy, drugs affecting thyroid hormone levels were excluded.Computing descriptive statistics was used. Any significant difference were tested using the unpaired sample student t-test.The case group had a mean age of 45.70 ± 13.76 and the controls, a mean age of 38.78 ± 15.63. There was a significant increase in the prevalence of gallstones after the age of 40years, especially in females. 20% of cases were hypothyroid and 12% were hyperthyroid when compared to the controls which were 10% hypothyroid and 6% hyperthyroid. The higher prevalence of hypothyroid among cases was statistically significant. Among the hypothyroid cases, 80% had subclinical hypothyroidism.Our study concludes by saying that thyroid assay could be made a part of the diagnostic work up of gallstone management thus providing early detection for thyroid dysfunction and thus reducing the surgical/anesthetic complications.