Relation of gall stone type with bile composition

The present study was planned to investigate the relation of gall stone type with bile composition. This study was carried out on 41 patients who underwent elective cholecystectomy for calcular cholecystitis. These patients were classified into three groups according to the chemical constituents of stones: group [1] comprised 25 patients with cholesterol gall stones, group [2] comprised 8 patients with mixed stones, and group [3] comprised 8 patients with pigment stones. In addition 8 subjects were included as a control group. Blood sample, gall bladder bile and stones were collected from every patient. Fasting blood glucose, bilirubin, albumin, AST, ALT and lipid profile were measured by the traditional colorimetric methods. At the same time plasma ascorbic acid was determined by dinitrophenyihydrazine thiourea copper sulphate [DTC] reagent. In addition serum insulin was measured by chemiluminescent method and leptin by enzyme immunoassay. Biliary bile acids were measured by HPLC while biliary cholesterol, phospholipids, calcium, bilirubin and total protein were determined by colorimetric methods The present study revealed that ages of patients with pigment stones were significantly higher while BMI was elevated in patients with cholesterol gall stones. Serum cholesterol, TG, LDL, insulin and leptin were significantly increased while HDL and serum ascorbic acid were significantly decreased in patients with cholesterol gall stones when compared to control group. In addition, there was significant positive correlation between leptin and BMI, insulin and biliary cholesterol. In patients with cholesterol gall stones there were significant increase of biliary protein, biliary cholesterol and decrease of biliary phospholipids, total and direct bilirubin when compared to control group. In patients with mixed and pigment gall stones, there were significant decrease of serum HDL, biliary phospholipid, total and direct biliary bilirubin beside significant increase of indirect bilirubin when compared to control group. Concerning biliamy bile acids there were significant decrease of primary bile acids conjugates [GCA, TCA, GCDCA, and TCDCA] and significant increase of secondary bile acids conjugates [GDCA, TDCA, GLCA, and TLCA] in all patient groups when compared to control group. Leptin was associated with increased risk of cholesterol gall stone formation while advance of age was associated with pigment gall stone. Hypovitaminosjs C may have a pivotal role in gall stone formation specially cholesterol type. Expand of secondary bile acid pool and contracted primary bile acid pool play an important role in various types of gall stones

pattern of dyslipoproteinemia in non- dialyzed chronic renal failure patients

Dyslipidemia is a common finding among patients with chronic renal failure [CRF] Lipid abnormality in CRF is a risk factor for atherosclerosis which is one of the leading causes of death in uremia. In biochemical lipid studies, the absolute and relative Concentrations of individual fractions of circulating triglyceride and cholesterol in different lipoprotein classes are more significant than their serum total levels. However, such studies are obviously rare. The aim of this study was to determine plasma triglyceride and cholesterol contents of VLDL. LDL and HDL classes in patients with chronic renal failure [not yet undergoine dialysis] due to chronic renal disease and to compare the data with their similar results in matched normal subjects. Twenty five male patients with chronic renal disease and CRF were recruited from Mansoura University Hospitals. Also twelve healthy male subjects matched for age and body weight were simultaneously investigated as a normal control After 12 hr overnight fast, blood samples were drawn into EDTA tubes and plasma were separated. Different plasma lipoproteins were layered by high performance density gradient ultracentrifugation. This was followed by measurement of triglyceride and cholesterol fractions in the different lipoprotein layers by the respective enzymatic-colon metric method. There were significant increases in plasma VLDL-TG, LDL-TG and HDL-TG values in CRF above the corresponding normal values. This induced significantly higher than normal circulating TG concentrations. At the same time, there were significantly lower LDL-C and HDL-C concentrations and significantly higher VLDL-C mean value in uremic patients than the corresponding value in the control. The sum of the different lipoproteins cholesterol concentrations gave insignificant change in total serum cholesterol concentration in CRF patients in comparison to normal control. All lipoproteins participate in carrying the excess triglyceride. Cholesterol bounds to lipoproteins was subnormal as regard LDL and HDL but higher than normal with VLDL. HypertrigIyceridemia enhances atherosclerosis of cerebral and/or coronary arteries in CRF