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Relation of gall stone type with bile composition
Arab Journal of Laboratory Medicine [The]. 2007; 33 (1): 39-52
in English | IMEMR | ID: emr-128781
ABSTRACT
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
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Index: IMEMR (Eastern Mediterranean) Main subject: Ascorbic Acid Deficiency / Bile / Cholecystectomy / Gallstones / Risk Factors / Leptin Limits: Female / Humans / Male Language: English Journal: Arab J. Lab. Med. Year: 2007

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Index: IMEMR (Eastern Mediterranean) Main subject: Ascorbic Acid Deficiency / Bile / Cholecystectomy / Gallstones / Risk Factors / Leptin Limits: Female / Humans / Male Language: English Journal: Arab J. Lab. Med. Year: 2007