The prevalence of undiagnosed thyroid dysfunction and diagnosed diseases of gallstones

ABSTRACT

Background: Cholelithiasis is a disease prevalent worldwide because of an imbalance of bile salt and cholesterol concentrations that leads to precipitation inside the gallbladder. Gall stones are the most common biliary pathology both in India and western countries. Recent studies concentrate on gall stones and thyroid hormones – T3 and T4 have an effect on both bile content and bile flow. Patients with hypothyroidism have a serum level of cholesterol approximately 50% higher level than in euthyroid patients and 90% of all hypothyroid patients have elevated cholesterol level. Likewise, low levels of t4 have an effect in relaxing the sphincter of odds, leading to biliary stasis and stone formation. The aim of the study To check thyroid status in patients who are diagnosed with gallstone disease, thereby dividing into euthyroid, hypothyroid, hyperthyroid and subclinically hypothyroid, correlating the prevalence of subclinical hypothyroidism in patients with cholelithiasis. Materials and methods: This study was conducted in the Department of General Surgery, Government Stanley Medical College, Chennai in 2018. Patients were divided according to history, clinical examination, and USG neck and lab estimation of T3, T4, and TSH. Subclinical hypothyroidism The symptom-free patient with TSH concentration above the upper limit of normal range and T3/T4or both decrease below normal limit. Clinical hypothyroidism In which there were symptoms of hypothyroidism with TSH level above the upper limit and T3/T4or both decreases below normal limit. Euthyroid group Where clinical and lab tests were within normal range. Manimegalai, T. Avvai. The prevalence of undiagnosed thyroid dysfunction and diagnosed diseases of gallstones. IAIM, 2019; 6(3) 231-236. Page 232 Results: The predominant age group was 51-60 years constituting 36.67% of patients. Youngest patient age was 21 years and the oldest was 80 years of age. Of the 60 patients, the majority of patients were euthyroid status 52 (86.67%). 6 (10%) patients were subclinical hypothyroidism, 2 (3.33%) were clinical hypothyroidism. Of the 60 patients, 52 were diagnosed with gallstone only and 8 were diagnosed with gallstone and CBD stones. In this study, hyperlipidemia was present in 7 of the hypothyroidism. Conclusion: There is a relationship between thyroid dysfunction particularly hypothyroidism and gallstone diseases. Hypothyroidism is seen more in GB stones patients compare with CBD stone patients. Subclinical hypothyroidism is more common than clinical hypothyroidism. Hypothyroidism has a higher prevalence in females than males. High cholesterol levels are seen in gallstone disease with thyroid dysfunction.