Subject(s)
Bile Ducts/injuries , Cholecystectomy, Laparoscopic/adverse effects , Indians, North American/statistics & numerical data , Choledocholithiasis/ethnology , Choledocholithiasis/surgery , Female , Humans , Indians, North American/ethnology , Male , Middle Aged , New Mexico/ethnology , Risk Factors , Rural Health/statistics & numerical dataABSTRACT
Choledocholithiasis (CDL) usually presents with biliary pain. Painless CDL is also known to occur, especially in the elderly. The purpose of this study is to determine whether the mode of presentation (painful vs. painless) influences the clinical course and outcomes of CDL in African American and Hispanic patients. Ten years of admission and discharge records (January 1998-December 2007) were reviewed retrospectively, yielding 527 community hospital patients, aged 23-97 years, with the final diagnosis of CDL. Patients with painless presentation had higher odds of having comorbidities compared to patients presenting with pain. However, patients who presented with biliary pain were predominantly younger (mean age 34 years), and 59% were Hispanic females (p = 0.001). In our study painless CDL was associated with higher morbidity and mortality.
Subject(s)
Black or African American/statistics & numerical data , Choledocholithiasis/diagnosis , Choledocholithiasis/ethnology , Hispanic or Latino/statistics & numerical data , Pain Measurement , Abdominal Pain/ethnology , Abdominal Pain/physiopathology , Adult , Age Factors , Aged , Aged, 80 and over , Biliary Tract/physiopathology , California , Cholangiopancreatography, Endoscopic Retrograde/methods , Cholecystectomy/methods , Cholecystectomy/statistics & numerical data , Choledocholithiasis/therapy , Cohort Studies , Confidence Intervals , Female , Follow-Up Studies , Gastrointestinal Agents/therapeutic use , Humans , Male , Middle Aged , Odds Ratio , Retrospective Studies , Risk Assessment , Severity of Illness Index , Sex Factors , Treatment Outcome , Urban Population , Young AdultABSTRACT
BACKGROUND AND AIMS: The gene product of the uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1) is crucial to bilirubin metabolism. Mutations in this gene subsequently result in disease presented with unconjugated hyperbilirubinemia. A previous study showed that a TA-repeat polymorphism in the promoter region of this gene might play a role in the metabolism of bilirubin. Whether this polymorphism might predispose choledocholithiasis is unclear. METHODS: We recruited 32 patients who were diagnosed with pigment choledocholithiasis (common bile duct stones) by endoscopic retrograde cholangiopancreatography (ERCP) morphology and 107 population controls. The TA-repeat in the UGT1A1 promoter was genotyped. RESULTS: We found that among the 32 patients, 15 (46.9%) were wild type (A[TA](6)TAA homozygous); 15 (46.9%) were a heterozygous variation (A[TA[(6)TAA/A[TA](7)TAA) and 2 (6.2%) were a homozygous variation (A[TA](7)TAA). Among the controls, 81 (75.7%) were wild type, 23 (21.5%) were a heterozygous variation and 3 (2.8%) were a homozygous variation. The genotype distribution was significantly different between patients and controls. CONCLUSIONS: The results suggest that the UGT1A1 promoter TA-repeat polymorphism is associated with choledocholithiasis in Taiwanese patients.
Subject(s)
Asian People/genetics , Choledocholithiasis/genetics , Glucuronosyltransferase/genetics , Polymorphism, Genetic , Promoter Regions, Genetic , Adult , Aged , Aged, 80 and over , Case-Control Studies , Cholangiopancreatography, Endoscopic Retrograde , Choledocholithiasis/diagnostic imaging , Choledocholithiasis/enzymology , Choledocholithiasis/ethnology , Female , Gene Frequency , Genetic Predisposition to Disease , Heterozygote , Homozygote , Humans , Male , Middle Aged , Odds Ratio , Phenotype , Risk Assessment , Taiwan/epidemiologyABSTRACT
OBJECTIVE: To investigate the relationship between IL-4 gene polymorphism and cholelithiasis in Chinese population. METHODS: Polymerase chain reaction combined with restriction enzyme digestion was used to detect the polymorphism of IL-4 gene in 81 cholecystolithiasis, 41 patients with biliary duct stone. RESULTS: There were no significant differences of the IL-4 gene polymorphism genotypes and alleles between 81 cholecystolithiasis patients (CC11.1%, CT34.6%, TT54.3%; C28.4.7%, T71.6%). There were significant differences of the IL-4 gene polymorphism genotypes and alleles between 41 patients with biliary duct stone (CC48.8%, CT36.6%, TT14.6%; C67.1%, T32.9%). CONCLUSIONS: The C589T polymorphism of IL-4 gene was not associated with cholecystolithiasis patients in Chinese, but was related to patients with biliary duct stone in Chinese.
