Abstract
The prevalence of cholesterol gallstones and common bile duct (CBD) stones in India is very high depending on dietary patterns and ethnic background. It is now widely accepted that the primary event in the pathogenesis of cholesterol gallstones is an altered lipid metabolism giving rise to a greater proportion of cholesterol relative to other bile lipids secreted from the liver into bile. The association of cholesterol super saturation of bile with cholesterol gallstones paved the way to a physical-chemical basis for gallstone formation. It however, soon became clear that other factors including nucleation of cholesterol crystal, binding together of these crystals with mucin, and hypo motility of the gall bladder played an equally important roles in gallstone formation.
In the present study bile and serum were collected from 46 choledocholithiasis patients during choledochotomy at the Nalanda Medical College Hospital, Patna, India. Of the 46 bile samples collected, the male to female ratio was 1:6.67 (6men and 40 women. Between 19 and 88 years of age, peak incidence of choledocholithiasis was at age 40.Serum and biliary lipid profile was done by enzymatic methods. Serum lipid profile was done for 19 healthy controls of both sexes aged between 25 and 55 years. Results showed significant elevation in both serum high density lipoprotein (HDL) and low density lipoprotein (LDL) when compared with controls. Biliary cholesterol, HDL and LDL was raised significantly when compared with serum samples. There is correlation between serum and biliary lipid profiles in causing common bile duct (cbd) stones in Indian population. Both serum and biliary HDL consistently showed higher values in Indian patients.
Keywords: HDL: High density lipoproteins LDL: Low density lipoproteins CSI: Cholesterol saturation index LI: Lithogenic index.
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Corresponding Author
Dr Tarannum Fatima Subhani
C/O Dr Naseer Ahmad, H.N-168/2, Sector-B,
New Azimabad Colony, Patna (Bihar, India) Pin Code- 800006
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