Abstract
Background: There was a debate whether hypothyroidism could lead to cholelithiasis over the last few decades. Recent studies showed that disturbances in lipid metabolism combined hypothyroid status, particularly of a cholesterol pathway and changes in the rate of bile excretion which could lead to the formation of gall stones. Recently, the pro-relaxing effect of serum total thyroxin (T4) on both human and pig sphincter of Oddi (SO) has been proven.
Objective: To assess the prevalence of hypothyroidism in patients with gall stones and try to establish hypothyroidism as a possible etiological factor for gallstones formation.
Methods: A cross sectional study was carried on in Basrah Teaching Hospital involving a 232 patients with gallstones whom admitted to the hospital during the period from April 2016 to October 2017. All patients were assessed by detailed clinical history and examination with appropriate investigations in form of abdominal USS, thyroid function tests and lipid profile.
Results: Out of 232 patients of gallstone, 200 patients were euthyroid and 32 patients were hypothyroidism, 22 patients were diagnosed as subclinical hypothyroidism and 10 patients were diagnosed as clinical hypothyroidism. Regarding lipid profile, 175(75.4%) of patients with gall stone had increased lipid profile, while 57(24.6%) had normal lipid profile.
Conclusion: Hypothyroidism which may lead to elevation of serum lipid profile and thus act as a cause of gall stone formation.
Keywords: Gall stone disease, Hypothyroidism, Prevalence.
References
- Shaffer EA. Epidemiology and risk factors for gall stone disease: has the paradigm changed in the 21st century, Curr Gastroenterol Rep. 2005; 7: 132–140
- Lambou-Gianoukos S, Heller SJ. Lithogenesis and bile metabolism. Surg Clin North Am 2008; 88: 1175-1194.
- Laukkarinen J, Sand J, Autio V, Nordback I. Bile duct stone procedures are more frequent in patients with hypothyroidism.A large, registry-based, cohort study in Finland. Scand J Gastroenterol 2010; 45: 70-74.
- Inkinen J, Sand J, Arvola P, Pörsti I, Nordback I. Direct effect of thyroxin on pig sphincter of Oddi contractility. Dig Dis Sci 2001; 46: 182-186.
- Laukkarinen J, Sand J, Aittomäki S, Pörsti I, Kööbi P, Kalliovalkama J, et al. Mechanism of the prorelaxing effect of thyroxin on the sphincter of Oddi. Scand J Gastroenterol 2002; 37: 667-673.
- Honore LH. A significant association between symptomatic cholesterol cholelithiasis and treated hypothyroidism in women. J Med 1981; 12: 199-203.
- Inkinen J, Sand J, Nordback I. Association between common bile duct stone and treated hypothyroidism, Hepatogastroe-nterol 2001; 47: 919-921.
- Kleinero, Ramesh J,Huleihel M,Cohen Z,Mordechai S, 2002. Acomartive study of gallstone from children and adult using FTIR spectroscopy and flurorescence microscopy. BMC Gastroenterol , 2: 3-15.
- Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000; 160: 526-534.
- Bergman F, Vander Linden W. Further studies on the influence of thyroxine on gallstones formation in hamsters. Acta Chir Scand 1966; 131: 319-328.
- Vassilakis JS, Nicolopoulos N. Dissolution of gallstones following thyroxine administration. A case report. Hepatogast-roenterol 1981; 28(1): 60-61.
- Volzke H, Daniel M, John U. Association between thyroid function and gall stones. World J Gastroenterol 2005; 35: 5530-5534.
- Chen CY, Lu CL, Huang YS, Tam TN, Chao Y, et al. Age is one of the risk factors in developing gallstone disease in Taiwan. Age and ageing 1998; 27: 437-41.
- Zaini HH, Zwain KM. Prevalence of hypothyroidism in patients with gallstone disease.QMJ 2009; 6: 108-117.
- Nath k, Kumar A, Acharya J , Prevalence of Hypothyroidism in Cholelithiasis Patients in Bikaner, Rajasthan (India) , Int J Med Res Prof 2017; 3(3); 65-69 .
- Sundeswari P, Ravisankar G, Kumar S, Premnath KSG. A prospective study of hypothyroidism in diagnosed case of gallstone. J Evid Med Healthcare 2016; 3(88): 4819-4823.
- Ibrahim SL. The impact of thyroid dysfunction and TSH on the pathogenesis of gallstone and its complication. Journal of Kufa for Nursing Science 2014; 4(1): 1-6.
- Kapora , evaluation of thyroid profile in patients with gall stone disease , Volume-6, Issue-2, February - 2017 • ISSN No 2277 – 8160 .
- Chih-Cheng Lai, Sai-Hung Tang, Dee Pei, Cheng-Yi Wang, Yen-Lin Chen, Chung-Ze Wu. et al. The Prevalence of Subclinical Thyroid Dysfunction and Its Association With Metabolic Syndrome in Taiwanese Elderly. Intern J Gerontol 2011; 5: 25–29.
- Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160: 526-534 .
- Inkinen J, Sand J, Arvola P, Porsti I, Nordback I. Direct effect of thyroxine on pig sphincter of Oddi contractility. Dig Dis Sci 2001; 46: 182-186.
Corresponding Author
Prof. Mohammed H. Al-Jawher
Department of Surgery, College of Medicine, University of Basrah, Basrah, Iraq
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.