Abstract
The aim of the present study was to investigate predisposing factors that lead to the formation of gallstones. In a group of 70 patients (51 with gallstones and 19 without, 20 possible risk factors were studied: percent of ideal body weight, the presence of superoxide dismutase in erythrocytes and in serum, lipid peroxide in serum, total serum cholesterol (Ch), high density lipoprotein (HDL)-cholesterol (Ch), low-density lipoprotein (LDL)-Ch, very low-density lipoprotein (VLDL)-Ch, serum triglyceride (TG), HDL-TG, LDL-TG, VLDL-TG, serum bile acids (lithocholic acid, deoxycholic acid, chenodeoxy cholic acid, ursodeoxycholic acid, and cholic acid) and serum apolipoproteins (apo A-1, apo B-100, and apo A-1/apo B-100). Levels of apo B-100 and serum insulin in patients with gallstone were strikingly higher, and superoxide dismutase in erythrocytes was significantly lower than in individuals with no gallstones. Apo A-1 and HDL-Ch were also higher and LDL-Ch was lower in the gallstone group, albeit non-significantly so (P>0.05) byt-test. However, Apo A-1, HDL-Ch, and LDL-Ch showed remarkably good discriminatory power in stepwise discriminant analysis of the 20 factors. Bile lipid composition was also measured and the cholesterol saturation index was calculated, but no significant differences were seen between the two groups. The results demonstrate that serum lipid patterns differ to some extent in patients with and without gallstones. Lipid derangement may contribute to the development of gallstone disease.
Similar content being viewed by others
References
Carey MC. Pathogenesis of gallstones. Am J Surg 1993;165:410–419.
LaRusso NF. Gallstones and cholecystitis. In: Kelley WW (eds) Textbook of internal medicine. Philadelphia: J.B. Lippincott, 1989:588–589.
Small DM. Pathogenesis of cholesterol stones: The biliary tract. In: Berk JM (ed) Gastroenterology, vol 1. 4th ed. Philadelphia: WB Saunders, 1988:3499–3509.
Doty JE, Pitt HA, Kuchenbocker SL, et al. Impaired gallbladder emptying before gallstone formation in the prairie dog. Gastroenterology 1983;85:168–174.
Fridhandler TM, Davison JS, Shaffer EA. Defective gallbladder contractility in the ground squirrel and prairie dog during the early stages of cholesterol gallstone formation? Gastroenterology 1983;85:830–836.
Magnuson TH, Lillemoe KD, Scheeres DE, et al. Altered bile composition during cholesterol gallstone formation. Cause of effect? J Surg Res 1990;48:584–589.
Carey MC. Critical tables for calculating the cholesterol saturation of native bile. J Lipid Res 1978;19:945–955.
Imai K, Tamura Z. Gas chromatography of bile acids as their hexafluoroisopropyl ester trifluoroacetyl derivatives. J Chromatogr 1976;120:181–186.
Bartlett GB: Phosphorus assay by column chromatography. J Biol Chem 1959;234:466–468.
Albers JJ, Grundy SM, Cleary PA, et al. National Cooperative Gallstone Study. Gastroenterology 1982;82:638–646.
Wilson DE, Spiger MJ, Done GA. A dual precipitation method of quantitative plasma lipoprotein measurement without ultracen-trifugation. J Lab Clin Med 1973;82:473–482.
Laurell CB. Quantitative estimation of protein by electrophoresis in agarose gel containing antibodies. Anal Biochem 1966;15:45–52.
Whiting MJ. A caution in the use of octadecylsilane-bonded silica cartridges for the extraction of bile acids from serum. Clin Chim Acta 1984;141:261–265.
Winterbourn CC, Hawkins RE, Brian M, et al. The estimation of red cell superoxide dismutase activity. J Clin Med 1975;85:337–341.
Feng Hua-Fang. A simple spectrophotometric method for the assay of lipid hydroperoxides in serum. Chin J Med Lab Technol 1991;14:266–268.
Metropolitan Life Insurance Company. Weight standards for men and women. In: Wyngaarden JB, Smith LS (eds) Cecil textbook of medicine 17th ed. Philadelphia: WB Saunders, 1985:1191–1191.
Holzbach RT, Marsh M, Olszewski M, et al. Cholesterol solubility in bile. J Clin Invest 1973;52:1467–1479.
Holan KR, Holzbach RT, Hermann RE. Nucleation time: A key factor in the pathogenesis of cholesterol gallstone diseases. Gastroenterology 1979;77:611–617.
Nakano K, Chijiiwa K. Reduced cholesterol metastability of hepatic bile and its fartherdecline in gallbadder bile in patients with cholesterol gall stones. Gut 1993;34:702–707.
Grundy SM, Kalser SC. Highlights of the meeting on prevention of gallstones. Hepatology 1987;7:946–951.
Hamsten A, Walldius G, Szamosi A, et al. Relationship of angiographically defined coronary artery disease to serum lipoproteins and apoproteins in young survivals of myocardial infarction. Circulation 1986;73:1097–1110.
Lehtonen A, Marniemi J, Inberg M, et al. Levels of serum lipids. apolipoproteins A-1 and B and pseudocholinesterase activity and their discriminativevalues in patients with coronary by-pass operation. Atherosclerosis 1986;59:215–221.
Lippi U, Cappelletti P, Signori D, et al. Clinical chemical indexes and severity of coronary atherosclerosis. clin Chim Acta 1983; 130:283–289.
Scobey MW, Johnson FL, Rudel LL Delivery of high-density lipoprotein free and esterified cholesterol to bile by perfused monkey liver. Am J Physiol 1989;257:G644–652.
Sampson WJ, Suffolk RA, Bowers P, et al. The role of acyl-CoA. Cholesterol acyltransferase in the metabolism of free cholesterol to cholesterol esters of bile acids in primary cultures of rat hepatocytes. Biochim Biophys Acta 1987;920:1–8.
Scragg RKR, Calvert GD, Oliver JR. Plasma lipids and insulin in gallstone disease: A case-control study. BMJ 1984;289:521–524
Laakso M, Suhonen M, Julkunen R, et al. Plasma insulin, serum lipids and lipoproteins in gall-stone disease in non-insulin-dependent diabetic subjects: A case control study. Gut 1990; 31:344–347.
Lichterberg D, Ragimova S, Peled Y, et al. Phospholipid peroxidation as a factor in gallstone pathogenesis. FEBS Lett 1988;228:179–181.
Hale WB, Turner B, LaMont Jt. Oxygen radicals stimulate guinea pig gallbladder glycoprotein secretion in vitro. Am J Physiol 1987;253:G627–630.
Tudyka J, Kratzer W, Kuhn K, et al. Combined bile acid therapy is more effective on biliary lipids and dissolution rates than monotherapy after gallstone lithotripsy. Am J Gastroenterol 1995;90:1942–1948.
Choe M, Jackson C, Yu BP. Lipid peroxidation contributions to age-related membrane rigidity. Free Radic Biol Med 1995;18:977–984.
Ernst L, Dallner G. Biochemical physiological and medical aspects of ubiquinone function. Biochim Biophys Acta 1995: 1271:195–204.
Zhang JR, Andrus PK, Hall ED. Age-related phospholipid hydroperoxide levels in gerbil brain measured by HPLC-chemiluminescence and their relation to hydroxyl radical stress. Brain Res 1994;639:275–282.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tang, WH. Serum and bile lipid levels in patients with and without gallstones. J Gastroenterol 31, 823–827 (1996). https://doi.org/10.1007/BF02358609
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02358609