Summary
Serum lipids and lipoproteins of gallstone patients were analyzed and compared with lithogenesity of bile and type of stones by roentgenographic and cross-sectional views.
Incidences of hypercholesterolemia and triglyceridemia were higher in patients with radiolucent gallstones than with radiopaque stones. Furthermore, an incidence of hypertriglyceridemia was higher in patients with radiolucent solitary stones than with radiolucent multiple stones. The degrees of hyperlipidemia were moderate.
Lipoprotein disc electrophoresis of sera of hyperlipidemic patients revealed type IIa, IIb or IV. More solitary and less multiple stones were seen in the hyperlipoproteinemic patients than normolipoproteinemic. Multiple stones with normolipoproteinemia were more accompanied by unsaturated bile (lithogenic index <1.0) than those with hyperlipoproteinemia and solitary stones with hyperlipoproteinemia or without.
Solitary stones obtained surgically from normolipoproteinemic patients were pure cholesterol, combination or mixed stones, while multiple stones not including pure cholesterol and combination stones with pure cholesterol in the center. Solitary stones in hyperlipoproteinemic patients proved mostly either pure cholesterol or combination stones with pure cholesterol in the center, while multiple stones containing all types of stones inclusive of a small number of other miscellaneous stones except cholesterol stones. Collectively more mixed and other miscellaneous stones except cholesterol stones, and less pure cholesterol and combination stones with pure cholesterol in the center were shown in normolipidemic patients, and vice versa in hyperlipoproteinemic patients.
These results suggested serum lipids and lipoproteins being closely related to the initial precipitation, aggregation of cholesterol crystals and development of cholesterol gallstones through lipid metabolism of the whole body.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Campbell JMH: Cholesterol in the blood in case of gallstones. Quart J Med 18: 123–131, 1924
Epstein EZ: Cholesterol of the blood plasma in hepatic and biliary diseases. AMA Arch Int Med 50: 204–222, 1932
Epstein EZ, Greenspan EB: Clinical significance of the cholesterol partition of the blood plasma in hepatic and in biliary diseases. AMA Arch Int Med 58: 860–890, 1936
Gardner JA, Gainsborough H: Blood cholesterol studies in biliary and hepatic disease. Quart J Med 23: 465–475, 1930
Robinson RHOB: Diagnostic value of the estimation of blood cholesterol in cholelithiasis. Lancet 2: 540–543, 1929
Wilensky AO: Hypercholesterolaemia. Surg Gynec and Obst 38: 163–170, 1924
Chauffard A: La Lithiase biliare. 2nd Ed Masson, Paris, 1922
Van DerLinden W, Bergman F: An analysis of data on human hepatic bile: relationship between main bile components, serum cholesterol and serum triglycerides. Scan J Clin Lab Invest 37: 741–744, 1977
Einarsson K, Hellström K, Kaliner M: Gallbladder disease in hyperlipoproteinemia. Lancet 1: 484–487, 1975
Bockus HL: Choledocholithiasis. 752–788. Gastroenterology. Ed HL Bockus, Vol 3, 3rd Ed WB Saunders Co, Philadelphia, 1976
Allain CC, Poon LS, Chan CS: Enzymatic determination of total serum cholesterol. Clin Chem 20: 470–475, 1974
Fletcher MJ: A colorimetric method for estimating serum triglycerides. Clin Chim Acta 22: 393–397, 1968
Wada M, Mise J: An investigation of human lipoprotein disc electrophoresis. I. Behaviour of serum Iipoproteins in disc type acrylamide gel electrophoresis. Jpn Circul J 36: 121–135, 1972
Beaumont JL: Classification of hyperlipidemias and hyperlipoproteinemias (memoranda). Bulletin of WHO 43: 891–915, 1970
Kawamoto T, Kajiyama G, Maruhashi A, Mizuno T, Yamada K, Fujiyama M, Miyoshi A: The influence of dietary cholesterol on the lithogenesity of bile in rats treated with clofibrate. Hiroshima J Med Sci 27: 147–153, 1978
Takayama S, Ito S, Mori A, Nagasaki H, Tanimizu K, Horiuchi Y, Imamura S, Ikuta S: Enzyme method for the determination of choline. Jpn J Clin Path 24 (Supple): 461, 1976. (Abst)
Thomas RT, Hofmann AF: A simple calculation of the lithogenic index of bile. Expressing biliary lipid composition on rectangular coordinates. Gastroent 65: 698–700, 1973
Holtzbach RT, Marsh M, Olszewski M, Holan K: Cholesterol solubility in bile: Evidence that supersaturated bile is frequent in healthy man. J Clin Invest 52: 1467–1479, 1973
Ishihara F, Nishikawa H: Structures and developmental mechanism of gallstones. Symposium on pathology of biliary tract diseases with special emphasis on gallstone disease. Jpn J Med 17: 57–59, 1978
Savage PJ, Hamman RF, Gregory B, Dippe SE, Miller T, Bennett PH: Serum cholesterol levels in American (Pima) Indian children and adolescents. Pediatrics 58: 274–282, 1976
Sampliner RE, Bennett PH, Comess LJ, Rose FA, Burch TA: Gallbladder disease in Pima Indians. Demonstration of high prevalence of early onset by cholecystography. New Engl J Med 283: 1358–1364, 1970
Sarles H, Gerolami A, Cros RC: Diet and cholesterol gallstones. A multicenter study. Digestion 17: 121–127, 1978
Mitropoulas KA, Myant NB, Gibbons GF, Balasubramaniam S, Reeves BEA: Cholesterol precursor pools for the synthesis of cholic and chenodeoxycholic acids in rats. J Biol Chem 249: 6052–6056, 1974
Schwartz ZR, Vlahcevic ZR, Halloran LG, Gregory DH, Meek JB, Leon S: Evidence for the existence of definitive hepatic cholesterol precursor compartments for bile acids and biliary cholesterol in man. Gastroent 69:1379–1382, 1975
Cahlin E, Jönsson J, Nilsson S, Scherstin T: Biliary lipid composition in normolipidemic and prebeta hyperlipoproteinemic gallstone patients. Influence of sucrose feeding of the patients on the biliary lipid composition. Scand J Gastroent8: 449–456, 1973
Aschoff L, Bacmeister A: Die Cholelithiasis. 17.29.36.78. 1909 Gustav. Fischer Jena
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kajiyama, G., Fujiyama, M., Takata, K. et al. Serum lipids and lipoproteins in patients with gallstone (relationship between serum lipids and types of stones in roentgenograms and sectional views). Gastroenterol Jpn 16, 553–562 (1981). https://doi.org/10.1007/BF02813789
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02813789