Open Access Open Access  Restricted Access Subscription Access

A CASE CONTROL STUDY TO EVALUATE THE RELATIONSHIP OF SERUM LIPID PROFILE, APO-LIPOPROTEINS, BODY MASS INDEX, WAIST HIP RATIO IN OCCURRENCE OF CHOLELITHIASIS

Vimal Bhandari, Surya Prakash Gora, H. G. Vyas, Charanjeet Kaur, Neelam Roy

Abstract


Introduction: The aim of this study was to evaluate the relationship of lipid profile, Apo-lipoprotein-A, Apo-lipoprotein-B, Body Mass Index, Waist Hip ratio with occurrence of gall stone disease.

Materials and Methods: The study was conducted in the Department of Surgery in collaboration with Department of Biochemistry on 100 patients for a period of one year. The patients were divided in two groups: 50 cases (40 women, 10 men: mean age 39.98 years) and 50 controls (40 women, 10 men: mean age 38.50years). The study design was case control study. Blood was collected in fasting state and analyzed for Lipid profile (total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, total triglyceride, Apo-lipoprotein A, Apo-lipoprotein B). Anthropometric measurements were done to calculate body mass index and waist hip ratio.

Results, Analysis and Discussion: Out of 100 patients, 80% were women and 20% were men. On lipid profile analysis in study group mean serum total cholesterol was 186.78±49.13 mg/dl, mean Triglyceride was 142.54±56.52 mg/dl, mean HDL-C was 39.46±27.97 mg/dl, LDL-C was 126.06±45.82 mg/dl, mean APO-A was 102.24±20.38 mg/dl, mean APO-B was 82.56±15.7 mg/dl. All above lipid profile parameter except HDL-C and APO-A were significantly higher in case group than control group p<0.001. While APO-A was significantly lower p<0.001 and HDL-C was lower but not significant p-0.179.The mean BMI was statistically higher in case group than control group (27.5±0.71 vs 24.31±0.32 kg/m2,p<0.001).The mean WHR was statistically higher in case group than control (0.87±0.39 vs 0.79±0.47,p<0.001).

Conclusion:  Elevated Triglyceride, Total Cholesterol, Low density lipoprotein cholesterol and it’s associated Apo lipoprotein-B(Apo-B) while decreased High density lipoprotein cholesterol and its associated Apo lipoprotein A (Apo-A) seems to play major contributing role in the pathogenesis of gall stone. Apo lipoproteins were more sensitive parameter than lipid profile in distinguishing patients with gall stone than without gall stones. Obesity and high Waist Hip Ratio (central obesity) were also associated with occurrence of cholelithiasis.


Keywords


Lipid profile, Serum lipid profile, Apo-lipoproteins, Body mass index, Waist hip ratio, Cholelithiasis.

Full Text:

PDF

References


Abhyankar BA. (1996). “Epidermiological study of cholelithiasis, A study of 53 cases”, Surgery J, Vol.1, pp.39-42.

Attili AF, Capo Coclia R, and Cornil N. (1997). “Factors associated with gall stone disease in mical experience”, Hepatology, Vol.26, pp.809-818.

Aulakh R, Mohan H, Attri AK, Kaur J, and Punia RP. (2007). “A comparative study of serum lipid profile and gallstone disease”, Indian J. Pathol Microbiol, Vol.50(2), pp.308-312.

Bell GD, Lewis B, Petrie A, and Dowling RH. (1973). “Serum Lipids in Cholelithiasis: Effect of Chenodeoxycholic Acid Therapy”, Br. Med. J., Vol.3, pp.520-523.

Channa NA, Khand F, Ghanghro AB, and Soomro AM. (2010). “Quantitative analysis of serum lipid profile in gall stone patients and controls”, Pak. J. Anal. Environ.Chem, Vol.11(1), pp.59-65.

Coehn DE. (2002). “Pathogenesis of Gall stone”, in Zakin D, and Boyer TD. (eds). (2002). “Hepatology a text book of liver disease”, 4th edition, WB Saunders, Philadelphia, pp.1713-1743.

Devesa F, Ferrando J, Caldentey M, Borghol A, Moreno MJ, Nolasco A, Moncho J, and Berenguer J. (2001). “Cholelithiasic disease and associated factors in a Spanish population”, Dig. Dis. Sc., Vol.46(7), pp.1424-1436.

Diehl DK. (2000). “Cholelithiasis and Insulin resistance syndrome”, Histopathology, Vol.37, pp.528-530.

Fu X, Gong K, and Shao X. (1995). “The relationship between serum lipid apolipoprotein level and bile lipids”, Chung Hua I Hsueh Tsa Chih, Vol.708, pp.656-659.

Garrow JS, and James WPT. (1993). “Human Nutrition and Dietetics”, 9th Edition, Churchill Livingstone, London.

Haffner SM, Diehl AK, Stern MP, and Hazuda HP. (1989). “Central Adiposity and gall bladder disease in Mexican Americans”, Am J Epdemiol, Vol.129(3), pp.587-595.

Hou L, Shu XO, Gao YT, Ji BT, Weiss JM, Yang G, Li HL, Blair A, Zheng W, and Chow WH. (2009). “Anthropometric measurements, physical activity, and the risk of symptomatic gallstone disease in Chinese women”, Ann epidemiol, Vol.19(5), pp.344-350.

Kumari DJ, and Krishna BSH. (2010). “Role of Body Mass Index, Physical Activity and Nutrition in Cholelithiasis”, J Hum Ecol, Vol.31(3), pp.151-155.

Kurtul N, Pence S, Kocoglu H, Aksoy H, and Capan Y. (2002). “Serum lipid and lipoproteins in gallstone patients”, Acta Medica (Hradec Kralove), Vol.45(2), pp.79-81.

Rosai J. (1996). “Ackerman’s Surgical Pathology, Gallbladder and Extrahepatic Bile Ducts”, 8th Edition, Mosby Publication, StLouis, Mo.

Sabanathan S, Oomeer S, and Jenkinson LR. (2008). “Cholecystectomy or cholelithiasis-a missed marker for hyperlipedimia? A Combined Retrospective and prospective Study”, Gastroenterology Research, Vol.1(1), pp.29-32, accessed through http://www.gastrores.org/index.php/Gastrores/article/view/25/31

Tirziu S, Bel S, Bondar CI, and Acalovschi M. (2008). “Risk factor for gall stone disease in patients with gall stones, having gall stone heredity. A case control study”, Rom. J. Intern. Med, Vol.46, pp.223-228.

Tsai CJ, Leitzmann MF, Willett WC, and Giovannucci EL. (2004). “Prospective study of abdominal adiposity and gallstone disease in US men”, Am J clin Nutr, Vol.80(1), pp.38-44.

Tsai CJ, Leitzmann MF, Willett WC, and Giovannucci EL. (2006). “Central adiposity, regional fat distribution, and the risk of cholecystectomy in women”, GUT, Vol.55(5), pp.708-714.

WHO. (2008). “Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation”, accessed through http://whqlibdoc.who.int/publications/2011/9789241501491_eng.pdf


Refbacks

  • There are currently no refbacks.


Send mail to ijsss@ijsss.com with questions or comments about this web site. 

International Journal of Surgery and Surgical Sciences, All rights reserved.