Evaluation of changes in serum lipid profile and fasting blood glucose levels in patients with gall stone disease before and after cholecystectomy
DOI:
https://doi.org/10.18203/2349-2902.isj20201012Keywords:
Cholecystectomy, Lipid profile, Blood glucoseAbstract
Background: There is paucity of information regarding the effects of cholecystectomy on serum lipid profile parameters and blood glucose levels in the patients of cholelithiasis. Therefore, this study was undertaken to compare some serum lipid parameters and blood glucose levels in patients of cholelithiasis and effect of cholecystectomy on the same.
Methods: The study was conducted on 50 patients of cholelithiasis who were admitted in Surgery department, MLN Medical College over a period of one year and were planned for cholecystectomy. Complete lipid profile (which included total cholesterol, triglycerides, high density lipoproteins (HDL) cholesterol, low density lipoproteins (LDL), very low density lipoproteins (VLDL) and atherogenic index) and fasting blood glucose was evaluated pre-operatively and post-operatively on the 3rd, 7th and further after 1 month of cholecystectomy.
Results: Out of 50 patients, maximum of 38% were in their 4th decade with females constituting 82% of total. There was significant elevation in fasting blood glucose and HDL cholesterol on 3rd, 7th and 30th day post-cholecystectomy as compared to pre-operative values (p value<0.0001). Triglyceride and VLDL cholesterol elevated on 3rd and 7th day but it significantly decreased one-month post-cholecystectomy as compared to pre-operative levels (p value<0.0001). However, LDL, total cholesterol and atherogenic index significantly decreased on 3rd ,7th and 30th day post-cholecystectomy.
Conclusions: Cholelithiasis is an important cause associated with significant pathological changes in many lipid profile parameters, which will return towards normal after cholecystectomy. This normalization will be a time dependent phenomenon with long term beneficial effects.
References
Al-Kataan MA. Lipid Measurement and Some Biochemical Changes Pre and Post-Cholecystectomy in gall stone patients. MSc thesis In Clinical Biochemistry, College of Medicine, University of Mosul, Iraq. JBMS. 2005;22(1):1-3.
Sherlock S, Dooly J. Diseases of the liver and biliary system. 11th Edition. Malden, USA: Blackwell; 2002; 597-623.
Erpecum VKJ. Pathogenesis of cholesterol and pigment gallstones: An update. Clin Res Hepatol Gastroenterol. 2011;35(4):281-87.
Paumgartner G. Biliary physiology and disease: Reflections of a physicianscientist. Hepatology. 2010;51(4):1095-96
Chen LY. Metabolic syndrome and gallstone disease. World J Gastroenterol. 2012;18(31):4215-20.
Tandon RK. Current development in the pathogenesis of gallstones. Trop Gastroenterol. 1990;11(3):130-39.
Ko CW, Lee SP. Gallstone formation. Local factors. Gastroenterol Clin North Am. 1999;28(1):99-115.
Novacek G. Gender and gallstone disease. Wien Med Wochenschr. 2006;156(19-20):527-33.
Ahmed A. Management of gallstones and their complications. American Family Physician. 2000;61(6):1673-87.
Johansson S, Wilhelmsen L, Lappas G, Rosengren A. High lipid levels and coronary disease in women in Goteborgeoutcome and secular trends: a prospective 19 years follow-up in the BEDA study. Eur Heart J. 2003;24:704-16.
Singh BK, Mehta JL. Management of dyslipidemia in the primary prevention of coronary heart disease. Curr Opin Cardiol. 2002;17:503-11.
Hachinski V, Graffagnino C, Beaudry M, Bernier G, Buck C, Donner A. Lipids and stroke: a paradox resolved. Arch Neurol. 1996;53:303-8.
Jacobson TA, Miller M, Schaefer EJ. Hypertriglyceridemia and cardiovascular risk reduction. Clin Ther. 2007;29:763-77.
Ford I, Murray H, Packard CJ, Shepherd J, Macfarlane PW, Cobbe SM. Longterm follow-up of the West of Scotland coronary prevention study. N Engl J Med. 2007;357:1477-86.
Cullen P. Evidence that triglycerides are an independent coronary heart disease risk factor. Am J Cardiol. 2000;86:943-9.
Friedewald WT, Levy RJ, Fredrickson DS. Estimation of the concentration of LDL-c in plasma without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499-502.
Bethesda MD. National Cholesterol Education Program. ATP III Guidelines at-a-Glance Quick Desk Reference. National Institutes of Health, National Heart, Lung, and Blood Institute, 2001.
Jindal N, Singh G, Ali I, Sali G, Reddy R. Effect of cholelithiasis and cholecystectomy on serum lipids and blood glucose parameters. Arch Int Surg. 2013;3:97-101.
Alkataan AM, Bashi AYD, Al-Khyatt MK. Some serum lipid profile and glucose levels pre and post-Cholecystectomy. J Bahrain Medical Society. 2010;22:18-22.
Devaki RN, Virupaksha HS, Rangaswamy M, Deepa K, Goud, Manjunatha, Nayal, Bhavna et al. Correlation of serum lipids and glucose tolerance test in cholelithiasis. International J Pharma Bio Sci. 2011;2:224-8.
Chapman BA, Wilson IR, Frampton CM, Chisholm RJ, Stewart NR, Eagar GM et al. Prevalence of gallbladder disease in diabetes mellitus. Dig Dis Sci. 1996;41:2222-8.
Olokoba AB. Relationship between gallstone disease and serum lipids in normal adult Nigerians. Afr Sci. 2006;7:302.
Shaffer EA, Small DM. Biliary lipid secretion in cholesterol gall stone disease, effect of cholecystectomy and obesity. J Clin Invest. 1977;59(5):828-40.
Sanchez MN, Norberto C, Tapia CC, Kuba MD, lara SK, Poncano G, Baptista H, Ramos MH et al. Metabolic syndrome as a risk factor for gall stone disease. World J Gastroenterol. 2005;11(11):1653-7.
Zhao JC, Xiao LJ, Zhu Y, Cheng NS. Changes of lipid metabolism in plasma, liver and bile during cholesterol gall stone formation in rabbit model. World J Gastroenterol. 1998;4(4):337-9.
Gill GS, Gupta K. Pre and Post-operative comparative analysis of serum lipid profile in patients with cholelithiasis. Int J App Basic Med Res. 2017;7:186-8.