Magnitude of hypothyroidism among patients of cholelithiasis in a tertiary care centre in rural West Bengal: a prospective study

Authors

  • Jaganmoy Maji Department of General Surgery, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India
  • Debjyoti Mandal Department of General Surgery, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India

DOI:

https://doi.org/10.18203/2349-2902.isj20214374

Keywords:

Hypothyroidism, Cholelithiasis, Hyperlipidemia, Billiary dyskinesia

Abstract

Background: Cholelithiasis is a common pathology of the gall bladder affecting about 10 to 15% of the adults in western countries and 2 to 29% in India. More than 80% of the patients with cholelithiasis are asymptomatic. Hypothyroidism may cause gall stone formation due to the hyperlipidemia, motility disorders affecting the bile duct and sphincter of Oddi.

Methods: This was a descriptive cross-sectional study conducted at Department of Surgery, Bankura Sammilani Medical College and Hospital, Bankura from March 2019 to February 2020 for duration of one and half year. The sample size was 54 and consecutive non-probability sampling technique was used for the sampling. All the collected data were recorded in a pre-designed proforma and analyzed in MS excel.

Results: Out of 54-patients with cholelithiasis, 28% patients were from the age group 45-54 years.40% patients were hypothyroid pre-dominantly females. Among 30-female patients 11 (26.82%) were hypothyroid and among 11-male patients 2 (15.38%) were hypothyroid. Hypothyroidism in male and female was statistically significant.

Conclusions: This study was introduced to determine the relationship between hypothyroidism and cholelithiasis. It was concluded that hypothyroidism was more common in female, obese and elder patients. The gender distribution of the hypothyroidism in patients with cholelithiasis was statistically significant while all other variables were statistically not significant.  

Author Biographies

Jaganmoy Maji, Department of General Surgery, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India

DEPARTMENT OF GENERAL SURGERY

Debjyoti Mandal, Department of General Surgery, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India

DEPARTMENT OF GENERAL SURGERY

References

Portincasa A, Di Ciaula G, Vendemiale. Gallbladder motilityand cholesterol crystallization in bile from patients with pigment and cholesterol gallstones. European Journal of Clinical Investigation. 2000;30:317-24.

Shaffer EA. Epidemiology and risk factors for gall stone disease: has the paradigm changed in the 21st century? CurrGastroenterol Rep. 2005;7:132-40.

Sundaram KR, Unnikrishnan AG, Jayakumar RV, Nair V, Kumar H. High prevalence of undetected thyroid disorders in an iodine sufficient adult south Indian population. J Indian Med Ass. 2009;107(2):72-7.

Thistle JL. Pathophysiology of bile duct stones. World J Surg. 1998;22:1114-87.

Geenen JE, Hogan WJ, Dodds WJ, Stewart ET, Arndorfer RC. Intraluminal pressure recording from the human sphincter of Oddi. Gastroenterology. 1980;78:317-27.

Osnes M, Lootveit T, Larsen S, Aune S. Duodenal diverticula and their relationship to age, sex, and biliary calculi. Scand J Gastroenterol. 1981;16:103-4.

Sandstad O, Osnes T, Skar V, Urdal P, Osnes M. Common bile duct stones are mainly brown and associated with duodenal diverticula. Gut.1994;35:1464-7.

Heaton KW, Braddon FE, Mountford RA, Hughes AO, Emmett PM .Symptomatic and silent gall stones in the community. Gut. 1991;32:3161-20.

Inkinen J, Sand J, Arvola P, Pörsti I, Nordback I. Direct effect of thyroxine on pig sphincter of Oddi contractility. Dig Dis Sci. 2001;46:182-4.

Laukkarinen J, Sand J, Aittomaki S. Mechanism of the prorelaxing effect of thyroxine on the sphincter of Oddi. Scandinavian J Gastroenterol. 2002;37(6):667-73.

Laukkarinen J, Ko¨ o¨bi P, Kalliovalkama J, Sand J, Mattila J, Turjanmaa V et al. Bile flow to duodenum is reduced in hypothyreosis and enhanced in hyperthyreosis. Neuro gastroenterol Motil. 2002;14:183-8.

Laukkarinen J, Sand J, Saaristo R, Salmi J, Turjanmaa V, Vehkalahti P, Nordback I. Is bile flow reduced in patients with hypothyroidism? Surgery. 2003;133:288-93.

Woeber KA. Update on the management of hyperthyroidism and hypothyroidism. Arch Intern Med. 2000;160:1067-71.

Woeber KA. Subclinical thyroid dysfunction. Arch Intern Med. 1997;157:1065-68.

Dickey RA, Feld S. The thyroid-cholesterol connection: an association between varying degrees of hypothyroidism and hypercholesterolemia in women. J Womens Health Gend Based Med. 2000;9:333-6.

U.S. Preventive Services Task Force. Screening for thyroid disease: recommendation statement. Ann Intern Med. 2004;140:125-7.

Helfand M. Screening for subclinical thyroid dysfunction in nonpregnant adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2004;140:128-41.

Gartner R. Subclinical hyperthyroidism—does it have to be treated? MMW Fortschr Med. 2004;146:37-9.

Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine. 2004;24:1-13.

Carey MC. Pathogenesis of gallstones. Am J Surg. 1993;165:410-9.

Andreini JP, Prigge WF, Ma C, Gebbard RL. Vesicles and mixed micelles in hypothyroid rat bile before and after thyroid hormone treatment: evidence for a vesicle transport system for biliary cholesterol secretion. J Lipid Res. 1994;35:1405-12.

Behar J, Lee KY, Thompson WR, Biancani P. Gallbladder contraction in patients with pigment and cholesterol stones. Gastroenterology. 1989;97:1479-84.

Jazrawi RP, Pazzi P, Petroni ML, Prandini N, Paul C, Adam JA et al. Postprandial gallbladder motor function: refilling and turnover of bile in health and in cholelithiasis. Gastroenterology. 1995;109:582-91.

Field FJ, Albright E, Mathur SN. Effect of dietary cholesterol on biliary cholesterol content and bile flow in the hypothyroid rat. Gastroenterology. 1986;91:297-304.

DiStefano 3rd JJ, Nguyen TT, Yen YM. Transfer kinetics of 3,5,3- triiodothyronine and thyroxine from rat blood to large and small intestines, liver, and kidneys in vivo. Endocrinology. 1993;132:1735-44.

Rutgers M, Heusdens FA, Bonthuis F, de Herder WW, Hazenberg MP, Visser TJ. Enterohepatic circulation of triiodothyronine (T3) in rats: importance of the microflora for the liberation and reabsorption of T3 from biliary T3 conjugates. Endocrinology. 1989;125:2822-30.

Vassilakis JS, Nicolopoulos N. Dissolution of gallstones following thyroxine administration. A case report. Hepatogastroenterology. 1981;28:60-1.

Nath K, Kumar A, Acharya J. Int J Med Res Prof. 2017;3(3):65- 9.

Singha D, Pawar NM, Prabhu BJ, Kumar N, Gopalarathnam S. Prevalence of previously undiagnosed hypothyroidism in patients with cholelithiasis in a tertiary care center, North-East India. Int Surg J. 2017;4:932-5.

Ghimire P, Gharti BB. Association of Gallstone Disease with Hypothyroidism in Western Region of Nepal IOSR Journal of Dental and Medical Sciences. 2017;16:2279-0853.

Arun N, Pushpalatha M, Mohanan P. The prevalence of hypothyroidism in diagnosed cases of cholelithiasis. International Journal of Clinical Biochemistry and Research. 2018;5(1):4648- 46.

Singh J, Singh M, Sharma RK, Singh K, Puri A. Can Thyroxine Reduce Gall Stone Formation in Hypothyroid Patients...? International Journal Of Scientific Progress And Research. 2018;49:2349-4689.

Hassan Y. Association between cholelithiasis and thyroid profile – a tertiary hospital care based study. WJPMR .2018;4(12):2112-17.

Manimegalai T, Avvai. The prevalence of undiagnosed thyroid dysfunction and diagnosed diseases of gallstones. IAIM. 2019;6(3):231-6.

Volzke H, Daniel M, John U. Association between thyroid function and gall stones. World J Gastroenterol. 2005;35:5530-4.

Ahmed A, Ranjan S K, Sinha D K, Kerketta M D, Usha P. Changing Incidence of Gall Stone Disease: A Single Centre Study from Eastern India. IOSR Journal of Dental and Medical Sciences. 2015;14(12):50-3.

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Published

2021-10-28

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Original Research Articles