Prevalence of undiagnosed hypothyroidism in patients with gall bladder stones in Belagavi
DOI:
https://doi.org/10.18203/2349-2902.isj20215143Keywords:
Hypothyroidism, Gallbladder stones, Thyroid function test, Biliary treeAbstract
Background: Contribution of hypothyroidism to gallstone formation is debated over years. With this background, the study intended to analyze the prevalence of undiagnosed hypothyroidism in patients with cholelithiasis. The aim is to understand the prevalence of hypothyroidism in patients with gallstones.Methods: A prospective, hospital-based study was done on 100 patients admitted for the management of gall stone disease in Belagavi. After initial screening, a detailed history was obtained with special reference to symptomatology and the risk factors as per proforma from patients meeting selection criteria. Thyroid function test was done on all eligible patients. Patients were divided into three groups of Euthyroid, Subclinical hypothyroid and clinical hypothyroidism. Statistical analysis used. Percentage of gall stones in different age groups and gender of the study population was calculated followed by prevalence of hypothyroidism and subclinical hypothyroidism in all the patients included.
Results: Among the study population, 40% were male and 60% were female. 23 of them have subclinical hypothyroidism and 6 of them were diagnosed with hypothyroidism. Majority of subclinical hypothyroid patients (39.13%) were aged 41-60 years. Hypothyroid symptoms were shown by the study population with unknown thyroid status.
Conclusions: The prevalence of hypothyroidism in cholelithiasis is 29% in the study and is significant. The study demands further studies to consider hypothyroidism as a cause /risk factor for biliary calculus.References
Pierre F Saldinger. Natural history of gall stones and asymptomatic gallstones. In: Jarnagin WR, Belghiti J, Blumgart LH eds. Blumgart's surgery of the liver, biliary tract, and pancreas. 6th ed. Philadelphia: Elsevier Saunders; 2012:483-583.
Laukkarinen J, Sand J, Aittomaki S, Porsti I, Koobi P, Kalliovalkama J, et al. Mechanism of the prorelaxing effect of thyroxine on the sphincter of Oddi. Scand J Gastroenterol. 2002;37(6):667-73.
Balakrishnan S, Balasubramanian MVP, Madhavan L, Selvam G. A study of prevalence of hypothyroidism in cholelithiasis. J Evid Based Med Health. 2017;4(11):606-10.
Laukkarinen J, Sand J, Saaristo R, Salmi J, Turjanmaa V, Vehkalahti P et al. Is bile flow reduced in patients with hypothyroidism? Surgery. 2003;133(3):288-93.
Laukkarinen J, Kiudelis G, Lempinen M, Räty S, Pelli H, Sand J et al. Increased prevalence of subclinical hypothyroidism in common bile duct stone patients. J Clin Endocrinol Metab. 2007;92(11):4260-4.
Laukkarinen J, Sand J, Autio V, Nordback I. Bile duct stone procedures are more frequent in patients with hypothyroidism. A large, registry-based, cohort study in Finland. Scand J Gastroenterol. 2010;45(1):70-4.
Inkinen J, Sand J, Arvola P, Pörsti I, Nordback I. Direct effect of thyroxine on pig sphincter of Oddi contractility. Digest Dis Sci. 2001;46(1):182-6.
Vassilakis JS, Nicolopoulos N. Dissolution of gallstones following thyroxine administration. A case reports. Hepato-gastroenterol. 1981;28(1):60-1.
Allen MJ, Borody TJ, Bugliosi TF, May GR, LaRusso NF, Thistle JL. Rapid dissolution of gallstones by methyl tert-butyl ether: preliminary observations. New Eng J Med. 1985;312(4):217-20.
Hellstern A, Leuschner U, Benjaminov A, Ackermann H, Heine T, Festi D, et al. Dissolution of gallbladder stones with methyl tert-butyl ether and stone recurrence. Digest Dis Sci. 1998;43(5):911-20.
Sigal GA, Medeiros-Neto G, Vinagre JC, Diament J, Maranhao RC. Lipid metabolism in subclinical hypothyroidism: plasma kinetics of triglyceride-rich lipoproteins and lipid transfers to high-density lipoprotein before and after levothyroxine treatment. Thyroid. 2011;21(4):347-53.
Duntas LH. Thyroid disease and lipids. Thyroid. 2002;12(4):287-93.
Ajdarkosh H, Khansari MR, Sohrabi MR, Hemasi GR, Shamspour N, Abdolahi N, et al. Thyroid dysfunction and choleduocholithiasis. Middle East J Dig Dis. 2013;5(3):141-2.
Maru NP, Parmar A, Dawan ML, Mahesh MS. Study the association between thyroid disorder and gall stone diseases (cholelithiasis & choledocholithiasis). J Evol Med Dent Sci. 2013;3(26):7286-90.
Singh RR, Gupta A, Shah S, Shah AS, Ded KS, Bhatia AS. Prevalence of hypothyroidism in patients with biliary stones: a prospective study. Int Surg J. 2016;3(4):2022-4.
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(3):932-5.
Watali YZ, Jain R, Bali RS, Mittal A. Is hypothyroidism a risk for gall stone disease? a study to assess the association. Int Surg J. 2017;4(8):2665-9.
Raghuwanshi BS, Jain S, Damor M, Patbamniya NK. Prevalence of subclinical hypothyroidism in cases of cholelithiasis. Int Surg J. 2017;5(1):34-8.
Sidduri S, Hanmayyagari B, Bongi V, Ayyagari M, Venkata S. Prevalence of hypothyroidism in common bile duct stone patients. Thyroid Res Practice. 2016;13(2):57-8.
Vadicharla M, Lakshmi S. Prevalence of subclinical hypothyroidism in gall bladder stone disease. Int J Sci Res. 2016;8:22-5.
Mousumi D, Alokananda P, Madhurima B, Shabnam B. Study of thyroid profile in cholelithiasis patients conducted in Silchar Medical college and Hospital, Silchar, Assam. Int J Sci Res. 2019;8:45-8
Dhamnetiya D, Goel MK, Dhiman B, Pathania OP. Gallstone disease and its correlates among patients attending teaching hospital of North India. J Family Med Prim Care. 2019;8(1):189-91.
Andreini JP, Prigge WF, 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(8):1405-12.
InkinenJ, Sand J, Nordback I. Association between common bile duct stones and treated hypothyroidism. Hepato-gastroenterol. 2000;47(34):919-21.
VölzkeH, Robinson DM, John U. Association between thyroid function and gallstone disease. World J Gastroenterol. 2005;11(35):5530-6.
Hassan HZ, Kussay MZ. Prevalence of hypothyroidism in patients with gallstone disease. Qatar Med J. 2009;6:337-9.
