Blood lipids in gallstone disease: associations with risk factors

Abstract

   Aim of the review – to present an analysis of the literature data on the association of serum lipids with the presence of gallstone disease (GSD), as well as with the main risk factors for GSD – age, female sex, obesity, type 2 diabetes mellitus (DM2), arterial hypertension (AH) over a 50-year period.   In numerous studies, hypertriglyceridemia (HTH), hypocholesterolemia of high-density lipoproteins (hypo-HDL) have been recognized as risk factors for GSD. In 1994–1995 in Novosibirsk (WHO MONICA project), in a population sample of women aged 25-64 (n = 870) and men aged 35–54 (n = 399) with sonographic diagnoses of GSD, GSD is much more common among men and women with lipid metabolism disorders: the highest frequency of GSD was noted in the 4th quartile of the distribution of total cholesterol (TC) levels (4.5 % for men and 12.4 % for women). For LDL cholesterol, the highest incidence of GSD was noted in the 5th quintile of the distribution (3.8 % in men and 10.9 % in women). When calculating by the largest χ2 method in women, the levels of TC (178 mg/dl), TG (177 mg/dl) in the blood were determined, exceeding which significantly increases the chance of GSD, for HDL cholesterol (68.5 mg/dl) the model is insignificant. There was a correlation between blood lipids and age, BMI, and DM2 in women with GSD, but not in men with GSD. The lipid profile in patients with GSD is not associated with AH. Most authors recognize GSD as a lipid-associated disease. However, the literature data are contradictory: there are opinions about a direct, inverse or absent association of blood lipids with GSD, perhaps due to differences in the design, size, and ethnicity of the subjects, as well as since the level of serum lipids is closely correlated with other risk factors for GSD, which significantly complicates the differentiated assessment of their contribution to the process of gallstone formation. Further studies of the contribution of lipid factors to the development of GSD are needed.