title: Solitary versus multiple gallstones: the importance of total biliary protein concentration and other factors.
abstract: BACKGROUND
  Nucleating and antinucleating factors play an important role in the pathogenesis of cholesterol crystal nucleation.
  
  
  METHODS
  In 88 gallstone patients (59 female, 29 male) bile was examined for total biliary protein and glycoprotein concentration, nucleation time and cholesterol saturation index. Gallstone density was measured by in vivo computed tomography.
  
  
  RESULTS
  Total biliary protein concentration was positively correlated with the number of gallstones (r = 0.84, p < 0.01) and higher in radiologically detectable isodense gallstones as compared to non-isodense stones (p < 0.01). A negative correlation between total biliary protein concentration, glycoprotein concentration and nucleation time was observed (r = -0.45, p < 0.01 and r = -0.49, p < 0.05). Nucleation time was significantly shorter in the case of multiple versus solitary stones (2.6 +/- 1.3 versus 8.5 +/- 3.0 days, p < 0.01). Cholesterol saturation index and biliary cholesterol concentration were similar in both cases, however a negative correlation between cholesterol saturation index and stone density (r = -0.79, p < 0.01) was found. No correlation was found between cholesterol saturation index and nucleation time (r = -0.04, p > 0.1), independent of gallstone number. None of the examined parameters was related to sex, age, weight or gallbladder function.
  
  
  CONCLUSIONS
  Multiple gallbladder stones seem to be associated with shorter nucleation time and higher biliary concentrations of total protein and glycoprotein than solitary stones.
authors: Department of Internal Medicine, Krankenhaus, Barmherzigen Brüder, University Clinic of Ulm.
authors: J
authors: J
authors: Tudyka
authors: W
authors: W
authors: Kratzer
authors: K
authors: K
authors: Kuhn
authors: R
authors: R
authors: Mason
authors: J G
authors: JG
authors: Wechsler
authors: G
authors: G
authors: Adler
mesh_terms: D001646:Bile / Q000378:metabolism*; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism*; D002784:Cholesterol / Q000378:metabolism*; D005260:Female; D006023:Glycoproteins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D006023:Glycoproteins; D002784:Cholesterol