Study of serum calcium and trace elements in chronic cholelithiasis.
BACKGROUND
High biliary calcium and trace elements (copper, zinc and iron) in patients with chronic cholelithiasis can be associated with gallstones.


METHODS
Estimations of calcium, copper, zinc and iron were done in the serum, gall bladder bile and gallstones of 48 patients with chronic cholelithiasis and in 20 age- and sex-matched controls. Biliary levels of calcium and trace elements and bile/serum ratio of calcium and trace elements were compared in the two groups.


RESULTS
Serum calcium was significantly less (P = 0.009) than controls, but biliary calcium was higher in the patients with chronic cholecystitis. All trace elements were found to be significantly higher (P </= 0.036) in the bile of patients with chronic cholelithiasis. The bile/serum ratio of calcium, copper and zinc was significantly greater (P </= 0.03) in patients of chronic cholelithiasis. Gall bladder bile in patients with chronic cholelithiasis was slightly more alkaline. Pigment stones contained significantly more calcium, copper and iron than cholesterol stones (P </= 0.001).


CONCLUSIONS
Higher biliary calcium and trace elements as well as a defective pH of gall bladder bile in patients with chronic cholelithiasis could be the underlying factor in the pathogenesis of gallstones.
Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. grverma@mantraonline.com
Ganga R
GR
Verma
Ajay K
AK
Pandey
Shashank M
SM
Bose
Rajendra
R
Prasad
D000328:Adult; D001646:Bile / Q000737:chemistry / Q000502:physiology; D002118:Calcium / Q000032:analysis*; D002769:Cholelithiasis / Q000097:blood* / Q000737:chemistry* / Q000503:physiopathology; D002908:Chronic Disease; D003300:Copper / Q000032:analysis*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007501:Iron / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D015032:Zinc / Q000032:analysis*
D003300:Copper; D007501:Iron; D015032:Zinc; D002118:Calcium