Thyroid dysfunction and choleduocholithiasis.
BACKGROUND
Disturbances in lipid metabolism which occur during hypothyroidism leadto the formation of gallstones. This study aims to evaluate the thyroid functionpattern in patients with common bile duct (CBD) stones.


METHODS
This case-control study recruited 151 patients with preliminary diagnosesof CBD stone who underwent ERCP (cases). The control group comprisedhealthy people who met the study criteria in the same hospital. The controlgroup underwent ultrasonography to exclude any asymptomatic bile duct lithiasis.A questionnaire that included demographic and anthropometrics datawere completed by an assigned physician. Morning blood samples that followed12 hours of fasting were taken from all participants for measurements ofserum total thyroxin (T4), serum thyroid stimulating hormone (TSH), fastingblood sugar (FBS), triglycerides (TG), total cholesterol, low density lipoprotein(LDL) and high density lipoprotein (HDL).


RESULTS
The mean TSH in patients (2.59 ± 4.86mg/dl) was higher than the controlgroup (2.53± 4.13 9mg/dl). In subclinical hypothyroidism, serum TSH levelshigher than 5 MU/L were found in 30.6% of cases compared with 22.5% ofcontrols [OR: 1.53; 95 % confidence interval (95% CI): 0.968-2.438). Hypothyroidismwas detected in 10.8% of the control group and in 11.3% of cases(OR: 1.87; 95% CI: 0.578-2.043). The mean total cholesterol levels in caseswas higher than the control group (p=0.61).The levels of TG (p=0.05), HDL(73.35 vs. 46.41; p<0.01) and LDL (64.81.88 vs. 111.04; p<0.01) was statisticallysignificant between both groups.


CONCLUSIONS
There is an association between thyroid disorders and the presence of bileduct stones. Thyroid testing in patients with gallstone and bile duct stones isrecommended because hypothyroidism may be a predisposing factor for stonepassage from the gallbladder.
Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Hossein
H
Ajdarkosh
Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Mohammad Reza
MR
Khansari
Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Masoud Reza
MR
Sohrabi
Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Gholam Reza
GR
Hemasi
Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Najmeh
N
Shamspour
Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Nafiseh
N
Abdolahi
Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Farhad
F
Zamani
Choledocholithiasis; Obesity; Thyroid hormones