Quantitative Analysis of Chemical Composition of Gallstones in North Indian Population (Rohilkhand Region, Uttar Pradesh)
Quantitative Analysis Of Chemical Composition Of Gallstones
Keywords:
cholesterol stones, pigment stones, mixed stones, oxalate, bilirubinAbstract
Background And Objectives: In India, it has been recognised that gallstones and gallbladder cancer are common in the Gangetic belt comprising of Uttar Pradesh, Bihar, West Bengal, and Assam. States in South India do not have a high incidence of these diseases. Aim: The present study was done to describe an extensive quantitative chemical analysis of gallstones and to find the association of gallstones with age distribution and also to compare this finding with previous workers. In this study we analysis the cholesterol, triglycerides, phospholipids, bilirubin, bile acids, calcium, phosphorus, magnesium,and oxalates in 3 different types of gallstones. Methods: Total 43 gallstones were collected from surgical operation and quantative analysis of these gallstones was done in the department of Biochemistry. The stones were classified into cholesterol (CS), pigment (PS), and mixed stones (MS). Total cholesterol was estimated by CHOD-PAP, total bilirubin by Diazo method, triglycerides by GPO-PAP method, oxalate by the method described by Satyapal and Pundir based on colorimetric enzymatic method (21), calcium by O-Cresolphthalein-Complexone method, Phospholipid and inorganic phosphate were determined according to Fiske and Subba Rao. Magnesium was measured by Calmagite method. Results: In our study, the incidence of gallstones was highest in age group of 37-46 years and Male : Female ratio was 1: 3.8. Out of 43 gallstones, 16 were pigment stones, 15 were mixed stones and 12 were cholesterol stones. Total cholesterol was a major component of all gall stones and triglycerides, total bilirubin, phospholipids, bile acids, calcium, magnesium, inorganic phosphate and oxalate were found in all types of gallstones. The cholesterol stones had higher content of total cholesterol, phospholipids, inorganic phosphate as compared to mixed and pigment stones. The mixed stones had higher content of triglycerides than to cholesterol and pigment stones. The pigment stones were richer in total bilirubin, bile acids, calcium, oxalate, and magnesium compared to cholesterol and mixed stones. Interpretation And Conclusion : Pigment stone was the most common type of gallstones in our studies and common age group for gallstone development was 37-46 years. The content of the total cholesterol and other metabolites in different gall stones indicating their different mechanism of formation. High cholesterol and triglyceride content in CS and MS suggests that dyslipidemic changes contribute to etiology. [Das B NJIRM 2014; 5(4) :4-12]
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