Abstract

Dr. Yaser Rahman, Dr. Yaqoob Hassan*, Dr. Aashaq Hussain, Dr. Mir Nazir Ahmad, Dr. Naseer Awan, Dr. Mohd Zaieem

ABSTRACT

Background: Biliary stones are hardened concretions that develop due to supersaturation of bile. The known risk factors for development of biliary stones include genetics, body weight, high fat diet, diabetes, women taking estrogen containing pills and decreased motility of gall bladder. Of late there has been discussion whether hypothyroidism could lead to formation of biliary stones. Aims and Objectives: The aim of this study was to find any association between cholelithiasis and thyroid profile in patients undergoing elective cholecystectomy for gall stone disease and to find the difference in the chemical composition of gallstones in these patients. Material and methods: This case control study was conducted in the Postgraduate Department of Surgery, Govt. Medical College Srinagar and associated SMHS hospital with a total of 300 patients recruited for this study, 150 patients each in case and control group over a period of two years. Cases were defined as patients diagnosed with gallstone diseases and undergoing cholecystectomies. The control group underwent ultrasonography to exclude any asymptomatic cholelithiasis. Fasting blood samples were taken from all participants for measurements of serum T3, T4, Free T4 and thyroid stimulating hormone (TSH). The gallstones received after cholecystectomy examined grossly and categorized according to their morphology and biochemical analysis. Results: In the cholelithiasis group a 4:1 Female to Male ratio was observed. There was a prevalence of 38.6% of hypothyroidism in cholelithiasis patients as compared to 22% in the control group. Subclinical hypothyroidism was seen in 30.0% in cases as compared to 17.3% in controls. Maximum number of cholelithiasis patients with hypothyroidism were females. Stone analysis among the hypothyroid and euthyroid patients showed 93.1% cholesterol stones in hypothyroid patients as compared to 69.6% cholesterol stones in euthyroid patients. Conclusion: Hypothyroidism was more common in the gallstone patients compared with controls. Prevalence of hypothyroidism in gallstone patients was more common in females compared to males.