Tang W H
Department of Surgery, Nanjing Railway Medical College, Peoples Republic of China.
J Gastroenterol. 1996 Dec;31(6):823-7. doi: 10.1007/BF02358609.
The aim of the present study was to investigate predisposing factors that lead to the formation of gallstones. In a group of 70 patients (51 with gallstones and 19 without, 20 possible risk factors were studied: percent of ideal body weight, the presence of superoxide dismutase in erythrocytes and in serum, lipid peroxide in serum, total serum cholesterol (Ch), high-density lipoprotein (HDL)-cholesterol (Ch), low-density lipoprotein (LDL)-Ch, very low-density lipoprotein (VLDL)-Ch, serum triglyceride (TG), HDL-TG, LDL-TG, VLDL-TG, serum bile acids (lithocholic acid, deoxycholic acid, chenodeoxy cholic acid, ursodeoxy-cholic acid, and cholic acid) and serum apolipoproteins (apo A-1, apo B-100, and apo A-1/apo B-100). Levels of apo B-100 and serum insulin in patients with gallstones were strikingly higher, and superoxide dismutase in erythrocytes was significantly lower than in individuals with no gallstones. Apo A-1 and HDL-Ch were also higher and LDL-Ch was lower in the gallstone group, albeit non-significantly so (P > 0.05) by t-test. However, Apo A-1, HDL-Ch, and LDL-Ch showed remarkably good discriminatory power in stepwise discriminant analysis of the 20 factors. Bile lipid composition was also measured and the cholesterol saturation index was calculated, but no significant differences were seen between the two groups. The results demonstrate that serum lipid patterns differ to some extent in patients with and without gallstones. Lipid derangement may contribute to the development of gallstone disease.
本研究的目的是调查导致胆结石形成的诱发因素。在一组70名患者中(51名有胆结石,19名无胆结石),研究了20种可能的危险因素:理想体重百分比、红细胞和血清中超氧化物歧化酶的存在、血清中脂质过氧化物、血清总胆固醇(Ch)、高密度脂蛋白(HDL)-胆固醇(Ch)、低密度脂蛋白(LDL)-Ch、极低密度脂蛋白(VLDL)-Ch、血清甘油三酯(TG)、HDL-TG、LDL-TG、VLDL-TG、血清胆汁酸(石胆酸、脱氧胆酸、鹅去氧胆酸、熊去氧胆酸和胆酸)以及血清载脂蛋白(载脂蛋白A-1、载脂蛋白B-100和载脂蛋白A-1/载脂蛋白B-100)。胆结石患者的载脂蛋白B-100水平和血清胰岛素水平显著更高,而红细胞中的超氧化物歧化酶显著低于无胆结石的个体。胆结石组中的载脂蛋白A-1和HDL-Ch也更高,LDL-Ch更低,尽管经t检验差异无统计学意义(P>0.05)。然而,在对这20个因素进行逐步判别分析时,载脂蛋白A-1、HDL-Ch和LDL-Ch显示出显著良好的判别能力。还测量了胆汁脂质成分并计算了胆固醇饱和指数,但两组之间未见显著差异。结果表明,有胆结石和无胆结石的患者血清脂质模式在一定程度上有所不同。脂质紊乱可能促成胆结石疾病的发展。