Gupta R L, Sharma S B, Kumar S P
University College of Medical Sciences, G.T.B. Hospital, Delhi.
Indian J Med Sci. 1998 Jul;52(7):309-16.
Present study has been undertaken to know the causative factors responsible for change in trend of gall-stone disease from middle aged, fertile, fat females to young asthenic females in twenties. Our findings reveal high incidence of gall stone formation in non-obese young females. Average fat consumption in non-obese patients was less (17%) than that of obese (26%). However, use of oral contraceptives was high in non-obese females and maximum users were in young age group while in obese in middle age group. Bilirubin content in gall bladder stones of non-obese was significantly more than that of obese (p < 0.01) whereas cholesterol content in gall bladder stones of obese was significantly high when compared to non-obese subjects. Analysis of bile showed significant increase in bilirubin and calcium level of non-obese when compared to control and obese subjects whereas phosphorus levels were significantly decreased in the bile of non obese subjects. These findings suggest that in non-obese females less intake of fat, early use of oral contraceptives, higher contents of bilirubin and calcium and low content of phosphorus in bile may be responsible for gall stone formation.
本研究旨在了解胆结石疾病趋势从中年、肥胖、生育期女性转变为二十多岁年轻消瘦女性的致病因素。我们的研究结果显示,非肥胖年轻女性中胆结石形成的发生率较高。非肥胖患者的平均脂肪摄入量(17%)低于肥胖患者(26%)。然而,非肥胖女性口服避孕药的使用率较高,且最大使用者为年轻年龄组,而肥胖女性的最大使用者为中年年龄组。非肥胖患者胆囊结石中的胆红素含量显著高于肥胖患者(p < 0.01),而与非肥胖受试者相比,肥胖患者胆囊结石中的胆固醇含量显著较高。胆汁分析显示,与对照组和肥胖受试者相比,非肥胖受试者的胆红素和钙水平显著升高,而非肥胖受试者胆汁中的磷水平显著降低。这些发现表明,在非肥胖女性中,脂肪摄入量少、早期使用口服避孕药、胆汁中胆红素和钙含量较高以及磷含量较低可能是胆结石形成的原因。