Relation of cholesterol metabolism to pediatric gallstone disease: a retrospective controlled study

BMC Gastroenterology

Markku J. Nissinen³  Helena Gylling²  Mikko Pakarinen¹  Antti Koivusalo¹ 

[1] Hospital for Children and Adolescents, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland;Department of Medicine, Division of Internal Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland;Biomedicum Helsinki, Room C422, POB 700, FI-00029 HUS, Helsinki, Finland

关键词: Plant sterols;    Non-cholesterol sterols;    Cholesterol gallstones;    Black pigment gallstones;   

Others  :  1223126
DOI  :  10.1186/s12876-015-0304-4

 received in 2015-01-25, accepted in 2015-06-17,  发布年份 2015

【 摘 要 】

Background

Cholesterol metabolism may be involved in pediatric gallstone disease. We aimed to reveal cholesterol metabolites and phytosterols and their relation to stone composition of sterols in children having black pigment and cholesterol stones.

Methods

We performed retrospective controlled clinical study, in which we examined parameters of cholesterol metabolism and liver function values in serum (n = 28) and gallstones (n = 46) of consecutively cholecystectomized children. Serum values of age-, body mass index- and sex-matched children (n = 82) and adult gallstones (n = 187) served as controls.

Results

Surrogate markers of cholesterol synthesis in serum (squalene/cholesterol, cholestenol/cholesterol and lathosterol/cholesterol) were 26–52 % higher in both stone subclasses compared to controls (p < 0.05 for all). Respectively, cholestanol/cholesterol and plant sterols campesterol/cholesterol and sitosterol/cholesterol (cholesterol absorption markers) had decreasing order in serum: black pigment stone group > controls > cholesterol stone group (p < 0.05 for all). In black pigment stone group, stone cholestanol/cholesterol was associated with serum bile acids (r = 0.620, p = 0.018). In cholesterol stone group, surrogate markers of cholesterol synthesis in serum (e.g., lathosterol/cholesterol) inversely reflected those of absorption (r-range -0.633–-0.706, p-range 0.036–0.015). In cholesterol stone group, serum and stone lathosterol/cholesterol and cholestanol/cholesterol were positively interrelated (r-range 0.727–0.847, p < 0.05 for both).

Conclusions

Gallstone subclasses shared enhanced cholesterol synthesis. Cholesterol stone children were low cholesterol absorbers with intact homeostasis of cholesterol metabolism. Black pigment stone group was characterized by deteriorated cholesterol metabolism, and accumulation of cholestanol, campesterol and sitosterol in serum and stones suggesting their participation in pathogenesis.

【 授权许可】

   
2015 Koivusalo et al.

【 图 表 】

Fig. 1.

Fig. 2.

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