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

BMC Gastroenterology

Research Article

Markku J. Nissinen¹  Helena Gylling²  Antti Koivusalo³  Mikko Pakarinen³ 

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

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

DOI  :  10.1186/s12876-015-0304-4

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

来源: Springer

【 摘 要 】

BackgroundCholesterol 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.MethodsWe 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.ResultsSurrogate 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).ConclusionsGallstone 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】

Unknown   
© Koivusalo et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.