GALL STONES AND HYPOTHYROIDISM: A REVIEW OF SYNCHRONOUS FINDINGS

Background: Cholelithiasis is considered to be the most common biliary pathology. Gall stones are deposition of bile pigments, cholesterol and calcium salts in the form of hard crystalline mass in the gall bladder. Thyroid disorders are also a very common endocrine pathology. The decreased thyroid-stimulating hormone (TSH) levels affect almost every nucleated cell in our body. On sphincter of Oddi, thyroid hormone receptors are present, and thyroxine has a strong relaxing effect on the sphincter. Hypothyroidism reduces the gall bladder contractility and causes lipid metabolism alteration which leads to biliary stasis. These promote the gall stone formation. Methods: A single centre observational study, was done among 273 patients diagnosed with cholelithiasis clinically and confirmed by ultrasonography. All patients were subjected to thyroid profile test, liver function test, fasting lipid profile test. Patient with history of hypothyroidism were excluded from the study. Results: Among 273 patients, 59 (21.6%) patients had hypothyroidism and 74 (27.1%) had subclinical hypothyroidism. Atotal 137 (50.2%) had overweight (BMI 25.0 – 29.9 kg/m²). Among all hypothyroid patients 36 (61.0%) patients had hypertriglyceridemia and 22 (37.3%) patients had hypercholesterolemia. Increased APL was found in 51 (86.4%) patients, among all hypothyroid patients. Conclusions: On analysis of gall stone in hypothyroid patients, decreased liver cholesterol metabolism, decreased bile emptying and decreased relaxation of sphincter of Oddi play a role. In our study there was a strong association between hypothyroidism and Cholelithiasis. Gall stone patients had also high BMI, abnormal total cholesterol, triglycerides and ALPlevels.