Thyroid Dysfunction and Choleduocholithiasis

BACKGROUND Disturbances in lipid metabolism which occur during hypothyroidism lead to the formation of gallstones. This study aims to evaluate the thyroid function pattern in patients with common bile duct (CBD) stones. METHODS This case-control study recruited 151 patients with preliminary diagnoses of CBD stone who underwent ERCP (cases). The control group comprised healthy people who met the study criteria in the same hospital. The control group underwent ultrasonography to exclude any asymptomatic bile duct lithiasis. A questionnaire that included demographic and anthropometrics data were completed by an assigned physician. Morning blood samples that followed 12 hours of fasting were taken from all participants for measurements of serum total thyroxin (T4), serum thyroid stimulating hormone (TSH), fasting blood sugar (FBS), triglycerides (TG), total cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL). RESULTS The mean TSH in patients (2.59 ± 4.86mg/dl) was higher than the control group (2.53± 4.13 9mg/dl). In subclinical hypothyroidism, serum TSH levels higher than 5 MU/L were found in 30.6% of cases compared with 22.5% of controls [OR: 1.53; 95 % confidence interval (95% CI): 0.968-2.438). Hypothyroidism was detected in 10.8% of the control group and in 11.3% of cases (OR: 1.87; 95% CI: 0.578-2.043). The mean total cholesterol levels in cases was higher than the control group (p=0.61).The levels of TG (p=0.05), HDL (73.35 vs. 46.41; p<0.01) and LDL (64.81.88 vs. 111.04; p<0.01) was statistically significant between both groups. CONCLUSION There is an association between thyroid disorders and the presence of bile duct stones. Thyroid testing in patients with gallstone and bile duct stones is recommended because hypothyroidism may be a predisposing factor for stone passage from the gallbladder.