The relationship between serum lipids, apolipoproteins level and bile lipids level, chemical type of stone

To pick up serum high risk lithogenic factors predisposing one to gallstone formation and protective factors against gallstone formation in gallbladder. We compared serum lipid and apolipoprotein level of patients with gallbladder stone (stone group) with that of patients without gallbladder stone (control group). The correlation between serum lipid, apolipoprotein level and bile lipid level, cholesterol saturated index (CSI), characteristics of lipidemia in different kinds of gallbladder stones were studied. The results showed that the increase of serum Apo A1, C2 and E level in the stone group was more significant than in the control group. But there was no statistical significance in TC, TG, LDL-C, HDL-C, Apo A2, B, C3 level between the stone and control groups. These results suggested that serum apolipoproteins perhaps are more sensitive parameters than serum lipids in distinguishing patients with stones from those without stones. There were different profiles of serum lipid and apolipoproteins in different chemical types of gallbladder stones. Increased level in serum LDL-C, Apo B and ratio of LDL-C/HDL-C were characterized by an index for cholesterol stone, otherwise that in serum TG and Apo C2 an index for pigment stones. There was a positive correlation between serum total cholesterol (TC) or Apo B, C2, C3 and cholesterol amount or CSI in gallbladder bile. Therefore, TC, Apo B, C2, C3 could be considered as high risk lithogenic factors. A positive correlation existed between serum HDL-C and lecithin in gallbladder or common bile duct (CBD) bile as well as between HDL-C and bile acids in CBD bile. Thus, HDL-C might be a protective factor against gallstone formation in gallbladder.