Prevalence of hypothyroidism in common bile duct stone patients

Srinivas Sidduri, Babulreddy Hanmayyagari, Vivekanand Bongi, Mythili Ayyagari, Subramanyam Venkata

Thyroid Research and Practice 2016 13(2):57-62

Background: Hypothyroidism affects bile content, bile flow, and functions of the sphincter of Oddi, thereby increases the formation of common bile duct (CBD) stones. The exact prevalence of hypothyroidism in CBD stone patients is not known. Objectives: The aims are: (1) To investigate the prevalence of undiagnosed thyroid dysfunction in CBD stone patients compared with controls, (2) Comparison of lipid parameters in CBD stone patients and healthy controls, (3) Comparison of lipid parameters in CBD stone patients with and without thyroid dysfunction. Materials and Methods: This study recruited 44 CBD stone patients diagnosed with endoscopic retrograde cholangiopancreatography (ERCP) (cases). The control group includes 33 age, sex, and body mass index (BMI) matched healthy people. The control group underwent ultrasonography to exclude any asymptomatic cholelithiasis. Fasting blood samples were taken from all participants for measurements of serum total thyroxine (T4), serum thyroid stimulating hormone (TSH), triglycerides (TG), total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Results: The mean values of TSH in cases and controls were 3.57 ± 1.7 and 2.58 ± 0.67, respectively (P value 0.0029). Subclinical hypothyroidism (SCH) found in 30% of cases compared with 9.09% of controls (P value < 0.05). In the CBD stone group, the prevalence of SCH was 36% in the patients older than 50 year compared to 22% in the less than 50 year age-group (P > 0.05). The prevalence of SCH was more in females (23%) compared with males (11%) (P > 0.05). There is a trend toward increase in the mean values of TC, LDL, and TG levels in cases compared to controls. There is a non-significant increase in mean HDL values in cases. On subanalysis of lipid parameters in CBD stone patients with and without thyroid dysfunction, there is a trend toward an increase in the mean TC and LDL-C in cases with SCH compared to those without SCH (P > 0.05). Conclusions: SCH was more common in the CBD stone patients compared with controls. SCH was more prevalent in CBD patients older than 50 years of age. Prevalence of SCH in CBD stone patients was more common in females compared to males. Dyslipidemia may be one of the contributing factors for increased CBD stone formation in SCH.

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