Hypothyroidism as a Risk Factor for Choledocholithiasis

Abstract

Background: Gallstone disease is a common world-wide health problem, with choledocholithiasis (CBD stones) as one of its complications. Hypothyroidism has been put forward as an etiological factor for gallstone formation based on its influence on lipid metabolism and biliary motility. This study assess the correlation between hypothyroidism and CBD stone formation and investigate thyroid function and lipid profile changes in affected patients.

Methods: The research was done in the hospital setting carried out using 140 study subjects, 70 patients with CBD stones and 70 healthy controls.  The thyroid function tests and the lipid profile tests were done.  The characteristics of CBD stones and the associated biliary conditions were compared in those with and without hypothyroidism.

Results: The prevalence of hypothyroidism was significantly greater among CBD stone patients (22.9%) compared to the control group (7.1%) (p=0.0095). The mean TSH levels were higher in the cases (3.6 ± 3 mIU/L) than in the controls (2.6 ± 1.5 mIU/L) (p=0.0014), along with decreased T3 and T4 levels in the cases. In cases total cholesterol and triglyceride levels along with reduced HDL levels in comparison to controls. An increased incidence of multiple CBD stones was seen in hypothyroid patients, at 62.5%. The incidence of associated pancreatitis was significantly lower in hypothyroid patients (25%) compared to non-hypothyroid patients (85.1%) (p<0.0001).

Conclusions: Hypothyroidism is associated to CBD stone development and dysfunctional thyroid function and lipid profile.  Gallstone disease patients should be screened for thyroid dysfunction to detect and avoid complications.