Bile lithogenicity dependence on carbohydrate and lipid metabolism indices in patients with diabetes mellitus type 2 and chronic acalculous cholecystitis

Authors

  • Yu.F. Marchuk Bukovinian State Medical University, Chernivtsi, Ukraine
  • N.V. Pashkovska Bukovinian State Medical University, Chernivtsi, Ukraine
  • D.R. Andriychuk Bukovinian State Medical University, Chernivtsi, Ukraine
  • O.I. Fediv Bukovinian State Medical University, Chernivtsi, Ukraine

DOI:

https://doi.org/10.22141/2224-0721.15.3.2019.172105

Keywords:

chronic acalculous cholecystitis, type 2 diabetes mellitus, lipid metabolism, cholesterol

Abstract

Background. The purpose of the study is to identify the features of changes in bile homeostasis and major stone-forming substrates in chronic acalculous cholecystitis and type 2 diabetes mellitus (DM). Materials and methods. The clinical examination was performed in 60 patients with type 2 DM and chronic acalculous cholecystitis, 60 individuals with chronic acalculous cholecystitis alone and 20 apparently healthy persons. A thorough examination was carried out using gene­rally accepted clinical, laboratory, biochemical, instrumental methods. The blood lipids and the gallbladder portion of bile have been determined. Results. In patients with chronic acalculous cholecystitis on the background of type 2 DM, there was an increase in the levels of total lipids (by 1.61 times in the blood), cholesterol (by 2.04 times in the blood and 1.62 — in bile), bile acids (by 4.4 times in the blood) and their decrease in bile (by 1.34 times), an increase in triacylglycerols (by 3.09 times in the blood), low-density lipoproteins (by 1.2 times in the blood) and a decrease in the content of high-density lipoproteins (by 1.98 times in the blood) and phospholipids (by 1.38 times in the blood and 1.48 — in bile), as well as a decrease in the two-component ratio of phospholipids/cholesterol (by 1.8 times) and bile acids/cholesterol (by 1.9 times), an increase in the three-component Isaxone index (by 1.85 times), indicating a significant imbalance of lipid metabolism as a predictor of the gallstone formation in this category of patients (p < 0.05). Conclusions. In persons with chronic acalculous cholecystitis combined with type 2 DM, there are significantly increased levels of total lipids, cholesterol, bile acids, triacylglycerols, and low-density lipoproteins against the background of lowering high-density lipoproteins and phospholipids in the blood serum and bile. The established correlations between blood lipids and bile give more complete and detailed information on disturbances of bile homeostasis in different groups of patients. The main stone-forming substrate in persons of the first group was cholesterol, and in the second — a deceased level of high-density lipoproteins.

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References

Gaur С, Mathur А, Agarwal А, Verma K, Jain R, Swaroop A. Diabetic autonomic neuropathy causing gall bladder dysfunction. J Assoc Physicians India. 2000 Jun;48(6):603-5.

Chi ML, Chung T, Chung YL, Chu CC, Meng LL, Jom HL. A population-based cohort study of symptomatic gallstones disease in diabetic patients. World J Gastroenterol. 2012 Apr 14;18(14):1652-9. doi: 10.3748/wjg.v18.i14.1652.

Karlsson SA, Franzén S, Svensson AM, et al. Prescription of lipid-lowering medications for patients with type 2 diabetes mellitus and risk-associated LDL cholesterol: a nationwide study of guideline adherence from the Swedish National Diabetes Register. BMC Health Serv Res. 2018 Nov 28;18(1):900. doi: 10.1186/s12913-018-3707-4.

Karim MN, Ahmed KR, Bukht MS, et al. Pattern and predictors of dyslipidemia in patients with type 2 diabetes mellitus. Diabetes Metab Syndr. 2013 Apr-Jun;7(2):95-100. doi: 10.1016/j.dsx.2013.02.011.

Katsiki N, Tentolouris N, Mikhailidis DP. Dyslipidaemia in type 2 diabetes mellitus: bad for the heart. Curr Opin Cardiol. 2017 Jul;32(4):422-429. doi: 10.1097/HCO.0000000000000407.

Noel RA, Braun DK, Patterson RE, Bloomgren GL. Increased risk of acute pancreatitis and biliary disease observed in patients with type 2 diabetes: a retrospective cohort study. Diabetes Care. 2009 May;32(5):834-8. doi: 10.2337/dc08-1755.

Freeman R. Diabetic autonomic neuropathy. Handb Clin Neurol. 2014;126:63-79 doi: 10.1016/B978-0-444-53480-4.00006-0.

Vergès B. Combination lipid therapy in type 2 diabetes mellitus. Expert Opin Pharmacother. 2011 Jun;12(9):1393-403. doi: 10.1517/14656566.2011.558503.

Vrablík M, Tůmová E. Cholesterol metabolism in patients with type 2 diabetes. Vnitr Lek. 2016 Mar;62(3):189-94. (in Czech).

Mooradian AD. Dyslipidemia in type 2 diabetes mellitus. Nat Clin Pract Endocrinol Metab. 2009;5(3):150-9. doi: 10.1038/ncpendmet1066.

Filippatos T, Tsimihodimos V, Pappa E, Elisaf M. Pathophysiology of Diabetic Dyslipidaemia. Curr Vasc Pharmacol. 2017;15(6):566-575. doi: 10.2174/1570161115666170201105425.

Chen SC, Tseng CH. Dyslipidemia, kidney disease, and cardiovascular disease in diabetic patients. Rev Diabet Stud. 2013;10(2-3):88-100. doi: 10.1900/RDS.2013.10.88.

Zhang P, Gao J, Pu C, Zhang Y. Apolipoprotein status in type 2 diabetes mellitus and its complications (Review). Mol Med Rep. 2017;16(6):9279-9286. doi: 10.3892/mmr.2017.7831.

Patti AM, Giglio RV, Papanas N, Rizzo M, Rizvi AA. Future perspectives of the pharmacological management of diabetic dyslipidemia. Expert Rev Clin Pharmacol. 2019;12(2):129-143. doi: 10.1080/17512433.2019.1567328.

Krushinska ZG, Yuzvenko TYu, Pankiv VI. Frequency of cardiovasculat complications in patients with type 2 diabetes mellitus depending on antihyperglycemic therapy. Mìžnarodnij endokrinologìčnij žurnal. 2018;14(6):570-578. doi: 10.22141/2224-0721.14.6.2018.146067. (in Ukrainian).

Pankiv VI. New possibilities of correction of hypercholesterolemia in patients with diabetes mellitus. Lik Sprava. 2014 May-Jun;(5-6):56-67. (in Russinian).

Faillie JL, Yu OH, Yin H, Hillaire-Buys D, Barkun A, Azoulay L. Association of bile duct and gallbladder diseases with the use of incretin-based drugs in patients with type 2 diabetes mellitus. JAMA Intern Med. 2016;176(10):1474-81. doi: 10.1001/jamainternmed.2016.1531.

Pacchioni M, Nicoletti C, Caminiti M. Association of obesity and type II diabetes mellitus as a risk factor for gallstones. Dig Dis Sci. 2000 Oct;45(10):2002-6.

Saryusz-Wolska M, Loba J, Czupryniak L. Delayed gastric emptying and gallbladder motylity dysfunction in long-standing diabetes mellitus. Diabetologia. 2009;52(Suppl 1):256. doi: 10.1007/s00125-009-1445-1.

Scheinberg N, Salbu RL, Goswami G, Cohen K. Treatment of diabetic autonomic neuropathy in older adults with diabetes mellitus. Consult Pharm. 2016 Nov 1;31(11):633-645. doi: 10.4140/TCP.n.2016.633.

Published

2021-09-01

How to Cite

Marchuk, Y., Pashkovska, N., Andriychuk, D., & Fediv, O. (2021). Bile lithogenicity dependence on carbohydrate and lipid metabolism indices in patients with diabetes mellitus type 2 and chronic acalculous cholecystitis. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 15(3), 202–209. https://doi.org/10.22141/2224-0721.15.3.2019.172105

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