Endocrine Abstracts

Introduction: In order to improve the early diagnostics of cholelithiasis in patients with chronic acalculous cholecystitis combined with diabetes mellitus type 2 (DM), individual parameters are usually not sufficient. Therefore, we decided to establish and analyze the correlation between the serum and biochemical parameters of bile to evaluate biochemical connections in a system of lipid homeostasis by comorbid pathology. The aim of our study was to determine the peculiarities of disorders of bile homeostasis by patients with chronic acalculous cholecystitis combined with diabetes mellitus type 2.

Methods: A detailed clinical examination was carried out in 50 patients with chronic acalculous cholecystitis combined with diabetes mellitus type 2 (group 1 in the main group), 40 patients with diabetes mellitus type 2 (2 group), 40 patients with chronic acalculous cholecystitis (3 group) and 20 practically healthy individuals.

Results and discussion: In patients of the 1st group, the ratio of bile acids/cholesterol (BA/CH) was significantly lower compared with patients with group 2 (P < 0.05). It was found that in the patients of the 1st group there was an inverse average strength correlation connection between the serum cholesterol level and the ratio of phospholipids/CH in bile (r = −0.64, P < 0.05). This indicates that the lithogenicity of bile in this category of patients depends on an elevated level of cholesterol in the blood, which can be used as a marker of lithogenesis. Patients in the 2nd group revealed a reliable direct correlation between the level of phospholipids (PL) in serum and the ratio of PL/CH in bile (r = 0.71, P < 0.05) and the inverse correlation between the concentration of β-lipoproteins and the ratio of BA/CH in bile (r = −0.74, P < 0.05). In patients of the 3rd group, we found a direct correlation between the level of high density lipoprotein (HDL) in serum and the ratio of PL/CH in the bile (r = 0.76, P < 0.05), the level of serum phospholipids andratio of PL/CH in bile (r = 0.66, P < 0.05), serum HDL and ratio BA/CH (r = 0.67, P < 0.05), and the level ofHDL and the Isaacson index (r = 0.77, P < 0.05).

Conclusion: Thus, patients with chronic acalculous cholecystitis and diabetes mellitus type 2 have established a reliable correlations between the serum cholesterol level and the ratio of phospholipids/cholesterol in the bladder portion of the bile in the absence of reliable correlations between the lipids of serum and the bile.