Journal du syndrome métabolique

Lipoprotein (a) Status and Effect of Laparoscopic Cholecystectomy on it in Bangladeshi Patients with Cholelithiasis

Abstract

Giasuddin ASM, Khadija Akther Jhuma, Md Abdul Mobin Choudhury, Mujibul Haq AM 

Objective: Although it was reported that cholecystectomy had complex impact on lipid profile in cholelithiasis, lipoprotein (a) [Lp(a)] was not studied. The present study was therefore conducted on serum Lp(a) status in Bangladeshi patients with cholelithiasis and effect of cholecystectomy on it.
Patients and Methods: Adult patients (n=44) with cholelithiasis and 30 normal controls (NC) were included in the study. The blood sample was taken from fasting patients before cholecystectomy (Serum-I0), gall bladder bile sample during cholecystectomy (Bile-I0) and blood sample again after 2-3 months at follow-up (Serum-II0) and from fasting NC subjects. Lp(a) level was quantitated in serum and bile by immunoturbidimetric method using commercially available research kit. The results were compared statistically by ANOVA, Student’s t-test and Chisquared test using SPSS programme.
Results: The Lp(a) status (mg/dl, Mean ± SD) in controls and patients and their statistical analysis revealed that Lp(a) was much higher in patients compared to controls (NC: 29.07 ± 14.1, Patients Serum-I0: 290.84 ± 110.93, Patients Bile-I0 : 37.12 ± 28.61, Patients Serum-II0: 203.70 ± 90.13) (P<0.001). Lp(a) was lowered after cholecystectomy, but remained elevated in patients Serum-II0 compared to NC significantly (P<0.001). No significant difference was observed for Lp(a) levels between NC and patients Bile-I0 (P=0.173). The proportions of patients for Serum-I0, Bile-I0 and Serum-II0 with Lp(a) levels above and within normal limits and their statistical analyses showed significant associations (P<0.001).
Conclusions: Cholelithiasis had complex impact on Lp(a) status indicating a special function of gall bladder relevant to its metabolism. Further studies are warranted.