TO DETERMINE THE INCIDENCE OF HYPOTHYROIDISM AMONG GALL STONE DISEASE PATIENTS AT A TERTIARY CARE HOSPITAL

Abstract

Background
Gall stone disease is prevalent among the population and several etiological factors have been described for the genesis of gall stone disease. Thyroid dysfunction particularly hypothyroidism and its association with gall stone disease is not well established in literature despite being a topic of discussion for many years. Hypothyroidism can cause sphincter of Oddi dysfunction leading to biliary stasis leading to formation of gallstones. Serum hypercholesterolemia is also seen in hypothyroidism which can cause bile to supersaturate with cholesterol further leading to formation of gallstones.
Methods
A total of 260 patients with documented gall stone disease were included in the study. These patients were interviewed and clinically evaluated. Thyroid function test and serum cholesterol (fasting) was performed in all of them. The incidence of hypothyroidism was obtained and compared with the general public and correlation was calculated between hypothyroidism and hypercholesterolemia.
Results
Of the 260 patients included in the study, 25% were found to be hypothyroid. Among 65 hypothyroid patients, majority were females (16.9%). Subclinical hypothyroidism (20%) was commonest. Most of gall stone patients with hypothyroidism were found to be in the age group of 50-59 years of age. The prevalence of hypothyroidism in local population is 9.23%. Statistically, hypothyroidism was found to be significantly higher in patients with gallstone disease. 70 percent of hypothyroid patients also had hypercholesterolemia and a positive correlation between hypothyroidism and hypercholesterolemia was identified.
Conclusion
It can be concluded from the findings of this study that incidence of hypothyroidism is high among gall stone disease patients especially in middle aged females. Left undetected it may result in complications. Positive correlation between hypothyroidism and hypercholesterolemia was identified. Clinicians should be aware of possible hypothyroid background and consider examining the thyroid profile at least in females over 30 years of age with gallstone disease, in which group the incidence of clinical and sub clinical hypothyroidism is the highest and initiate prompt and adequate thyroxine therapy.