Microstructural Diversity of Gallstones Revealed by Spectral Microanalyses and Their Association with Hepatic Parameters

Overview

Journal Indian J Gastroenterol

Specialty Gastroenterology

Date 2019 Dec 7

PMID 31808141

Citations 1

Authors

Muhammed A P Manzoor

Abhijith S Sudhakar

Sajida Abdul Kadar

M S Moosabba

Punchappady-Devasya Rekha

Affiliations

Soon will be listed here.

Abstract

Background: Gallstones (GS) are formed as a result of impaired metabolic regulation and can be reflected in serum parameters. This study was focused on classifying GS based on spectral microanalysis and identifying the possible role of serum hepatic parameters on GS of different compositions.

Methods: The study included a total of 126 GS from 80 consecutive patients who underwent cholecystectomy for GS diseases in a single center. The composition and microstructure of GS were analyzed using Fourier-transform infrared (FTIR) spectroscopy, field emission scanning electron microscopy (FESEM), and energy dispersive X-ray spectroscopy (EDS). The serum hepatic parameters were studied in order to establish a possible etiologic relationship with GS composition.

Results: In the study group, the incidence of GS was higher in females 62 (77.5%) compared with males 18 (22.5%). The mean age was 42.81 ± 13.01 and 43.78 ± 14.4 years for female and male patients, respectively. Based on composition, the GS were assigned to four major groups: cholesterol, pigment, phosphate, and mixed stones. Mixed composition stones totally represented the majority 53 (66.3%), followed by pure cholesterol 23 (28.8%), pigment stones 2 (2.5%), and phosphate stones 2 (2.5%), respectively. Elemental composition revealed the presence of carbon (C), oxygen (O), calcium (Ca), and phosphorus (P) to be major elements along with traces of sodium (Na), magnesium (Mg), aluminum (Al), iron (Fe), copper (Cu), bromine (Br), manganese (Mn), and zinc (Zn). Among serum parameters, total bilirubin, direct bilirubin, indirect bilirubin, serum glutamic-oxaloacetic transaminase, and total protein were higher in patients with pigment GS than cholesterol GS.

Conclusions: Characterization of GS indicates that different types of stones have different characteristics in terms of microstructure, elemental composition, and distribution. Serum hepatic function test profiles showed an association with the compositions of GS.

Citing Articles

Association between serum iron and gallstones in US adults: a cross-sectional study.

Wen S, Tang X, Tang T, Ye Z BMC Nutr. 2024; 10(1):136.

PMID: 39402643 PMC: 11472443. DOI: 10.1186/s40795-024-00947-6.

References

Manzoor M, Singh B, Agrawal A, Arun A, Mujeeburahiman M, Rekha P . Morphological and micro-tomographic study on evolution of struvite in synthetic urine infected with bacteria and investigation of its pathological biomineralization. PLoS One. 2018; 13(8):e0202306. PMC: 6091953. DOI: 10.1371/journal.pone.0202306. View

Katsika D, Grjibovski A, Einarsson C, Lammert F, Lichtenstein P, Marschall H . Genetic and environmental influences on symptomatic gallstone disease: a Swedish study of 43,141 twin pairs. Hepatology. 2005; 41(5):1138-43. DOI: 10.1002/hep.20654. View

Cirillo D, Wallace R, Rodabough R, Greenland P, LaCroix A, Limacher M . Effect of estrogen therapy on gallbladder disease. JAMA. 2005; 293(3):330-9. DOI: 10.1001/jama.293.3.330. View

Jayanthi V, Sarika S, Varghese J, Vaithiswaran V, Sharma M, Reddy M . Composition of gallbladder bile in healthy individuals and patients with gallstone disease from north and South India. Indian J Gastroenterol. 2016; 35(5):347-353. DOI: 10.1007/s12664-016-0685-5. View

Manzoor M, Agrawal A, Singh B, Mujeeburahiman M, Rekha P . Morphological characteristics and microstructure of kidney stones using synchrotron radiation μCT reveal the mechanism of crystal growth and aggregation in mixed stones. PLoS One. 2019; 14(3):e0214003. PMC: 6430423. DOI: 10.1371/journal.pone.0214003. View

Njeze G . Gallstones. Niger J Surg. 2014; 19(2):49-55. PMC: 3899548. DOI: 10.4103/1117-6806.119236. View

Johnston D, KAPLAN M . Pathogenesis and treatment of gallstones. N Engl J Med. 1993; 328(6):412-21. DOI: 10.1056/NEJM199302113280608. View

Weerakoon H, Navaratne A, Ranasinghe S, Sivakanesan R, Galketiya K, Rosairo S . Chemical characterization of gallstones: an approach to explore the aetiopathogenesis of gallstone disease in Sri Lanka. PLoS One. 2015; 10(4):e0121537. PMC: 4390354. DOI: 10.1371/journal.pone.0121537. View

Harris I, WATT D . Analysis of minor and trace elements in gallstones by induction of characteristic ionising radiation. Phys Med Biol. 1984; 29(2):175-84. DOI: 10.1088/0031-9155/29/2/012. View

10.

Al-Kassab A, Malatani T . The pattern of serum biochemical abnormalities in patients with gallstones. Eur J Clin Chem Clin Biochem. 1992; 30(1):21-5. DOI: 10.1515/cclm.1992.30.1.21. View

11.

Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B . Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA. 1998; 280(7):605-13. DOI: 10.1001/jama.280.7.605. View

12.

Chandran P, Kuchhal N, Garg P, Pundir C . An extended chemical analysis of gallstone. Indian J Clin Biochem. 2012; 22(2):145-50. PMC: 3453815. DOI: 10.1007/BF02913334. View

13.

Stinton L, Shaffer E . Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012; 6(2):172-87. PMC: 3343155. DOI: 10.5009/gnl.2012.6.2.172. View

14.

Stewart L, Ponce R, Oesterle A, Griffiss J, Way L . Pigment gallstone pathogenesis: slime production by biliary bacteria is more important than beta-glucuronidase production. J Gastrointest Surg. 2000; 4(5):547-53. DOI: 10.1016/s1091-255x(00)80100-6. View

15.

Sharma M, Duphare H, Nijhawan S, Dasarathy S . Gallstone disease in north India: clinical and ultrasound profile in a referral hospital. J Clin Gastroenterol. 1990; 12(5):547-9. DOI: 10.1097/00004836-199010000-00012. View

16.

Zeng F, Hai H, Jin L . [Analysis on infrared spectrum of human body gallstone with comparative method]. Guang Pu Xue Yu Guang Pu Fen Xi. 2003; 21(3):314-6. View

17.

Sarin S, Kapur B, Tandon R . Cholesterol and pigment gallstones in northern India. A prospective analysis. Dig Dis Sci. 1986; 31(10):1041-5. DOI: 10.1007/BF01300256. View

18.

Acalovschi M . Gallstones in patients with liver cirrhosis: incidence, etiology, clinical and therapeutical aspects. World J Gastroenterol. 2014; 20(23):7277-85. PMC: 4064073. DOI: 10.3748/wjg.v20.i23.7277. View

19.

Ravnborg L, Teilum D, Pedersen L . Gallbladder stones classified by chemical analysis of cholesterol content. Frederiksberg, 1987-1988. Scand J Gastroenterol. 1990; 25(7):720-4. DOI: 10.3109/00365529008997598. View

20.

Qiao T, Ma R, Luo X, Yang L, Luo Z, Zheng P . The systematic classification of gallbladder stones. PLoS One. 2013; 8(10):e74887. PMC: 3790764. DOI: 10.1371/journal.pone.0074887. View