The role of routine thyroid assay in the management of gallstones

Abstract

Background: Cholelithiasis is a type of biliary stone disease, with a high prevalence. Along with classic risk factors like obesity, weight loss, female sex hormones, age, an association with thyroid dysfunction has been established. Objectives: To evaluate the importance of thyroid profile as a diagnostic/therapeutic workup of gallstones. Materials and Methods: The study included 200 subjects, above 18 years. 100 subjects (50 males+50 females) had cholelithiasis confirmed by ultrasonography and remaining as 100 subjects(50males+50females) control group without gallstones. After a detailed history and clinical examination, blood samples were analyzed for TSH, T3 and T4, using Chemiluminescence-Immunoassay. Subjects with history of thyroid dysfunction or on thyroid replacement therapy, diabetes mellitus, pregnancy, drugs affecting thyroid hormone levels were excluded. Statistical analysis: Computing descriptive statistics was used. Any significant difference were tested using the unpaired sample student t-test. Result: The case group had a mean age of 45.70 ± 13.76 and the controls, a mean age of 38.78 ± 15.63. There was a significant increase in the prevalence of gallstones after the age of 40years, especially in females. 20% of cases were hypothyroid and 12% were hyperthyroid when compared to the controls which were 10% hypothyroid and 6% hyperthyroid. The higher prevalence of hypothyroid among cases was statistically significant. Among the hypothyroid cases, 80% had subclinical hypothyroidism. Conclusion:Our study concludes by saying that thyroid assay could be made a part of the diagnostic work up of gallstone management thus providing early detection for thyroid dysfunction and thus reducing the surgical/anesthetic complications.