The Prevalence of Asymptomatic Gallstones in Relation to Fasting Gallbladder volume in Type 2 Diabetic Patients
Background: The sustained effect of poor glycemic control in diabetics results in a wide array of end-organ damage as a result of small and large vessels pathology. Mortality and morbidity are related to the progress of this damage but often there are acute metabolic deteriorations “1”. Autonomic neuropathy (sympathetic or parasympathetic) typically accompanies other chronic complications of DM and may play a pathogenic role through disturbed regulation of local blood flow and affecting many systems in the body including the gastrointestinal leading to(hyper-motility or hypo-motility of different organs leading to diarrhea, constipation, gastroparesis and gall bladder hypo-motility). The gallbladder tone is maintained by the vagal activity, but the sympathetic activity has little or no effect on the gallbladder “5”. Due to autonomic neuropathy, the contraction of gallbladder is poor resulting in hypo-motility, impaired gall-bladder emptying and biliary stasis “13,14” resulting in increased gallbladder volume, which predispose to gallstones formation“15”.
Aim of study: to evaluate the prevalence of asymptomatic gallstones in relation to of FGBV in type 2 diabetics.
Subjects and methods: 47 patient with type 2 DM were included in this study ( 37 patients were women and 10 patients were men). At first, we studied the presence of gallstones and then we divided the subjects into two groups, those who have gallstones and those who haven’t gallstones. Thereafter, we evaluated the fasting gall bladder volume (FGBV) in each group to study the relation between the presence of gallstones and the volume of the gallbladder in the fasting state. other parameters were studied in both groups including ( gender, age, BMI, duration of DM, serum cholesterol and TG, cigarettes smoking, family history of gallstones and HbA1c).
Result and discussion: In this study that studied two diabetic groups, one of group with gallstones and the other have no gallstones, we found that in the diabetic group without gallstones,69.7% of the patients were women, while all the diabetics with gallstones (100%) were women with a significant difference (P-value= 0.020). The study also shows that diabetics group with gallstones have higher FGBV levels than diabetics without gallstones as most of the diabetics with gallstones (35.7%) have FGBV in the reference range of( 21 - 30 mL³), 35.7% have FGBV in the reference range of (31 - 40 mL³), while most of the diabetics without gall-stones have FGBV levels less than20 mL³ with significant difference between the two groups (P-value=0.0004).
Conclusion: The prevalence of asymptomatic gallstones is higher in diabetic patients with higher levels of FGBV than in diabetics with lower FGBV levels especially in women.
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