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

Abstract

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.