Study On Serum Leptin, Leptin-receptor, Metabolismof Lipids As Well As Their Corrdlation In Gallbladder Cholesterol Stones

Gallbladder cholesterol gallstone is a common disease. Yeas of clinical and animal reserach has indicated that, the main pathophysiological change of gallbladder cholesterol gallstone formation is biliary cholesterol hypersecre- tion, which is related to lipid metabolism, the change of serum lipid, lipoprotein and apolipoprotein levels may have been involved in the formation of the gallstone. The study on serum total cholesterol,triglyceride, high density lipoprotein, low density lipoprotein and the levels of some apolipoproteins gives us a chance to discuss the characteristic representation of gallbladder cholesterol gallstone in serum lipid, lipoprotein, apolipoprotein,leptin and leptin-receptor. By analyzing some ingredients in the gallbladder bile of the patients suffering from gallbladder cholesterol stone, the experiment- conductor intends to further explore the formation mechanism, namely how total cholesterol and total bile acid in the gallbladder bile acts to form the disease of gallbladder cholesterol gallstone.Thus may suggest a new theoretical basis of approach to the prevention and therapy of this disease. However, there has been few clinical studies on the correlation of serum leptin-receptor and cholesterol gallstone, and the correlation between serum leptin, leptin-receptor,lipid, lipoprotein, apolipoprotein and total cholesterol ,total bile acid of the gallbladder bile.Object : Measure the serum levels of serum lipid, lipoprotein, apolipoprotein and total cholesterol,total bile acid in the gallbladder bile of gallbladder cholesterol gallstone patients and gallbladder polypi,and study the correlation between serum leptin, leptin-receptor,serum lipid, lipoprotein, apolipoprotein,and total cholesterol,total bile acid of the gallbladder bile. Discuss the characteristics of serum lipid,lipoprotein, apolipoprotein, leptin and the mechanism of gallbladder cholesterol gallstone formation, evaluate the value of measuring serum leptin levels and other parameters for gallbladder cholesterol gallstone patients.Methods: 30 cases of gallbladder cholesterol gallstone patients are selected as gallbladder cholesterol gallstone group with another 22 cases of gallbladder polypi as the control group. Patients of gallbladder cholesterol gallstone group are without bile duct stone,and gallbladder gallstones are identified as cholesterol gallstones with cholesterol content greater than 70% for component analysis using biochemical method. Two groups of objects are without cardiac, pulmonary, renal, hepatic and endocrine diseases. there is no significant difference in gender and age.Measured parameters include:body-height,weight,body mass index,serum total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, apolipoprotein AI, apolipoprotein B, apolipoprotein E,total cholesterol and total bile acid of the gallbladder bile,serum leptin and lepin-receptor levers.Serum lipid,lipoprotein,apolipoprotein,total cholesrterol and total bile acid of the gallbladder bile levels were detected by automatic analyzer,while serum leptin was measured using ELISA.lepin-receptor level was detected by reverse transcription PCR(RT-PCR).The data are processed by SPSS 14.0 for statistical analysis, with P<0.05 considered statistically different.Results:Serum HDL and Apo-AI are lower in gallbladder cholesterol gallstone group than in gallbladder polypi ,while serum triglyceride,total cholesterol,LDL are higher than in gallbladder polypi. Serum leptin levels and lepin-receptor mRNA were significant higher in gallbladder cholesterol gallstone patients than in gallbladder polypi. There are no significant differences of Apo-B, Apo-E between the two groups. total cholesterol of the gallbladder bile is higher in cholesterol gallstone group than in gallbladder polypi, while total bile acid of the gallbladder bile is lower in gallbladder cholesterol gallstone group than in gallbladder polypi.In two groups,leptin is positively correlated to BMI, serum leptin levels and lepin-receptor mRNA in gallbladder cholesterol gallstone group is much higher than another groups. At the weight level of BMI>25, BMI, serum leptin levels and lepin-receptor mRNA is much higher in gallbladder cholesterol gallstone group than in gallbladder polypi. At the weight level of BMI≤25, there are no significant differences between the two groups. In gallbladder cholesterol gallstone group, serum leptin level is positive correlated to body mass index,serum total cholesterol,triglyceride,Apo-AI and total cholesterol of the gallbladder bile, while HDL and total bile acid of the gallbladder bile are negative correlation. There are correlated to be found in gallbladder polypi. The serum leptin and total cholesterol LDL, Apo-B, Apo-E are no correlation in two groups.Conclusions:1 These results show:Compared with gallbladder polypi,serum triglyceride, total cholesterol,LDL,total cholesterol of the gallbladder bile are higher, while serum HDL,Apo-AI and total bile acid of the gallbladder bile are lower in cholesterol gallstone group.2 There is significant higher level in serum leptin and lepin-receptor mRNA of gallbladder cholesterol gallstone patients than in gallbladder polypi.3 Serum leptin may be play a key role in cholesterol gallstone formation .In conclusion, serum leptin, HDL,LDL,and Apo-AI are important prognosis factors for gallbladder cholesterol gallstone, may be used for early prevention and early treatment.