PDF(Pubmed)
Abstract：
Cholelithiasis is considered to be the most common biliary pathology. They have been categorized into three types, which are pigment stones, cholesterol stones, and mixed types of stones with varying incidence. The condition may be asymptomatic for significantly long durations and in most cases, the presence of gall stones is an incidental finding. The patients may present with pain in the abdomen in stages of cholecystitis or advanced stages or cases of gall stones causing the obstruction. Gallbladder stones are formed through a very complex procedure with the contribution of numerous factors, where the main initiating step is supposed to be the development of a state wherein there is supersaturation of the bile, which in turn gives rise to accumulation and stasis of the bile and the development of gall stones. One of the factors is said to be the hypothyroid state. Hypothyroidism itself is a significantly common endocrine disorder that affects almost every nucleated cell in the body. There is decreased efficacy of the thyroid gland. The serum T3 and T4 levels might be found on the lower side whereas thyroid-stimulating hormone (TSH) values are found to be high. In some of the cases, though the T3 and T4 levels are maintained within the normal limits, the TSH shows raised values, which are labeled as subclinical hypothyroidism. The state of hypothyroidism may act upon the amount of bile secretion, the flow of bile into the intestines, cholesterol metabolism, and the action of the sphincter of Oddi. Studies have shown results pointing towards the correlation between these two factors. The basic mechanism behind the correlation between cholelithiasis and hypothyroidism is supposed to be due to the action of the hypothyroid state on the functioning of the sphincter of Oddi. The hypothyroid state is supposed to be decreasing the tendency of the sphincter of Oddi to relax, thus causing stasis of the bile, which over time leads to initiation of supersaturation of the bile and formation of gall stones. Both subclinical hypothyroidism and clinical hypothyroidism are found to be significantly common in patients having cholelithiasis. We, in this review article, have taken into consideration various studies which have been performed regarding this topic worldwide. The studies have been performed on individuals who are already diagnosed with either of these diseases and are then screened for the presence of the other disease included in this study. The degree of correlation varies according to the location of the stones and their sizes. Though various studies show varying results to some extent, overall almost all the studies show significant pieces of evidence of the correlation between cholelithiasis and hypothyroidism.
摘要：
胆石症被认为是最常见的胆道病理。它们被分为三种类型，是颜料石，胆固醇结石,以及发病率不同的混合类型的结石。这种情况可能在相当长的持续时间内无症状，在大多数情况下，胆结石的存在是一个偶然的发现。在胆囊炎或晚期或引起阻塞的胆结石病例中，患者可能会出现腹部疼痛。胆囊结石是通过非常复杂的手术形成的，有许多因素的作用，其中主要的启动步骤应该是胆汁过饱和状态的发展，这反过来又引起胆汁的积累和停滞以及胆结石的发展。据说其中一个因素是甲状腺功能减退状态。甲状腺功能减退症本身是一种非常常见的内分泌疾病，几乎影响身体中的每个有核细胞。甲状腺的功效下降。血清T3和T4水平可能位于较低的一侧，而甲状腺刺激激素（TSH）值较高。在某些情况下,尽管T3和T4水平保持在正常范围内，TSH显示升高的值，被标记为亚临床甲状腺功能减退症。甲状腺功能减退的状态可能会影响胆汁的分泌量，胆汁流入肠道，胆固醇代谢，以及Oddi括约肌的动作.研究表明，结果指向这两个因素之间的相关性。胆石症与甲状腺功能减退之间相关性的基本机制被认为是由于甲状腺功能减退状态对Oddi括约肌功能的作用。甲状腺功能减退状态应该会降低Oddi括约肌的放松趋势，从而导致胆汁淤滞，随着时间的推移，这导致胆汁的过饱和和胆结石的形成。在胆石症患者中，亚临床甲状腺功能减退症和临床甲状腺功能减退症均明显常见。我们,在这篇评论文章中，已经考虑到在全球范围内就这一主题进行的各种研究。已经对已经诊断出患有这些疾病中的任一种的个体进行了研究，然后对该研究中包括的其他疾病的存在进行了筛查。相关程度根据石头的位置和大小而变化。尽管各种研究在某种程度上显示出不同的结果，总的来说，几乎所有的研究都显示了胆石症与甲状腺功能减退症之间存在相关性的重要证据。
