- The document summarizes a proposed study on evaluating the relationship between serum lipid profiles, body mass index (BMI), waist-to-hip ratio, and gallstone disease.
- The study aims to measure BMI, waist-to-hip ratio, and serum lipid parameters including total cholesterol, LDL, triglycerides, and HDL in patients diagnosed with gallstones.
- Previous studies have found associations between obesity, serum lipid levels, and increased risk of gallstones, but the relationships require further investigation.
- The document summarizes a proposed study on evaluating the relationship between serum lipid profiles, body mass index (BMI), waist-to-hip ratio, and gallstone disease.
- The study aims to measure BMI, waist-to-hip ratio, and serum lipid parameters including total cholesterol, LDL, triglycerides, and HDL in patients diagnosed with gallstones.
- Previous studies have found associations between obesity, serum lipid levels, and increased risk of gallstones, but the relationships require further investigation.
- The document summarizes a proposed study on evaluating the relationship between serum lipid profiles, body mass index (BMI), waist-to-hip ratio, and gallstone disease.
- The study aims to measure BMI, waist-to-hip ratio, and serum lipid parameters including total cholesterol, LDL, triglycerides, and HDL in patients diagnosed with gallstones.
- Previous studies have found associations between obesity, serum lipid levels, and increased risk of gallstones, but the relationships require further investigation.
- The document summarizes a proposed study on evaluating the relationship between serum lipid profiles, body mass index (BMI), waist-to-hip ratio, and gallstone disease.
- The study aims to measure BMI, waist-to-hip ratio, and serum lipid parameters including total cholesterol, LDL, triglycerides, and HDL in patients diagnosed with gallstones.
- Previous studies have found associations between obesity, serum lipid levels, and increased risk of gallstones, but the relationships require further investigation.
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SYNOPSIS
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE EVALUATION OF SERUM LIPID PROFILE AND BODY MASS INDEX/ WAIST TO HIP RATIO IN PATIENTS WITH GALLSTONE DISEASE Name of the candidate
Dr. AURELIA FRANCISCA M. VAS
Guide
Dr. JOHN JOSEPH S. MARTIS
Course and Subject
M.S. (GENERAL SURGERY)
DEPARTMENT OF GENERAL SURGERY
FATHER MULLER MEDICAL COLLEGE, KANKANADY, MANGALORE 575002. 2012
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION 1.
Name of the Candidate and Address
[in block letters] Dr. AURELIA FRANCISCA M VAS PG IN GENERAL SURGERY,
FR. MULLER MEDICAL COLLEGE,
KANKANADY, MANGALORE 575002
2.
Name of the Institution
FATHER MULLER MEDICAL COLLEGE, KANKANADY, MANGALORE 575002. 3.
Course of study and subject
MASTER OF SURGERY GENERAL SURGERY 4.
Date of admission to Course
02-05-2012 5.
TITLE OF THE TOPIC:
EVALUATION OF SERUM LIPID PROFILE AND BODY MASS INDEX/ WAIST TO HIP RATIO IN PATIENTS WITH GALLSTONE DISEASE
6 6.1 NEED FOR THE STUDY The prevalence of cholesterol gallstones is increased in obese persons. The risk is especially high in those with the highest body mass index.(1) High triglycerides and low HDL have been most consistently associated with gallstones, whereas the associations of total cholesterol and LDL with gallstones are less consistent.(2) Cholesterol gallstone disease is extremely common. Three major stages are recognized for stone formation, namely bile that becomes supersaturated with cholesterol, cholesterol nucleation leading to crystal formation and finally retention of the crystals in the gallbladder resulting in stone formation. Supersaturation is common but nucleation into crystals probably requires protein nucleating factors. Impaired motility of the gallbladder causes crystal retention and is probably very important in stone formation.(3)
6.2 REVIEW OF LITERATURE:
Acalovschi M(4) in his study concluded that there was a striking monotonic increase in gallstone risk with obesity was observed. The annual gallstone incidence rose parallel with the BMI, up to 2/100/year in morbidly obese. Further studies confirmed that men's chances of having gallstones are increased by having an abdominal distribution of body fat, leading to the conclusion that obesity represents a risk for gallstones both through total body fat mass and through fat regional distribution.
Channa et al (5) in their study concluded that elevated serum total cholesterol, LDL cholesterol, triacylglycerols and decreased levels of HDL cholesterol seem to play a major contributing role in the pathogenesis of gallstones, especially in females. Thijs et al (6) assessed the role of serum lipids in the etiology of gallstones in a case-control study.The highest gallstone risk was found at low high-density cholesterol levels and high triglyceride levels. An additional weakly negative association was found between total cholesterol level and gallstone risk. Kodama et al
(7)
in their cross- sectional study concluded that BMI was
significantly associated with an increased risk of prevalent gallstones. WHR also
showed a significant positive association. When BMI and WHR were mutually adjusted for, both of the obesity indices tended to be associated positively with prevalent gallstones. These findings indicate that obesity is associated with increased gallstone risk in men. 3
6.3 OBJECTIVES OF THE STUDY:
1. To measure BMI and waist to hip ratio in gallstone patients 2. To estimate serum lipid profile parameters in gallstone patients
7.
MATERIALS AND METHODS:
7.1 Source of Data: Patients diagnosed to have Gallstone disease in Father Muller Medical College Hospital, Mangalore between July 2012 and June 2014. 7.2 Method of Collection of Data: Study type: Descriptive Correlative study Method of collection of data: 4
A sample size of minimum 50 consenting inpatients diagnosed to have gallstone
disease in Father Muller Medical College Hospital selected by purposive sampling technique based on inclusion and exclusion criteria. Prior to selection, they underwent routine history taking, physical examination and investigations to exclude co-existing diseases or generalized debility. Ethical committee approval was taken prior to the study. Data collected includes: Name, Age, Sex, In Patient no (IP no), Diagnosis Body Mass Index/ Waist to hip ratio of the patients. Quantitative analysis of Serum Lipid Profile which includes serum total cholesterol, serum LDL cholesterol, serum triglycerides, serum HDL cholesterol.
Inclusion criteria:
Patients of any age group and sex diagnosed to have Gallstone disease in Father Muller Medical College Hospital.
Exclusion criteria:
Patients who have cirrhosis, biliary tract infections, hemolytic anaemia, Crohns disease, congenital cystic fibrosis, hepatitis.
Patients who are on cholesterol lowering drugs.
Patients who are on artificial feeding or Total Parenteral Nutrition.
Pregnant women with gallstones.
5
Plan for data analysis:
Data collected will be analyzed by Karl Pearson's Correlation Coefficient and Chi Square test.
7.3 Does the study require any investigations or interventions to be conducted on
patients or other humans or animals? If so, please describe briefly: Yes, the study requires all patients included to undergo quantitative analysis of serum lipid profile & BMI/ waist to hip ratio calculation.
7.4 Has ethical clearance been obtained from your institution in case of 7.3? Yes.
8. REFERENCES 1) Erlinger S. Gallstones in obesity and weight loss. Eur J Gastroenterol Hepatol. 2000 Dec;12(12):1347-52. 2) Andreotti G, Chen J, Gao YT, Rashid A, Chang SC, Shen MC, et al. Serum lipid levels and the risk of biliary tract cancers and biliary stones: A population-based study in China. Int J Cancer. 2008 May 15;122(10): 2322-9. 3) Strasberg SM, Clavien PA and Harvey PR. Pathogenesis of Cholesterol Gallstones. HPB Surg. 1991; 3(2):79-102. 4) Acalovschi M. Cholesterol gallstones: from epidemiology to prevention. Postgrad Med J. 2001 April; 77(906): 221-229. 6
5) Channa NA, Khand F, Ghanghro AB and Soomro AM. Quantitative analysis of
Serum Lipid Profile in Gallstone Patients and Controls. Pak. J. Anal. Environ. Chem. 2010;11(1):59-65. 6) Thijs C, Knipschild P, Brombacher P. Serum lipids and gallstones: a case-control study. Gastroenterology. 1990 Sep;99(3):843-9. 7) Kodama H, Kono S, Todoroki I, Honjo S, Sakurai Y, Wakabayashi K et al. Gallstone disease risk in relation to body mass index and waist-to-hip ratio in Japanese men. Int J Obe Relat Metab Disord. 1999 Feb;23(2):211-6.
9.
Signature of the candidate
10.
Remarks of the guide
11.
Name and Designation of
Dr. JOHN JOSEPH S. MARTIS
(in block letters)
PROFESSOR AND UNIT HEAD,
11.1 Guide
DEPARTMENT OF GENERAL SURGERY,
FR. MULLER MEDICAL COLLEGE, KANKANADY, MANGALORE. -2
11.2 Signature
11.3 Head of the Department
Dr. EREL A. I. DIAZ
PROFESSOR AND HEAD OF THE DEPARTMENT, DEPARTMENT OF GENERAL SURGERY, 7
FATHER MULLER MEDICAL COLLEGE
AND HOSPITAL, KANKANADY, MANGALORE-2 11.4 Signature
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