Skip to main content
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1984 Sep 1;289(6444):521–525. doi: 10.1136/bmj.289.6444.521

Plasma lipids and insulin in gall stone disease: a case-control study.

R K Scragg, G D Calvert, J R Oliver
PMCID: PMC1442729  PMID: 6432171

Abstract

Fasting plasma lipid and insulin concentrations were measured in 173 patients with gall stones and 284 hospital controls to investigate their relationship to this disease. Multivariate methods of analysis were used to estimate the net associations between individual plasma variables and the risk of developing gall stones. In both sexes increased plasma insulin values were associated with an increased risk of gall stones independently of plasma triglyceride values; increased plasma triglyceride concentrations were associated with an increased risk of gall stones in young subjects only; increased plasma total cholesterol concentrations were associated with a decreased risk of gall stones only after controlling for plasma insulin and triglyceride concentrations; while increased plasma high density lipoprotein cholesterol concentrations were associated with a decreased risk of gall stones, but were confounded by plasma insulin and triglyceride values. These associations were independent of obesity and dietary intake.

Full text

PDF
521

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahlberg J. Serum lipid levels and hyperlipoproteinaemia in gallstone patients. Acta Chir Scand. 1979;145(6):373–377. [PubMed] [Google Scholar]
  2. Albano J. D., Ekins R. P., Maritz G., Turner R. C. A sensitive, precise radioimmunoassay of serum insulin relying on charcoal separation of bound and free hormone moieties. Acta Endocrinol (Copenh) 1972 Jul;70(3):487–509. doi: 10.1530/acta.0.0700487. [DOI] [PubMed] [Google Scholar]
  3. Albers J. J., Grundy S. M., Cleary P. A., Small D. M., Lachin J. M., Schoenfield L. J. National Cooperative Gallstone Study: the effect of chenodeoxycholic acid on lipoproteins and apolipoproteins. Gastroenterology. 1982 Apr;82(4):638–646. [PubMed] [Google Scholar]
  4. Albers J. J., Warnick G. R., Wiebe D., King P., Steiner P., Smith L., Breckenridge C., Chow A., Kuba K., Weidman S. Multi-laboratory comparison of three heparin-Mn2+ precipitation procedures for estimating cholesterol in high-density lipoprotein. Clin Chem. 1978 Jun;24(6):853–856. [PubMed] [Google Scholar]
  5. Andersen J. M., Nervi F. O., Dietschy J. M. Rate constants for the uptake of cholesterol from various intestinal and serum lipoprotein fractions by the liver of the rat in vivo. Biochim Biophys Acta. 1977 Feb 23;486(2):298–307. doi: 10.1016/0005-2760(77)90025-x. [DOI] [PubMed] [Google Scholar]
  6. Bailey C. J., Ahmed-Sorour H. Role of ovarian hormones in the long-term control of glucose homeostasis. Effects of insulin secretion. Diabetologia. 1980 Nov;19(5):475–481. doi: 10.1007/BF00281829. [DOI] [PubMed] [Google Scholar]
  7. Bennion L. J., Grundy S. M. Effects of diabetes mellitus on cholesterol metabolism in man. N Engl J Med. 1977 Jun 16;296(24):1365–1371. doi: 10.1056/NEJM197706162962401. [DOI] [PubMed] [Google Scholar]
  8. Boyd G. S., Onajobi F. D. Control of cholesterol biosynthesis by a plasma apo-lipoprotein. Nature. 1969 Feb 8;221(5180):574–575. doi: 10.1038/221574b0. [DOI] [PubMed] [Google Scholar]
  9. Cahlin E., Jönsson J., Nilsson S., Scherstén T. Biliary lipid composition in normalipidemic and prebeta hyperlipoproteinemic gallstone patients. Influence of sucrose feeding of the patients on the biliary lipid composition. Scand J Gastroenterol. 1973;8(5):449–456. [PubMed] [Google Scholar]
  10. Carlson L. A., Ericsson M. Quantitative and qualitative serum lipoprotein analysis. Part 2. Studies in male survivors of myocardial infarction. Atherosclerosis. 1975 May-Jun;21(3):435–450. doi: 10.1016/0021-9150(75)90055-6. [DOI] [PubMed] [Google Scholar]
  11. Einarsson K., Hellström K., Kallner M. Gallbladder disease in hyperlipoproteinaemia. Lancet. 1975 Mar 1;1(7905):484–487. doi: 10.1016/s0140-6736(75)92831-7. [DOI] [PubMed] [Google Scholar]
  12. Friedman G. D., Kannel W. B., Dawber T. R. The epidemiology of gallbladder disease: observations in the Framingham Study. J Chronic Dis. 1966 Mar;19(3):273–292. doi: 10.1016/0021-9681(66)90132-9. [DOI] [PubMed] [Google Scholar]
  13. Garnick M. B., Bennett P. H., Langer T. Low density lipoprotein metabolism and lipoprotein cholesterol content in southwestern American Indians. J Lipid Res. 1979 Jan;20(1):31–31. [PubMed] [Google Scholar]
  14. Haber G. B., Heaton K. W. Lipid composition of bile in diabetics and obesity-matched controls. Gut. 1979 Jun;20(6):518–522. doi: 10.1136/gut.20.6.518. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Halloran L. G., Schwartz C. C., Vlahcevic Z. R., Nisman R. M., Swell L. Evidence for high-density lipoprotein-free cholesterol as the primary precursor for bile-acid synthesis in man. Surgery. 1978 Jul;84(1):1–7. [PubMed] [Google Scholar]
  16. Hove E., Geill T. Serum cholesterol and incidence of gallstones. Analysis of one-year autopsy material. Geriatrics. 1968 Jan;23(1):114–118. [PubMed] [Google Scholar]
  17. Kadziolka R., Nilsson S., Scherstén T. Prevalence of hyperlipoproteinemia in men with gallstone disease. Scand J Gastroenterol. 1977;12(3):353–355. doi: 10.3109/00365527709180940. [DOI] [PubMed] [Google Scholar]
  18. Kajiyama G., Oyamada K., Nakao S., Miyoshi A. The effect of diabetes mellitus and its treatment on the lithogenesity of bile in man. Hiroshima J Med Sci. 1981 Sep;30(3):221–227. [PubMed] [Google Scholar]
  19. Kim H. J., Kalkhoff R. K. Sex steroid influence on triglyceride metabolism. J Clin Invest. 1975 Oct;56(4):888–896. doi: 10.1172/JCI108168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Kolterman O. G., Gray R. S., Griffin J., Burstein P., Insel J., Scarlett J. A., Olefsky J. M. Receptor and postreceptor defects contribute to the insulin resistance in noninsulin-dependent diabetes mellitus. J Clin Invest. 1981 Oct;68(4):957–969. doi: 10.1172/JCI110350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Larsen J. A., Christensen K. D. Insulin-stimulated bile formation in cats. Acta Physiol Scand. 1978 Mar;102(3):301–309. doi: 10.1111/j.1748-1716.1978.tb06077.x. [DOI] [PubMed] [Google Scholar]
  22. Nepokroeff C. M., Lakshmanan M. R., Ness G. C., Dugan R. E., Porter J. W. Regulation of the diurnal rhythm of rat liver beta-hydroxy-beta-methylglutaryl coenzmye A reductase activity by insulin, glucagon, cyclic AMP and hydrocortisone. Arch Biochem Biophys. 1974 Feb;160(2):387–396. doi: 10.1016/0003-9861(74)90412-3. [DOI] [PubMed] [Google Scholar]
  23. Nervi F. O., Dietschy J. M. Ability of six different lipoprotein fractions to regulate the rate of hepatic cholesterogenesis in vivo. J Biol Chem. 1975 Nov 25;250(22):8704–8711. [PubMed] [Google Scholar]
  24. Neuberger J., Portmann B., Macdougall B. R., Calne R. Y., Williams R. Recurrence of primary biliary cirrhosis after liver transplantation. N Engl J Med. 1982 Jan 7;306(1):1–4. doi: 10.1056/NEJM198201073060101. [DOI] [PubMed] [Google Scholar]
  25. Norton J. J., Smith L. R., Hamper E. Diabetes mellitus and gallstones with special reference to insulin assay. Am J Gastroenterol. 1968 Sep;50(3):214–220. [PubMed] [Google Scholar]
  26. Olefsky J. M., Farquhar J. W., Reaven G. M. Reappraisal of the role of insulin in hypertriglyceridemia. Am J Med. 1974 Oct;57(4):551–560. doi: 10.1016/0002-9343(74)90006-0. [DOI] [PubMed] [Google Scholar]
  27. Orchard T. J., Becker D. J., Kuller L. H., Wagener D. K., LaPorte R. E., Drash A. L. Age and sex variations in glucose tolerance and insulin responses: parallels with cardiovascular risk. J Chronic Dis. 1982 Feb;35(2):123–132. doi: 10.1016/0021-9681(82)90113-8. [DOI] [PubMed] [Google Scholar]
  28. Petitti D. B., Friedman G. D., Klatsky A. L. Association of a history of gallbladder disease with a reduced concentration of high-density-lipoprotein cholesterol. N Engl J Med. 1981 Jun 4;304(23):1396–1398. doi: 10.1056/NEJM198106043042305. [DOI] [PubMed] [Google Scholar]
  29. Portman O. W., Alexander M., O'Malley J. P. Metabolism of free and esterified cholesterol and apolipoproteins of plasma low and high density lipoproteins. Biochim Biophys Acta. 1980 Sep 8;619(3):545–558. doi: 10.1016/0005-2760(80)90106-x. [DOI] [PubMed] [Google Scholar]
  30. Puavilai G., Drobny E. C., Domont L. A., Baumann G. Insulin receptors and insulin resistance in human pregnancy: evidence for a postreceptor defect in insulin action. J Clin Endocrinol Metab. 1982 Feb;54(2):247–253. doi: 10.1210/jcem-54-2-247. [DOI] [PubMed] [Google Scholar]
  31. Reiser S., Handler H. B., Gardner L. B., Hallfrisch J. G., Michaelis O. E., 4th, Prather E. S. Isocaloric exchange of dietary starch and sucrose in humans. II. Effect on fasting blood insulin, glucose, and glucagon and on insulin and glucose response to a sucrose load. Am J Clin Nutr. 1979 Nov;32(11):2206–2216. doi: 10.1093/ajcn/32.11.2206. [DOI] [PubMed] [Google Scholar]
  32. Sampliner R. E., Bennett P. H., Comess L. J., Rose F. A., Burch T. A. Gallbladder disease in pima indians. Demonstration of high prevalence and early onset by cholecystography. N Engl J Med. 1970 Dec 17;283(25):1358–1364. doi: 10.1056/NEJM197012172832502. [DOI] [PubMed] [Google Scholar]
  33. Savage P. J., Hamman R. F., Bartha G., Dippe S. E., Miller M., Bennett P. H. Serum cholesterol levels in American (Pima) Indian children and adolescents. Pediatrics. 1976 Aug;58(2):274–282. [PubMed] [Google Scholar]
  34. Schwartz C. C., Berman M., Vlahcevic Z. R., Halloran L. G., Gregory D. H., Swell L. Multicompartmental analysis of cholesterol metabolism in man. Characterization of the hepatic bile acid and biliary cholesterol precursor sites. J Clin Invest. 1978 Feb;61(2):408–423. doi: 10.1172/JCI108952. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Scragg R. K., McMichael A. J., Baghurst P. A. Diet, alcohol, and relative weight in gall stone disease: a case-control study. Br Med J (Clin Res Ed) 1984 Apr 14;288(6424):1113–1119. doi: 10.1136/bmj.288.6424.1113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Scragg R. K., McMichael A. J., Seamark R. F. Oral contraceptives, pregnancy, and endogenous oestrogen in gall stone disease--a case-control study. Br Med J (Clin Res Ed) 1984 Jun 16;288(6433):1795–1799. doi: 10.1136/bmj.288.6433.1795. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Sievers M. L. Serum cholesterol levels in Southwestern American Indians. J Chronic Dis. 1968 May;21(2):107–115. doi: 10.1016/0021-9681(68)90099-4. [DOI] [PubMed] [Google Scholar]
  38. Sodhi H. S., Kudchodkar B. J. Correlating metabolism of plasma and tissue cholesterol with that of plasma-lipoproteins. Lancet. 1973 Mar 10;1(7802):513–519. doi: 10.1016/s0140-6736(73)90329-2. [DOI] [PubMed] [Google Scholar]
  39. Storer G. B., Topping D. L., Trimble R. P. Direct stimulation by glucose and insulin of glycogen synthesis in perfused rat liver. FEBS Lett. 1981 Dec 21;136(1):135–137. doi: 10.1016/0014-5793(81)81231-8. [DOI] [PubMed] [Google Scholar]
  40. Stout R. W., Balmer J. P., Henry R. W., Buchanan K. D. Plasma lipids and gastro-intestinal hormones in subjects with gallstones. Horm Metab Res. 1978 Jul;10(4):357–357. doi: 10.1055/s-0028-1095833. [DOI] [PubMed] [Google Scholar]
  41. Szanto S., Yudkin J. The effect of dietary sucrose on blood lipids, serum insulin, platelet adhesiveness and body weight in human volunteers. Postgrad Med J. 1969 Sep;45(527):602–607. doi: 10.1136/pgmj.45.527.602. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Thornton J. R., Heaton K. W., Macfarlane D. G. A relation between high-density-lipoprotein cholesterol and bile cholesterol saturation. Br Med J (Clin Res Ed) 1981 Nov 21;283(6303):1352–1354. doi: 10.1136/bmj.283.6303.1352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Topping D. L., Mayes P. A. Insulin and non-esterified fatty acids. Acute regulators of lipogenesis in perfused rat liver. Biochem J. 1982 May 15;204(2):433–439. doi: 10.1042/bj2040433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Wilson J. D. The role of bile acids in the overall regulation of steroid metabolism. Arch Intern Med. 1972 Oct;130(4):493–505. [PubMed] [Google Scholar]
  45. Wynn V., Adams P. W., Godsland I., Melrose J., Niththyananthan R., Oakley N. W., Seed M. Comparison of effects of different combined oral-contraceptive formulations on carbohydrate and lipid metabolism. Lancet. 1979 May 19;1(8125):1045–1049. doi: 10.1016/s0140-6736(79)92949-0. [DOI] [PubMed] [Google Scholar]
  46. Zumoff B., Strain G. W., Kream J., O'Connor J., Levin J., Fukushima D. K. Obese young men have elevated plasma estrogen levels but obese premenopausal women do not. Metabolism. 1981 Oct;30(10):1011–1014. doi: 10.1016/0026-0495(81)90102-5. [DOI] [PubMed] [Google Scholar]
  47. de Leon M. P., Ferenderes R., Carulli N. Bile lipid composition and bile acid pool size in diabetes. Am J Dig Dis. 1978 Aug;23(8):710–716. doi: 10.1007/BF01072357. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES