Download PDF
Exp Clin Endocrinol Diabetes 2009; 117(8): 395-399
DOI: 10.1055/s-0029-1202850
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Gallbladder Motor Function in Patients with Different Thyroid Hormone Status

M. Cakir1 , E. Kayacetin2 , H. Toy3 , S. Bozkurt4
  • 1Meram School of Medicine, Division of Endocrinology and Metabolism, Selcuk University, Konya, Turkey
  • 2Meram School of Medicine, Division of Gastroenterology, Selcuk University, Konya, Turkey
  • 3Department of Internal Medicine, Meram School of Medicine, Selcuk University, Konya, Turkey
  • 4Department of Biostatistics and Medical Informatics, School of Medicine, Akdeniz University, Antalya, Turkey
Further Information

Publication History

received 09.04.2008 first decision 30.10.2008

accepted 09.02.2009

Publication Date:
16 April 2009 (online)

Also available at
    Permissions and Reprints

Abstract

Hypothyroidism and hyperthyroidism are known to affect cholesterol metabolism, bile acid synthesis and bile content. There are previous studies reporting increased prevalence of gallstone and common bile duct stone formation in hypothyroidism. The aim of this study was to compare gallbladder (GB) motor function between euthyroid, hypothyroid and hyperthyroid subjects by conventional ultrasonography. Eighteen euthyroid, 14 hypothyroid and 20 hyperthyroid, age, sex and body mass index matched subjects were included in the study. Etiology of hypothyroidism comprised of thyroidectomy, Hashimoto's thyroiditis and previous radioactive iodine therapy. Hyperthyroid group included patients with toxic nodular goitre and Graves’ disease. Patients who have diseases or are under drug treatment known to affect biliary function were not included in the study. Fasting and post-stimulus GB volumes were measured by real-time conventional ultrasonography and computer unit (Aloka UST-979, 3.5 mHz electronic convex probe, Japan). No significant differences were noted for fasting, post-stimulus GB volumes and GB ejection fraction between euthyroid, hypothyroid and hyperthyroid subjects. Measuring GB motility accurately is not straightforward because besides being not static during fasting, after a meal, intermittent emptying and refilling of GB occurs. Ultrasonography is affected by GB filling and measures “net” GB emptying. Although cumbersome, additional evaluation with cholescintigraphy which detects “absolute” GB emptying and is not affected by GB filling may provide complete assessment of motor function and may be more informative in evaluating subjects with different thyroid hormone status.

Key words

gallbladder motor function - hypothyroidism - hyperthyroidism

References

  • 1 Andreini JP, Prigge WF, Ma C. et al . Vesicles and mixed micelles in hypothyroid rat bile before and after thyroid hormone treatment: evidence for a vesicle transport system for biliary cholesterol secretion.  J Lipid Res. 1994;  35 1405-1412
    PubMedSearch in Google Scholar
  • 2 Behar J, Lee KY, Thompson WR. et al . Gallbladder contraction in patients with pigment and cholesterol stones.  Gastroenterology. 1989;  97 1479-1484
    PubMedSearch in Google Scholar
  • 3 Dodds WJ, Groh WJ, Darweesh RM. et al . Sonographic measurement of gallbladder volume.  Am J Roentgenol. 1985;  145 1009-1011
    PubMedSearch in Google Scholar
  • 4 Donovan JM. Physical and metabolic factors in gallstone pathogenesis.  Gastroenterol Clin North Am. 1999;  28 75-97
    CrossrefPubMedSearch in Google Scholar
  • 5 Field FJ, Albright E, Mathur SN. Effect of dietary cholesterol on biliary cholesterol content and bile flow in the hypothyroid rat.  Gastroenterology. 1986;  91 297-304
    PubMedSearch in Google Scholar
  • 6 Fisher RS, Stelzer F, Rock E. et al . Abnormal gallbladder emptying in patients with gallstones.  Dig Dis Sci. 1982;  27 1019-1024
    CrossrefPubMedSearch in Google Scholar
  • 7 Honore LH. A significant association between symptomatic cholesterol cholelithiasis and treated hypothyroidism in women.  J Med. 1981;  12 199-203
    PubMedSearch in Google Scholar
  • 8 Inkinen J, Sand J, Nordback I. Association between common bile duct stones and treated hypothyroidism.  Hepatogastroenterology. 2000;  47 919-921
    PubMedSearch in Google Scholar
  • 9 Jazrawi RP, Pazzi P, Petroni ML. et al . Postprandial gallbladder motor function: refilling and turnover of bile in health and in cholelithiasis.  Gastroenterology. 1995;  109 582-591
    CrossrefPubMedSearch in Google Scholar
  • 10 Jazrawi RP. Measurement of gallbladder motor functions: an overview.  Dig Liver Dis. 2003;  35 S51-S55
    CrossrefPubMedSearch in Google Scholar
  • 11 Lanzini A, Lanzarotto F, Baisini O. et al . Value of measuring gallbladder motility in clinical practice.  Dig Liver Dis. 2003;  35 S46-S50
    PubMedSearch in Google Scholar
  • 12 Laukkarinen J, Kiudelis G, Lempinen M. et al . Increased prevalence of subclinical hypothyroidism in common bile duct stone patients.  J Clin Endocrinol Metab. 2007;  92 4260-4264
    CrossrefPubMedSearch in Google Scholar
  • 13 Laukkarinen J, Koobi P, Kalliovalkama J. et al . Bile flow to the duodenum is reduced in hypothyreosis and enhanced in hyperthyreosis.  Neurogastroenterol Motil. 2002;  14 183-188
    PubMedSearch in Google Scholar
  • 14 Laukkarinen J, Sand J, Aittomäki S. et al . Mechanism of the prorelaxing effect of thyroxine on the sphincter of Oddi.  Scand J Gastroenterol. 2002;  37 667-673
    CrossrefPubMedSearch in Google Scholar
  • 15 Laukkarinen J, Sand J, Saaristo R. et al . Is bile flow reduced in patients with hypothyroidism?.  Surgery. 2003;  133 288-293
    CrossrefPubMedSearch in Google Scholar
  • 16 La Vecchia C, Negri E, D’Avanzo B. et al . Risk factors for gallstone disease requiring surgery.  Int J Epidemiol. 1991;  20 209-215
    CrossrefPubMedSearch in Google Scholar
  • 17 Layden TJ, Boyer JL. The effect of thyroid hormone on bile salt-independent bile flow and Na+, K+ -ATPase activity in liver plasma membranes enriched in bile canaliculi.  J Clin Invest. 1976;  57 1009-1018
    CrossrefPubMedSearch in Google Scholar
  • 18 Lin TH, Rubinstein R, Holmes WL. A study of the effect of D- and L-triiodothyronine on bile acid excretion of rats.  J Lipid Res. 1963;  4 63-67
    PubMedSearch in Google Scholar
  • 19 Marzio L. Factors affecting gallbladder motility: drugs.  Dig Liver Dis. 2003;  35 S17-S19
    PubMedSearch in Google Scholar
  • 20 Portincasa P, Moschetta A, Colecchia A. et al . Measurements of gallbladder motor function by ultrasonography: towards standardization.  Dig Liver Dis. 2003;  35 S56-S61
    CrossrefPubMedSearch in Google Scholar
  • 21 Prandini N. Methods of measuring gallbladder motor functions – the need for standardization: scintigraphy.  Dig Liver Dis. 2003;  35 S62-S66
    PubMedSearch in Google Scholar
  • 22 Stone BG, Ansel HJ, Peterson FJ. et al . Gallbladder emptying stimuli in obese and normal-weight subjects.  Hepatology. 1992;  15 795-798
    CrossrefPubMedSearch in Google Scholar
  • 23 Van Steenbergen W, Fevery J, De Vos R. et al . Thyroid hormones and the hepatic handling of bilirubin. I. Effects of hypothyroidism and hyperthyroidism on the hepatic transport of bilirubin mono- and diconjugates in the Wistar rat.  Hepatology. 1989;  9 314-321
    PubMedSearch in Google Scholar
  • 24 Volzke H, Robinson DM, John U. Association between thyroid function and gallstone disease.  World J Gastroenterol. 2005;  11 5530-5534
    CrossrefPubMedSearch in Google Scholar
  • 25 Wasan SM, Sellin JH, Vasilopoulou-Sellin R. The gastrointestinal tract and liver in hypothyroidism. In: Braverman LE, Utiger RD (eds). Werner & Ingbar's The Thyroid: A Fundamental & Clinical Text. 9th edn. Philadelphia: Lippincott Williams & Wilkins 2005: 796-803
    Search in Google Scholar
  • 26 Wasan SM, Sellin JH, Vasilopoulou-Sellin R. The gastrointestinal tract and liver in thyrotoxicosis. In: Braverman LE, Utiger RD (eds). Werner & Ingbar's The Thyroid: A Fundamental & Clinical Text. 9th edn. Philadelphia: Lippincott Williams & Wilkins 2005: 589-595
    Search in Google Scholar
  • 27 Wiley ZD, Lavigne MD, Liu KM. et al . The effect of hyperthyroidism on gastric emptying rates and pancreatic exocrine and biliary secretion in man.  Am J Dig Dis. 1978;  23 1003-1008
    CrossrefPubMedSearch in Google Scholar

Correspondence

M. CakirMD 

Division of Endocrinology and Metabolism

Meram School of Medicine

Selcuk University

42080 Meram

Konya/Turkey

Phone: +90/332/223 77 39

Fax: +90/332/223 61 81

Email: cakirmehtap@yahoo.com