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Relation of cholesterol metabolism to pediatric gallstone disease: a retrospective controlled study

Antti Koivusalo1, Mikko Pakarinen2, Helena Gylling3

  • 1Hospital for Children and Adolescents, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. antti.koivusalo@hus.fi.

BMC Gastroenterology
|July 1, 2015
PubMed

Insights

Pediatric gallstones show altered cholesterol metabolism, with black pigment stones linked to impaired cholesterol processing and plant sterol accumulation. Cholesterol stones indicate reduced absorption but maintained cholesterol homeostasis in children.

Area of Science:

  • Biochemistry
  • Pediatric Gastroenterology
  • Metabolomics

Background:

  • Cholesterol metabolism is implicated in pediatric gallstone formation.
  • This study investigates cholesterol metabolites and phytosterols in children with black pigment and cholesterol gallstones.

Purpose of the Study:

  • To identify cholesterol metabolites and phytosterols in pediatric gallstones.
  • To determine the relationship between these metabolites and gallstone composition (sterols).

Main Methods:

  • Retrospective controlled clinical study.
  • Analysis of serum and gallstone samples from children undergoing cholecystectomy (n=46).
  • Comparison with age-, BMI-, and sex-matched healthy children (n=82) and adult gallstones (n=187).

Main Results:

  • Children with gallstones exhibited elevated serum markers of cholesterol synthesis (26-52% higher than controls).
  • Cholesterol absorption markers (cholestanol/cholesterol, plant sterols) showed a decreasing trend: black pigment stone group > controls > cholesterol stone group.
  • Black pigment stones were associated with serum bile acids; cholesterol stones showed inverse relationships between synthesis and absorption markers.

Conclusions:

  • Both pediatric gallstone types share enhanced cholesterol synthesis.
  • Cholesterol stone patients had low cholesterol absorption and stable cholesterol metabolism.
  • Black pigment stone patients displayed deteriorated cholesterol metabolism with cholestanol, campesterol, and sitosterol accumulation, suggesting their role in pathogenesis.
Abstract

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