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Haal S, Guman MSS, Acherman YIZ, et al. Gallstone Formation Follows a Different Trajectory in Bariatric Patients Compared to Nonbariatric Patients. Metabolites. 2021;11(10)doi: 10.3390/metabo11100682.
Haal, S., Guman, M. S. S., Acherman, Y. I. Z., Jansen, J. P. G., van Weeghel, M., van Lenthe, H., Wever, E. J. M., Gerdes, V. E. A., Voermans, R. P., & Groen, A. K. (2021). Gallstone Formation Follows a Different Trajectory in Bariatric Patients Compared to Nonbariatric Patients. Metabolites, 11(10), . https://doi.org/10.3390/metabo11100682
Haal, Sylke, et al. "Gallstone Formation Follows a Different Trajectory in Bariatric Patients Compared to Nonbariatric Patients." Metabolites vol. 11,10 (2021). doi: https://doi.org/10.3390/metabo11100682
Haal S, Guman MSS, Acherman YIZ, Jansen JPG, van Weeghel M, van Lenthe H, Wever EJM, Gerdes VEA, Voermans RP, Groen AK. Gallstone Formation Follows a Different Trajectory in Bariatric Patients Compared to Nonbariatric Patients. Metabolites. 2021 Oct 05;11(10). doi: 10.3390/metabo11100682. PMID: 34677397; PMCID: PMC8541369.
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Metabolites. 2021 Oct 05;11(10). doi: 10.3390/metabo11100682.

Gallstone Formation Follows a Different Trajectory in Bariatric Patients Compared to Nonbariatric Patients.

Metabolites

Sylke Haal, Maimoena S S Guman, Yair I Z Acherman, Johannes P G Jansen, Michel van Weeghel, Henk van Lenthe, Eric J M Wever, Victor E A Gerdes, Rogier P Voermans, Albert K Groen

Affiliations

  1. Department of Internal Medicine, Spaane Gasthuis, 2134 TM Hoofddorp, The Netherlands.
  2. Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, 1105 AZ Amsterdam, The Netherlands.
  3. Department of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, 1105 AZ Amsterdam, The Netherlands.
  4. Department of Surgery, Spaarne Gasthuis, 2134 TM Hoofddorp, The Netherlands.
  5. Laboratory of Genetic Metabolic Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Cardiovascular Sciences, 1105 AZ Amsterdam, The Netherlands.
  6. Core Facility Metabolomics, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
  7. Bioinformatics Laboratory, Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands.

PMID: 34677397 PMCID: PMC8541369 DOI: 10.3390/metabo11100682

Abstract

Since obese patients form cholesterol gallstones very rapidly after bariatric surgery, in patients who did not form gallstones during preceding years, we hypothesized that gallstone formation follows a different trajectory in bariatric patients compared to nonbariatric patients. We therefore analyzed the lipid composition of gallbladder bile derived from 18 bariatric gallstone patients and 17 nonbariatric gallstone patients (median (IQR) age, 46.0 (28.0-54.0) years; 33 (94%) female) during laparoscopic cholecystectomy using an enzymatic and lipidomics approach. We observed a higher concentration of total lipids (9.9 vs. 5.8 g/dL), bile acids (157.7 vs. 81.5 mM), cholesterol (10.6 vs. 5.4 mM), and phospholipids (30.4 vs. 21.8 mM) in bariatric gallstone patients compared to nonbariatric gallstone patients. The cholesterol saturation index did not significantly differ between the two groups. Lipidomics analysis revealed an interesting pattern. Enhanced amounts of a number of lipid species were found in the gallbladder bile of nonbariatric gallstone patients. Most striking was a fivefold higher amount of triglyceride. A concomitant ninefold increase of apolipoprotein B was found, suggesting secretion of triglyceride-rich lipoproteins (TRLs) at the canalicular pole of the hepatocyte in livers from nonbariatric gallstone patients. These findings suggest that gallstone formation follows a different trajectory in bariatric patients compared to nonbariatric patients. Impaired gallbladder emptying might explain the rapid gallstone formation after bariatric surgery, while biliary TRL secretion might contribute to gallstone formation in nonbariatric patients.

Keywords: bariatric surgery; bile; gallstones; lipidomics; triglyceride-rich lipoproteins

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