THE INFLUENCE OF AGING UPON GALLSTONES : CHANGES IN SERUM LIPIDS, LITHOGENESITY OF BILE AND CROSS-SECTIONAL VIEWS OF STONES WITH AGE

Differences in lithogenesity of bile, and the type of stones of the radiolucent gallstone patients were investigated by both the roentgenogram (solitary and multiple) and cross-sectional views in comparison between the patients of ages below 39 and above 40 either with or without hyperlipidemia and lipoproteinemia.

Hypercholesterolemia was rare in patients of age below 39 in contrast to those of above 40 in cases of solitary (p<0.05) and multiple stones (N. S.). The incidence of hypertriglyceridemia was high in these patients of both generations. In the lipoprotein DISC electrophoresis, 14 (37.8%) of 37 patients of age below 39 had hyperlipoproteinemia, whereas 41 (47.1%) of 87 patients of age over 40 had hyperlipoproteinemia that belonged to type IIa, IIb or IV.

Among the types of hyperlipoproteinemia, IIa and IIb were seldom seen in the patients of age below 39 but IIa, IIb and IV were almost equally spreaded over in the patients of age above 40. The solitary stone, on the whole, was accompanied with a high incidence of supersaturated bile irrespectively of the generation and presence or absence of hyperlipoproteinemia. The incidence of supersaturated bile was rare in the normolipidemic patients with multiple stones, particularly the patients of age above 40. This incidence in the patients of age above 40 with multiple stones was significantly lower in the normolipidemic than hyperlipoproteinemic patients (p<0.01). The patients with solitary stone had highly concentrated cholesterol stones as compared with those with multiple stones which sometimes contained other stones than the cholesterol stone. The stones of hyperlipoproteinemic patients also contained generally the higher concentration of cholesterol than those of normolipoproteinemic patients.

The patients of age above 40 had more combination stones (11 : 1) and other stones (remainder) (5 : 1) than those of age below 39.