Cholesterol, non-cholesterol sterols and bile acids in paediatric gallstones

BackgroundDepending on underlying aetiopathogenetic factors human gallstones contain various amounts of cholesterol, non-cholesterol sterols and bile acids, which have remained unexplored in paediatric gallstone patients.AimsTo evaluate sterol and bile acids compositions of paediatric gallstones.Patients and methodsStudy group included 21 consecutively cholecystectomised children. Gas–liquid chromatography was used to quantitate gallstone sterols and bile acids. Results were compared to adult gallstones (n = 194).ResultsCholesterol stones (n = 9) had higher proportions of cholestenol and lathosterol, but lower those of lanosterol and phytosterols than pigment stones (n = 12) (p < 0.05 for each). Patients with gallstone cholesterol content over 70% were female. Gallstone cholesterol positively reflected body mass index and, in cholesterol stones-group, age (r = ∼+0.700, p < 0.05). Three patients on parenteral nutrition had brown pigment stones consisting of high amounts of campesterol and sitosterol ranging 483–9303 μg/100 mg of stone. Pigment stones had 13-fold higher amount of bile acids than cholesterol stones (p < 0.05). Black pigment stones contained ∼3-fold higher phytosterol proportions, and pigment stones and cholesterol stones had ∼43% lower proportions of deoxycholic acid than adults (p < 0.05).ConclusionGallstones in patients on parenteral nutrition are rich in phytosterols. With respect to gallstone sterols, gallstone disease of adolescent girls resembles that of adults. Composition of bile acids in paediatric gallstones is different from adults.