The serum cholesterol level of choledocholithiasis patients was significantly lower than that of healthy people 

The serum cholesterol level of choledocholithiasis patients was significantly lower than that of healthy people | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The serum cholesterol level of choledocholithiasis patients was significantly lower than that of healthy people Linzhen Li, Tulan Hu, Di Wang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5038382/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background and purpose Choledocholithiasis is a common disease. The specific pathogenesis of choledocholithiasis is still unclear. The objective of this study was to investigate whether serum cholesterol level is related to the incidence of choledocholithiasis. Patients and Methods: A total of 169 choledocholithiasis patients were include in this study. We investigated whether total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), TC/TG, LDL/HDL in choledocholithiasis patients differed from that in healthy people. Results There were 64 male and 105 female patients. There were no statistically significant difference in age ( P = 0.927), TC/TG ( P = 0.516) and LDL/HDL ( P = 0.139) between the two groups. There were significant differences in TC ( P <0.001), TG ( P = 0.006), HDL ( P <0.001) and LDL ( P = 0.001) between the two groups. The TC, TG, HDL, LDL in the choledocholithiasis patients group were significantly lower than that in the healthy population. In the subgroup analysis, we further investigate whether above parameters in choledocholithiasis patients differed from that in healthy people by gender. There was no significant difference in TG ( P = 0.182), TC/TG ( P = 0.982), LDL/HDL ( P = 0.392) between the male choledocholithiasis patients group and the male healthy population group. There were significant differences in TC ( P = 0.001), HDL ( P = 0.014) and LDL ( P = 0.026) between the two groups. There were no significant difference in TC/TG ( P = 0.590), LDL/HDL ( P = 0.116) between the female choledocholithiasis patients group and the female healthy population group. There were significant differences in TC ( P <0.001), TG ( P = 0.016), HDL ( P <0.001) and LDL ( P = 0.009) between the two groups. Conclusions The serum TC, HDL and LDL in choledocholithiasis patients were significantly lower than those in healthy people, and TG in female patients was significantly lower than that in healthy people, but there was no difference in male patients. Health sciences/Diseases/Endocrine system and metabolic diseases Health sciences/Diseases/Gastrointestinal diseases choledocholithiasis triglyceride total cholesterol high density lipoprotein low density lipoprotein 1. Introduction Choledocholithiasis is a common digestive tract disease, which can be divided into primary and secondary choledocholithiasis according to the source. Primary stones usually form in cases of bile duct stasis or physiologic bile duct dilatation, both of which are more likely to form intrabile stones [ 1 ] . Secondary choledocholithiasis is more common and is usually caused by a cholesterol-forming gallstone falling into the common bile duct [ 1 ] . The prevalence of choledocholithiasis varies from country to country, ranging from 8–20% in symptomatic gallstones [ 2 – 6 ] . A light and regular diet can help prevent common bile duct stones. Serious complications of choledocholithiasis include biliary pancreatitis and acute cholangitis, which can increase the mortality of patients [ 7 ] . Choledocholithiasis is more common in older adults with choledochal physiologically dilated. Previous studies [ 8 ] have shown that in patients with prior cholecystectomy, common bile duct may physiologically expand to 10mm, leading to cholestasis and primary stone formation. Typical clinical symptoms of choledocholithiasis are pain in the upper abdomen, which may be accompanied by nausea and vomiting. The pain cannot be relieved by changing position and is not related to eating. Clinically, imaging tests that can be used to diagnose choledocholithiasis include transabdominal ultrasound, computerized tomography, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, laparoscopic ultrasound and endoscopic ultrasound [ 9 – 13 ] . Lipids are a general term for neutral fats (triglycerides and cholesterol) and lipids (phospholipids, glycolipids, sterols, steroids) in plasma, which are widely found in the human body. They are essential for the basic metabolism of living cells. In general, the main components of blood lipids are triglycerides and cholesterol, in which triglycerides are involved in energy metabolism in the human body, and cholesterol is mainly used for the synthesis of cell serous membranes, steroid hormones and bile acids. Cholesterol is involved in the development of atherosclerosis and is associated with acute ischemic arterial embolism events [ 14 , 15 ] . Since bile contains cholesterol components, whether abnormal cholesterol metabolism is involved in the formation of bile duct stones? The objective of this study was to investigate whether there were significant differences in serum cholesterol and triglycerides between choledocholithiasis patients and healthy people. 2. Methods 2.1. Ethical considerations The research was performed according to the Declaration of Helsinki including patients’ consent. The study was approved by the local Ethics Committee. 2.2. Patients and study design A total of 169 choledocholithiasis patients (January 2022-July 2024) in the Department of Gastroenterology of the First Affiliated Hospital of Wannan Medical College were include in this study. The inclusion criteria were as follows: (1) patients who meet the diagnostic criteria for choledocholithiasis, (2) blood was drawn for total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL). The exclusion criteria were as follows: (1) have been or are taking lipid-lowering medications, (2) complicated with coronary heart disease, cerebral infarction and other cardiovascular and cerebrovascular diseases. Gender, age, TC, TG, HDL, LDL, TC/TG, LDL/HDL were recorded. To investigate differences in total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein between choledocholithiasis patients and normal people, 169 patients who underwent physical examination in our hospital from January 2022-July 2024 were randomly selected and their age, sex and TC, TG, HDL, LDL, TC/TG, LDL/HDL were also recorded. First, we investigated whether TC, TG, HDL, LDL, TC/TG, LDL/HDL in choledocholithiasis patients differed from that in healthy people. If there is a significant difference, in the subgroup analysis, we further investigate whether TC, TG, HDL, LDL, TC/TG, LDL/HDL in choledocholithiasis patients differed from that in healthy people by gender. 2.3. Statistical Analysis Descriptive data are expressed in terms of ‾x ± s. All numerical variables were tested for normal distribution (Kolmogorov-Smirnov test). Independent-samples T test was used for parametric tests, and Chi-square test or Fisher's exact test was used for categorical variables. SPSS 21.0 software was used for statistical analysis. A P -value < 0.05 indicated statistical significance. 3. Results 3.1. Clinical features of the 169 choledocholithiasis patients A total of 169 choledocholithiasis patient were include in this study. There were 64 (37.87%) males and 105 (62.13%) females. The mean age was 56.26 ± 10.80 years old. The mean of TC, TG, HDL, LDL were 4.30 ± 1.03 mmol/L, 1.33 ± 0.76 mmol/L, 1.27 ± 0.37 mmol/L and 2.51 ± 0.77 mmol/L respectively. (Table 1 ). Table 1 Clinical features of choledocholithiasis patients Sex (M/F) 64/105 Age (years): x̄ ± s 56.26 ± 10.80 TC:x̄ ± s, mmol/L 4.30 ± 1.03 TG: x̄ ± s, mmol/L 1.33 ± 0.76 HDL: x̄ ± s, mmol/L 1.27 ± 0.37 LDL:x̄ ± s, mmol/L 2.51 ± 0.77 TC:total cholesterol, TG:triglyceride, HDL:high density lipoprotein, LDL:low density lipoprotein 3.2. Comparison of TC, TG, HDL, LDL, TC/TG, LDL/HDL between choledocholithiasis patients group and control group There were 64 males and 105 females in choledocholithiasis patients group, while 74 males and 95 females in control group. The difference wasn’t statistically significant ( P = 0.268). Similarly, there was no statistically significant difference in age between the two groups ( P = 0.927). There were significant differences in TC ( P <0.001), TG ( P = 0.006), HDL ( P <0.001) and LDL ( P = 0.001) between the two groups. But there were no significant differences in TC/TG ( P = 0.516) and LDL/HDL ( P = 0.139). The TC, TG, HDL, LDL in the choledocholithiasis patients group were significantly lower than that in the healthy population. (Table 2 ). Table 2 Analysis of the differences between choledocholithiasis group and control group choledocholithiasis group n = 169 control group n = 169 P Sex (M/F) 64/105 74/95 0.268 Age (years): x̄ ± s 56.26 ± 10.80 56.15 ± 10.53 0.927 TC:x̄ ± s, mmol/L 4.30 ± 1.03 4.96 ± 0.97 <0.001 TG: x̄ ± s, mmol/L 1.33 ± 0.76 1.61 ± 1.10 0.006 HDL: x̄ ± s, mmol/L 1.27 ± 0.37 1.44 ± 0.34 <0.001 LDL:x̄ ± s, mmol/L 2.51 ± 0.77 2.79 ± 0.75 0.001 TC/TG:x̄ ± s 4.20 ± 2.53 4.03 ± 2.07 0.516 LDL/HDL: x̄ ± s 2.16 ± 0.95 2.02 ± 0.69 0.139 TC:total cholesterol, TG:triglyceride, HDL:high density lipoprotein, LDL:low density lipoprotein 3.3. Whether there were differences between the choledocholithiasis group and the control group by gender In the subgroup analysis, we divided both groups again into male and female groups to compare the above parameters for differences. There was no significant difference in age ( P = 0.313), TG ( P = 0.182), TC/TG ( P = 0.982), LDL/HDL ( P = 0.392) between the male choledocholithiasis patients group and the male healthy population group. There were significant differences in TC ( P = 0.001), HDL ( P = 0.014) and LDL ( P = 0.026) between the two groups. There was no significant difference in age ( P = 0.317), TC/TG ( P = 0.590), LDL/HDL ( P = 0.116) between the female choledocholithiasis patients group and the female healthy population group. There were significant differences in TC ( P <0.001), TG ( P = 0.016), HDL ( P <0.001) and LDL ( P = 0.009) between the two groups. The results of male choledocholithiasis patients were consistent with those of female choledocholithiasis patients, except for difference in TG. (Table 3 ). Table 3 Whether there were differences between the choledocholithiasis group and the control group by gender Sex:male Sex:female choledocholithiasis group n = 64 control group n = 74 P choledocholithiasis group n = 105 control group n = 95 P Age (years): x̄ ± s 55.09 ± 11.33 57.00 ± 10.77 0.313 56.97 ± 10.44 55.49 ± 10.34 0.317 TC:x̄ ± s, mmol/L 4.13 ± 1.16 4.75 ± 1.02 0.001 4.40 ± 0.93 5.13 ± 0.90 <0.001 TG: x̄ ± s, mmol/L 1.44 ± 0.91 1.69 ± 1.20 0.182 1.26 ± 0.65 1.56 ± 1.01 0.016 HDL: x̄ ± s, mmol/L 1.16 ± 0.37 1.30 ± 0.30 0.014 1.33 ± 0.35 1.55 ± 0.33 <0.001 LDL:x̄ ± s, mmol/L 2.42 ± 0.84 2.73 ± 0.80 0.026 2.56 ± 0.72 2.83 ± 0.72 0.009 TC/TG:x̄ ± s 3.61 ± 1.77 3.61 ± 1.76 0.982 4.55 ± 2.85 4.36 ± 2.24 0.590 LDL/HDL: x̄ ± s 2.34 ± 1.15 2.20 ± 0.78 0.392 2.04 ± 0.80 1.89 ± 0.58 0.116 TC:total cholesterol, TG:triglyceride, HDL:high density lipoprotein, LDL:low density lipoprotein 4. Discussion Since Poulletier Delasalle first isolated cholesterol from human gallstones in 1769, its unique physiological and pathological effects have been extensively studied [ 16 ] . Cholesterol has three basic biological functions: cell signaling, hormone synthesis and metabolic homeostasis [ 17 ] . Cholesterol is an important and indispensable substance in animal tissue cells, it not only participates in the formation of cell membranes, but also is the raw material for the synthesis of bile acids, vitamin D and steroid hormones. Cholesterol can also be metabolized into bile acids, steroid hormones, 7-dehydrocholesterol, and 7-dehydrocholesterol is converted into vitamin D3 when exposed to ultraviolet light. On the other hand, excess cholesterol can be harmful or even fatal to nucleated cells [ 18 ] . Because the accumulation of cholesterol promotes the activation of innate and adaptive inflammatory responses [ 19 ] . Previous studies had established high plasma cholesterol levels as a causal risk factor for atherosclerosis and cardiovascular disease [ 20 ] . A study indicated that higher serum levels of total cholesterol and LDL-C were associated with an increased severity of acute pancreatitis [ 21 ] . A study showed that abnormal liver cholesterol metabolism, such as excessive liver cholesterol biosynthesis, liver cholesterol intake or output interference, liver cholesterol esterification abnormalities, can cause cholesterol gallstones [ 22 ] . Since abnormal cholesterol metabolism is associated with a variety of diseases, and the main component of secondary choledocholithiasis is also cholesterol, is choledocholithiasis also caused by abnormal cholesterol metabolism? This study found that serum total cholesterol, HDL and LDL levels in both male and female choledocholithiasis patients were significantly lower than those in healthy people. We suspect that the cause of this result may be abnormal liver cholesterol metabolism. Previous studies have confirmed that cholesterol supersaturation in bile is related to the increase of liver and plasma cholesterol content, which is the main pathogenic factor of gallstone [ 23 , 24 ] . Since various Niemann-Pick C1-like 1 (NPC1L1) mutations have been found to increase biliary cholesterol concentrations, which in turn increases the risk of gallstone, the abundance of NPC1L1 proteins in the human liver is considered a plausible defense against gallstone [ 25 ] . In other words, the human liver has NPC1L1, which reduces the excretion of biliary cholesterol. Therefore, when the expression of NPC1L1 in the liver is reduced, it may lead to the supersaturation of cholesterol in the secreted bile, which makes the formation of choledocholithiasis more likely. Because more cholesterol is discharged through bile, the plasma cholesterol is relatively reduced, which is why the serum total cholesterol, HDL and LDL of choledocholithiasis patients are significantly lower than that of healthy people. In this study, although the triglyceride level of the female choledocholithiasis group was significantly lower than that of the healthy population group, there was no significant difference between the triglyceride level of the male choledocholithiasis group and the healthy population group. Therefore, whether triglyceride is related to the formation of choledocholithiasis still needs to be further studied. This study has some limitations. First, this study only found that the serum cholesterol level of choledocholithiasis patients was significantly lower than that of healthy people, and did not study whether the bile cholesterol content of choledocholithiasis patients was significantly higher than that of healthy people. Secondly, patients with cardiovascular and cerebrovascular diseases and taking lipid-lowering drugs were excluded, and these people were basically over 70 years old, so people over 70 years old were not included. Last, this study was a single-center retrospective study with a small sample size. Therefore, it is hoped that further studies will be conducted in the future and more patients will be included. Whether abnormal cholesterol metabolism is related to the formation of choledocholithiasis and its mechanism, whether taking lipid-lowering drugs can reduce the incidence of choledocholithiasis remains to be studied. In conclusion, the results of this study are of great clinical significance. The serum TC, HDL and LDL in choledocholithiasis patients were significantly lower than those in healthy people, and TG in female patients was significantly lower than that in healthy people, but there was no difference in male patients. Declarations Acknowledgements None. Funding None Author information Authors and Affiliations Departments of Gastroenterology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China Linzhen Li, Tulan Hu Departments of Endocrinology department, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China. Di Wang Departments of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221006, P.R. China. Contributions Di Wang and Linzhen Li conceived and designed the paper and extracted data; Linzhen Li wrote the manuscript. Tulan Hu and Linzhen Li analyzed the data and completed the tables. Corresponding author Correspondence to Di Wang MD. Ethics declarations Ethics approval and consent to participate The study protocol was in accordance with the Declaration of Helsinki Ethical Guidelines and was approved by the institutional review board of Wannan medical college (No.12, 2021). All participants give informed consent. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Data availability Data is provided within the manuscript or supplementary information files. References Copelan A, Kapoor BS. Choledocholithiasis: Diagnosis and Management. Tech Vasc Interv Radiol. 2015. 18(4): 244-55. Möller M, Gustafsson U, Rasmussen F, Persson G, Thorell A. Natural course vs interventions to clear common bile duct stones: data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks). JAMA Surg. 2014. 149(10): 1008-13. Collins C, Maguire D, Ireland A, Fitzgerald E, O', Sullivan GC. A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy: natural history of choledocholithiasis revisited. Ann Surg. 2004. 239(1): 28-33. Murison MS, Gartell PC, McGinn FP. Does selective peroperative cholangiography result in missed common bile duct stones. 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Mechanisms and regulation of cholesterol homeostasis. Nat Rev Mol Cell Biol. 2020. 21(4): 225-245. Lingwood D, Simons K. Lipid rafts as a membrane-organizing principle. Science. 2010. 327(5961): 46-50. Yvan-Charvet L, Bonacina F, Guinamard RR, Norata GD. Immunometabolic function of cholesterol in cardiovascular disease and beyond. Cardiovasc Res. 2019. 115(9): 1393-1407. Tall AR, Yvan-Charvet L. Cholesterol, inflammation and innate immunity. Nat Rev Immunol. 2015. 15(2): 104-16. Ference BA, Kastelein J, Ginsberg HN, et al. Association of Genetic Variants Related to CETP Inhibitors and Statins With Lipoprotein Levels and Cardiovascular Risk. JAMA. 2017. 318(10): 947-956. Zhou X, Jin S, Pan J, et al. Relationship between Cholesterol-Related Lipids and Severe Acute Pancreatitis: From Bench to Bedside. J Clin Med. 2023. 12(5): 1729. Zhang C, Dai W, Yang S, Wu S, Kong J. Resistance to Cholesterol Gallstone Disease: Hepatic Cholesterol Metabolism. J Clin Endocrinol Metab. 2024. 109(4): 912-923. Schäfer C, Schuh A, Rau BM. [Diagnosis and therapy of gallstone disease]. MMW Fortschr Med. 2021. 163(6): 40-45. Wang DQ, Carey MC. Complete mapping of crystallization pathways during cholesterol precipitation from model bile: influence of physical-chemical variables of pathophysiologic relevance and identification of a stable liquid crystalline state in cold, dilute and hydrophilic bile salt-containing systems. J Lipid Res. 1996. 37(3): 606-30. Krawczyk M, Niewiadomska O, Jankowska I, et al. Common variant p.D19H of the hepatobiliary sterol transporter ABCG8 increases the risk of gallstones in children. Liver Int. 2022. 42(7): 1585-1592. Additional Declarations No competing interests reported. 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Introduction","content":"\u003cp\u003eCholedocholithiasis is a common digestive tract disease, which can be divided into primary and secondary choledocholithiasis according to the source. Primary stones usually form in cases of bile duct stasis or physiologic bile duct dilatation, both of which are more likely to form intrabile stones\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Secondary choledocholithiasis is more common and is usually caused by a cholesterol-forming gallstone falling into the common bile duct\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. The prevalence of choledocholithiasis varies from country to country, ranging from 8\u0026ndash;20% in symptomatic gallstones\u003csup\u003e[\u003cspan additionalcitationids=\"CR3 CR4 CR5\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. A light and regular diet can help prevent common bile duct stones. Serious complications of choledocholithiasis include biliary pancreatitis and acute cholangitis, which can increase the mortality of patients\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. Choledocholithiasis is more common in older adults with choledochal physiologically dilated. Previous studies\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e have shown that in patients with prior cholecystectomy, common bile duct may physiologically expand to 10mm, leading to cholestasis and primary stone formation. Typical clinical symptoms of choledocholithiasis are pain in the upper abdomen, which may be accompanied by nausea and vomiting. The pain cannot be relieved by changing position and is not related to eating. Clinically, imaging tests that can be used to diagnose choledocholithiasis include transabdominal ultrasound, computerized tomography, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, laparoscopic ultrasound and endoscopic ultrasound\u003csup\u003e[\u003cspan additionalcitationids=\"CR10 CR11 CR12\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eLipids are a general term for neutral fats (triglycerides and cholesterol) and lipids (phospholipids, glycolipids, sterols, steroids) in plasma, which are widely found in the human body. They are essential for the basic metabolism of living cells. In general, the main components of blood lipids are triglycerides and cholesterol, in which triglycerides are involved in energy metabolism in the human body, and cholesterol is mainly used for the synthesis of cell serous membranes, steroid hormones and bile acids. Cholesterol is involved in the development of atherosclerosis and is associated with acute ischemic arterial embolism events\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. Since bile contains cholesterol components, whether abnormal cholesterol metabolism is involved in the formation of bile duct stones? The objective of this study was to investigate whether there were significant differences in serum cholesterol and triglycerides between choledocholithiasis patients and healthy people.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Ethical considerations\u003c/h2\u003e \u003cp\u003e The research was performed according to the Declaration of Helsinki including patients\u0026rsquo; consent. The study was approved by the local Ethics Committee.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Patients and study design\u003c/h2\u003e \u003cp\u003eA total of 169 choledocholithiasis patients (January 2022-July 2024) in the Department of Gastroenterology of the First Affiliated Hospital of Wannan Medical College were include in this study. The inclusion criteria were as follows: (1) patients who meet the diagnostic criteria for choledocholithiasis, (2) blood was drawn for total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL). The exclusion criteria were as follows: (1) have been or are taking lipid-lowering medications, (2) complicated with coronary heart disease, cerebral infarction and other cardiovascular and cerebrovascular diseases. Gender, age, TC, TG, HDL, LDL, TC/TG, LDL/HDL were recorded.\u003c/p\u003e \u003cp\u003eTo investigate differences in total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein between choledocholithiasis patients and normal people, 169 patients who underwent physical examination in our hospital from January 2022-July 2024 were randomly selected and their age, sex and TC, TG, HDL, LDL, TC/TG, LDL/HDL were also recorded.\u003c/p\u003e \u003cp\u003eFirst, we investigated whether TC, TG, HDL, LDL, TC/TG, LDL/HDL in choledocholithiasis patients differed from that in healthy people. If there is a significant difference, in the subgroup analysis, we further investigate whether TC, TG, HDL, LDL, TC/TG, LDL/HDL in choledocholithiasis patients differed from that in healthy people by gender.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Statistical Analysis\u003c/h2\u003e \u003cp\u003eDescriptive data are expressed in terms of \u0026oline;x\u0026thinsp;\u0026plusmn;\u0026thinsp;s. All numerical variables were tested for normal distribution (Kolmogorov-Smirnov test). Independent-samples T test was used for parametric tests, and Chi-square test or Fisher's exact test was used for categorical variables. SPSS 21.0 software was used for statistical analysis. A \u003cem\u003eP\u003c/em\u003e-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicated statistical significance.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Clinical features of the 169 choledocholithiasis patients\u003c/h2\u003e \u003cp\u003eA total of 169 choledocholithiasis patient were include in this study. There were 64 (37.87%) males and 105 (62.13%) females. The mean age was 56.26\u0026thinsp;\u0026plusmn;\u0026thinsp;10.80 years old. The mean of TC, TG, HDL, LDL were 4.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.03 mmol/L, 1.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76 mmol/L, 1.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37 mmol/L and 2.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77 mmol/L respectively. (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical features of choledocholithiasis patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex (M/F)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64/105\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years): x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e56.26\u0026thinsp;\u0026plusmn;\u0026thinsp;10.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTC:x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTG: x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL: x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL:x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eTC:total cholesterol, TG:triglyceride, HDL:high density lipoprotein, LDL:low density lipoprotein\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Comparison of TC, TG, HDL, LDL, TC/TG, LDL/HDL between choledocholithiasis patients group and control group\u003c/h2\u003e \u003cp\u003eThere were 64 males and 105 females in choledocholithiasis patients group, while 74 males and 95 females in control group. The difference wasn\u0026rsquo;t statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.268). Similarly, there was no statistically significant difference in age between the two groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.927). There were significant differences in TC (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.006), HDL (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001) and LDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001) between the two groups. But there were no significant differences in TC/TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.516) and LDL/HDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.139). The TC, TG, HDL, LDL in the choledocholithiasis patients group were significantly lower than that in the healthy population. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnalysis of the differences between choledocholithiasis group and control group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003echoledocholithiasis group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;169\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003econtrol group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;169\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex (M/F)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64/105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74/95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.268\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years): x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56.26\u0026thinsp;\u0026plusmn;\u0026thinsp;10.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.15\u0026thinsp;\u0026plusmn;\u0026thinsp;10.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.927\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTC:x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTG: x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.61\u0026thinsp;\u0026plusmn;\u0026thinsp;1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL: x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL:x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTC/TG:x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.20\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.03\u0026thinsp;\u0026plusmn;\u0026thinsp;2.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.516\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL/HDL: x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.139\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eTC:total cholesterol, TG:triglyceride, HDL:high density lipoprotein, LDL:low density lipoprotein\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.3. Whether there were differences between the choledocholithiasis group and the control group by gender\u003c/h2\u003e \u003cp\u003eIn the subgroup analysis, we divided both groups again into male and female groups to compare the above parameters for differences. There was no significant difference in age (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.313), TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.182), TC/TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.982), LDL/HDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.392) between the male choledocholithiasis patients group and the male healthy population group. There were significant differences in TC (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), HDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.014) and LDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.026) between the two groups. There was no significant difference in age (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.317), TC/TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.590), LDL/HDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.116) between the female choledocholithiasis patients group and the female healthy population group. There were significant differences in TC (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.016), HDL (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001) and LDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.009) between the two groups. The results of male choledocholithiasis patients were consistent with those of female choledocholithiasis patients, except for difference in TG. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eWhether there were differences between the choledocholithiasis group and the control group by gender\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eSex:male\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eSex:female\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003echoledocholithiasis group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;64\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003econtrol group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;74\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003echoledocholithiasis group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;105\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003econtrol group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;95\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years): x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e55.09\u0026thinsp;\u0026plusmn;\u0026thinsp;11.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e57.00\u0026thinsp;\u0026plusmn;\u0026thinsp;10.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.313\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e56.97\u0026thinsp;\u0026plusmn;\u0026thinsp;10.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e55.49\u0026thinsp;\u0026plusmn;\u0026thinsp;10.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.317\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTC:x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e4.75\u0026thinsp;\u0026plusmn;\u0026thinsp;1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e4.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e5.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTG: x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.69\u0026thinsp;\u0026plusmn;\u0026thinsp;1.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.26\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e1.56\u0026thinsp;\u0026plusmn;\u0026thinsp;1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL: x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e1.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL:x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.42\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e2.56\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e2.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTC/TG:x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.61\u0026thinsp;\u0026plusmn;\u0026thinsp;1.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.61\u0026thinsp;\u0026plusmn;\u0026thinsp;1.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e4.55\u0026thinsp;\u0026plusmn;\u0026thinsp;2.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e4.36\u0026thinsp;\u0026plusmn;\u0026thinsp;2.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.590\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL/HDL: x̄\u0026thinsp;\u0026plusmn;\u0026thinsp;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.34\u0026thinsp;\u0026plusmn;\u0026thinsp;1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.392\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e2.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e1.89\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.116\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eTC:total cholesterol, TG:triglyceride, HDL:high density lipoprotein, LDL:low density lipoprotein\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eSince Poulletier Delasalle first isolated cholesterol from human gallstones in 1769, its unique physiological and pathological effects have been extensively studied\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. Cholesterol has three basic biological functions: cell signaling, hormone synthesis and metabolic homeostasis\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. Cholesterol is an important and indispensable substance in animal tissue cells, it not only participates in the formation of cell membranes, but also is the raw material for the synthesis of bile acids, vitamin D and steroid hormones. Cholesterol can also be metabolized into bile acids, steroid hormones, 7-dehydrocholesterol, and 7-dehydrocholesterol is converted into vitamin D3 when exposed to ultraviolet light. On the other hand, excess cholesterol can be harmful or even fatal to nucleated cells\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. Because the accumulation of cholesterol promotes the activation of innate and adaptive inflammatory responses\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. Previous studies had established high plasma cholesterol levels as a causal risk factor for atherosclerosis and cardiovascular disease\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e. A study indicated that higher serum levels of total cholesterol and LDL-C were associated with an increased severity of acute pancreatitis\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. A study showed that abnormal liver cholesterol metabolism, such as excessive liver cholesterol biosynthesis, liver cholesterol intake or output interference, liver cholesterol esterification abnormalities, can cause cholesterol gallstones\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. Since abnormal cholesterol metabolism is associated with a variety of diseases, and the main component of secondary choledocholithiasis is also cholesterol, is choledocholithiasis also caused by abnormal cholesterol metabolism?\u003c/p\u003e \u003cp\u003eThis study found that serum total cholesterol, HDL and LDL levels in both male and female choledocholithiasis patients were significantly lower than those in healthy people. We suspect that the cause of this result may be abnormal liver cholesterol metabolism. Previous studies have confirmed that cholesterol supersaturation in bile is related to the increase of liver and plasma cholesterol content, which is the main pathogenic factor of gallstone\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. Since various Niemann-Pick C1-like 1 (NPC1L1) mutations have been found to increase biliary cholesterol concentrations, which in turn increases the risk of gallstone, the abundance of NPC1L1 proteins in the human liver is considered a plausible defense against gallstone\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. In other words, the human liver has NPC1L1, which reduces the excretion of biliary cholesterol. Therefore, when the expression of NPC1L1 in the liver is reduced, it may lead to the supersaturation of cholesterol in the secreted bile, which makes the formation of choledocholithiasis more likely. Because more cholesterol is discharged through bile, the plasma cholesterol is relatively reduced, which is why the serum total cholesterol, HDL and LDL of choledocholithiasis patients are significantly lower than that of healthy people.\u003c/p\u003e \u003cp\u003eIn this study, although the triglyceride level of the female choledocholithiasis group was significantly lower than that of the healthy population group, there was no significant difference between the triglyceride level of the male choledocholithiasis group and the healthy population group. Therefore, whether triglyceride is related to the formation of choledocholithiasis still needs to be further studied.\u003c/p\u003e \u003cp\u003eThis study has some limitations. First, this study only found that the serum cholesterol level of choledocholithiasis patients was significantly lower than that of healthy people, and did not study whether the bile cholesterol content of choledocholithiasis patients was significantly higher than that of healthy people. Secondly, patients with cardiovascular and cerebrovascular diseases and taking lipid-lowering drugs were excluded, and these people were basically over 70 years old, so people over 70 years old were not included. Last, this study was a single-center retrospective study with a small sample size. Therefore, it is hoped that further studies will be conducted in the future and more patients will be included. Whether abnormal cholesterol metabolism is related to the formation of choledocholithiasis and its mechanism, whether taking lipid-lowering drugs can reduce the incidence of choledocholithiasis remains to be studied.\u003c/p\u003e \u003cp\u003eIn conclusion, the results of this study are of great clinical significance. The serum TC, HDL and LDL in choledocholithiasis patients were significantly lower than those in healthy people, and TG in female patients was significantly lower than that in healthy people, but there was no difference in male patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003eAuthor information\u003c/p\u003e\n\u003cp\u003eAuthors and Affiliations\u003c/p\u003e\n\u003cp\u003eDepartments of Gastroenterology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China\u003c/p\u003e\n\u003cp\u003eLinzhen Li, Tulan Hu\u003c/p\u003e\n\u003cp\u003eDepartments of Endocrinology department, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China.\u003c/p\u003e\n\u003cp\u003eDi Wang\u003c/p\u003e\n\u003cp\u003eDepartments of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221006, P.R. China.\u003c/p\u003e\n\u003cp\u003eContributions\u003c/p\u003e\n\u003cp\u003eDi Wang and Linzhen Li conceived and designed the paper and extracted data; Linzhen Li wrote the manuscript. Tulan Hu and Linzhen Li analyzed the data and completed the tables.\u003c/p\u003e\n\u003cp\u003eCorresponding author\u003c/p\u003e\n\u003cp\u003eCorrespondence to Di Wang MD.\u003c/p\u003e\n\u003cp\u003eEthics declarations\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eThe study protocol was in accordance with the Declaration of Helsinki Ethical Guidelines and was approved by the institutional review board of Wannan medical college (No.12, 2021). All participants give informed consent.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eData availability\u003c/p\u003e\n\u003cp\u003eData is provided within the manuscript or supplementary information files.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCopelan A, Kapoor BS. Choledocholithiasis: Diagnosis and Management. Tech Vasc Interv Radiol. 2015. 18(4): 244-55.\u003c/li\u003e\n\u003cli\u003eM\u0026ouml;ller M, Gustafsson U, Rasmussen F, Persson G, Thorell A. Natural course vs interventions to clear common bile duct stones: data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks). JAMA Surg. 2014. 149(10): 1008-13.\u003c/li\u003e\n\u003cli\u003eCollins C, Maguire D, Ireland A, Fitzgerald E, O\u0026amp;#x27, Sullivan GC. A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy: natural history of choledocholithiasis revisited. Ann Surg. 2004. 239(1): 28-33.\u003c/li\u003e\n\u003cli\u003eMurison MS, Gartell PC, McGinn FP. Does selective peroperative cholangiography result in missed common bile duct stones. J R Coll Surg Edinb. 1993. 38(4): 220-4.\u003c/li\u003e\n\u003cli\u003eKo CW, Lee SP. Epidemiology and natural history of common bile duct stones and prediction of disease. Gastrointest Endosc. 2002. 56(6 Suppl): S165-9.\u003c/li\u003e\n\u003cli\u003eWilkins T, Agabin E, Varghese J, Talukder A. Gallbladder Dysfunction: Cholecystitis, Choledocholithiasis, Cholangitis, and Biliary Dyskinesia. Prim Care. 2017. 44(4): 575-597.\u003c/li\u003e\n\u003cli\u003eWilliams EJ, Green J, Beckingham I, Parks R, Martin D, Lombard M. Guidelines on the management of common bile duct stones (CBDS). Gut. 2008. 57(7): 1004-21.\u003c/li\u003e\n\u003cli\u003ePark SM, Kim WS, Bae IH, et al. Common bile duct dilatation after cholecystectomy: a one-year prospective study. J Korean Surg Soc. 2012. 83(2): 97-101.\u003c/li\u003e\n\u003cli\u003eMaple JT, Ben-Menachem T, Anderson MA, et al. The role of endoscopy in the evaluation of suspected choledocholithiasis. Gastrointest Endosc. 2010. 71(1): 1-9.\u003c/li\u003e\n\u003cli\u003eTseng CW, Chen CC, Chen TS, Chang FY, Lin HC, Lee SD. Can computed tomography with coronal reconstruction improve the diagnosis of choledocholithiasis. J Gastroenterol Hepatol. 2008. 23(10): 1586-9.\u003c/li\u003e\n\u003cli\u003eTang G, Zhang J, Chen R, Zhang J, Zhou R. Percutaneous transhepatic cholangioscopy combined with endoscopic retrograde cholangiopancreatography for bilateral biliary bridge drainage for malignant biliary obstruction. 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Liver Int. 2022. 42(7): 1585-1592.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"choledocholithiasis, triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein","lastPublishedDoi":"10.21203/rs.3.rs-5038382/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5038382/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground and purpose\u003c/h2\u003e \u003cp\u003eCholedocholithiasis is a common disease. The specific pathogenesis of choledocholithiasis is still unclear. The objective of this study was to investigate whether serum cholesterol level is related to the incidence of choledocholithiasis.\u003c/p\u003e\u003ch2\u003ePatients and Methods:\u003c/h2\u003e \u003cp\u003eA total of 169 choledocholithiasis patients were include in this study. We investigated whether total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), TC/TG, LDL/HDL in choledocholithiasis patients differed from that in healthy people.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThere were 64 male and 105 female patients. There were no statistically significant difference in age (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.927), TC/TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.516) and LDL/HDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.139) between the two groups. There were significant differences in TC (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.006), HDL (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001) and LDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001) between the two groups. The TC, TG, HDL, LDL in the choledocholithiasis patients group were significantly lower than that in the healthy population. In the subgroup analysis, we further investigate whether above parameters in choledocholithiasis patients differed from that in healthy people by gender. There was no significant difference in TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.182), TC/TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.982), LDL/HDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.392) between the male choledocholithiasis patients group and the male healthy population group. There were significant differences in TC (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), HDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.014) and LDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.026) between the two groups. There were no significant difference in TC/TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.590), LDL/HDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.116) between the female choledocholithiasis patients group and the female healthy population group. There were significant differences in TC (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), TG (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.016), HDL (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001) and LDL (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.009) between the two groups.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe serum TC, HDL and LDL in choledocholithiasis patients were significantly lower than those in healthy people, and TG in female patients was significantly lower than that in healthy people, but there was no difference in male patients.\u003c/p\u003e","manuscriptTitle":"The serum cholesterol level of choledocholithiasis patients was significantly lower than that of healthy people ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-18 03:02:32","doi":"10.21203/rs.3.rs-5038382/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"73889ba7-cbf7-497b-a476-e6004725b413","owner":[],"postedDate":"November 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":39984951,"name":"Health sciences/Diseases/Endocrine system and metabolic diseases"},{"id":39984952,"name":"Health sciences/Diseases/Gastrointestinal diseases"}],"tags":[],"updatedAt":"2024-12-10T16:23:50+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-18 03:02:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5038382","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5038382","identity":"rs-5038382","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}