Abstracts
1998 Digestive Disease Week

#1045

IRON DEFICIENCY INHIBITS GALLBLADDER MOTILITY. K.P.Murray, J.H. Shin, M.K.Fox-Talbot, S.M. Johnston, P.A.Lipsett, K.D. Lillemoe and H.A.Pitt. Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD and Medical College of Wisconsin, Milwaukee, WI.

Cholesterol gallstones occur most commonly in multiparous women. The same patient population is prone to iron deficiency anemia. We have previously demonstrated that an iron deficient diet causes cholesterol crystal formation without supersaturation of bile. Therefore, we tested the hypothesis that iron deficiency also alters gallbladder motility. Two groups of adult female prairie dogs were fed either an iron supplemented (Fe+) (200ppm) control or an iron deficient (Fe-) (8ppm) diet. A third iron supplemented group underwent serial phlebotomy. The percentage change in serum iron saturation (% _ Fe Sat) was assayed as an index of iron deficiency. Gallbladder bile was examined for the presence of cholesterol crystals. Bile cholesterol, phospholipids and bile acids were measured, and a cholesterol saturation index (CSI) was calculated. C14 cholic acid was injected, and the distribution of counts between gallbladder and hepatic bile was calculated to give the ratio of specific activity (Rsa), an index of gallbladder emptying. Results were:

_ p = 0.06 vs baseline, § p < 0.03 vs baseline (by paired T-test)
* p < 0.05 vs control, _ p = 0.05 vs control (by ANOVA)

These data suggests that iron deficiency results in 1) gallbladder stasis and
2) cholesterol crystal formation without increasing the cholesterol saturation index. We conclude that iron deficiency causes gallbladder stasis which leads to cholesterol crystal formation. This study further confirms the hypothesis that iron deficiency plays a role in gallstone pathogenesis.

Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.