A retrospective study on the correlation between lipoprotein and occult pancreaticobiliary reflux complicated with gallbladder cholesterolosis

Objective It is found in clinical practice that many patients with gallbladder stone also have occult pancreaticobiliary reflux (OPBR) and cholesterol deposition on the gallbladder wall. However, there is no study reporting their correlations. The purpose of the present study was to explore the correlation between lipid metabolism and occult pancreaticobiliary reflux (OPBR) with complicated gallbladder cholesterolosis by analyzing lipoproteins in the venous blood. Methods According to the inclusion and exclusion criteria, 407 patients who received gallbladder surgery at the Center for Gallbladder Diseases of Shanghai East Hospital between December 2020 and November 2021 were included, of whom 55 patients were consistent with the diagnosis of OPBR. The baseline information and preoperative lipid levels of all patients were collected to analyze the correlation between lipid metabolism and OPBR with complicated gallbladder cholesterolosis. Results Serum lipoprotein associated phospholipase (LP-PL)-A2 and low-density lipoprotein cholesterol (LDL-C) in the Study group were significantly higher than those in the Control group ( p = 0.0023; p = 0.0344 ). LP-PL-A2 showed a moderately strong correlation with OPBR (R = 0.446, p = 0.002), and LDL-C showed a weak correlation (R = 0.277, p = 0.042). Multivariate Logistics regression analysis showed that LP-PL-A2 (OR: 1.014, 95%CI: 1.001 ~ 1.026, p = 0.029) was an independent risk factor. The AUC value of ROC curve for LP-PL-A diagnosis of OPBR with cholesterolosis was 0.7592, with 95%CI: 0.616 ~ 0.902, specificity: 96.15% and sensitivity: 57.14% ( p = 0.0025). Conclusion LP-PL-A2 is an independent risk factor for OPBR complicated with cholesterolosis, showing a certain clinical value for the diagnosis of OPBR with cholesterolosis. Inhibiting the expression and secretion of LP-PL-A2 by using drugs to inhibit inflammatory cells or reduce the activity of LP-PL-A2 should be a viable option to block the development and progression of cholesterolosis in OPBR patients so as to protect the gallbladder function and slow down the progression of gallbladder diseases.