Association of circulating vitamin E (α- and γ-Tocopherol) levels with gallstone disease

Established risk factors for developing gallstones include being female, overweight or obese, older, and having dyslipidemia. Oxidative stress is also thought to play a role in the pathophysiology, with higher markers of oxidative stress detected in the gallbladder mucosa and in the circulation of patients with gallstone disease. Considering that vitamin E is a lipid-soluble antioxidant, researchers are beginning to explore whether there is an association between vitamin E status and the risk of gallstone disease. 

Methods

A study published in 2018 in the journal Nutrients evaluated vitamin E status and the presence of gallstone disease in a cross-sectional, community-based sample. The study population included 582 adults (median age = 62 years; 38.5% women). Circulating alpha-tocopherol and gamma-tocopherol concentrations were measured as indications of vitamin E status. Gallstone disease was defined as gallbladder stones visualized on ultrasound examination.

practitioner examining a patient
Risk factors for developing gallstones include being female, overweight or obese, older, and having dyslipidemia.

Results

Of the 582 participants, 46 (7.9%) had gallstones detected on ultrasound. Participants with gallstones were older and had lower circulating alpha-tocopherol and gamma-tocopherol to cholesterol ratios compared with participants without gallstones. When compared with the lowest tertile of alpha-tocopherol/cholesterol ratio as the reference group, those in the highest tertile of alpha-tocopherol/cholesterol ratio had a significantly lower risk of gallstone disease (adjusted OR=0.31; 95% CI, 0.13-0.76).

Conclusions

The cross-sectional design of this study precludes any claims of causality. It is possible that lower vitamin E status increases oxidative stress and therefore increases the risk of gallstone disease. It is also possible, however, that cholestatic conditions impair vitamin E absorption and contribute to vitamin insufficiency. Further research is needed to fully understand the interactions between vitamin E and gallstone disease.

Waniek, S., di Giuseppe, R., Esatbeyoglu, T., Ratjen, I., Enderle, J., Jacobs, G., … Lieb, W. (2018). Association of circulating vitamin E (α- and γ-Tocopherol) levels with gallstone disease. Nutrients, 10(2).