Far from noisy cities, in the heart of Siberia, scientists have discovered unique metabolic features that change our understanding of biliary tract diseases.
Imagine a world where traditional lifestyle and nutrition form a unique body biochemistry that protects against diseases considered common in modern society. Researchers encountered precisely this phenomenon while studying the indigenous rural population of the Republic of Tuva.
The biliary tract is a complex transport system in our body, on which normal digestion and metabolism depend. When problems arise in this system, the entire body suffers.
Of particular interest to science are serum and bile lipids - complex fat molecules that play a key role in the development of biliary system diseases.
Research on lipid metabolism in indigenous residents of Tuva is not just a regional scientific interest, but an opportunity to understand the fundamental mechanisms of biliary tract diseases under minimal urbanization influence.
Indigenous residents with traditional lifestyle
Limited impact on nutrition and lifestyle
Unmasked by urbanization consequences
Scientists have established that lipid metabolism plays a key role in the pathogenesis of biliary diseases in Tuva residents, and their dietary and lifestyle characteristics impose a specific imprint on these processes 2 .
Complex of fats and fat-like substances circulating in the bloodstream:
Complex of substances secreted by the liver and part of bile composition:
The basis for gallstone disease development is disruption of bile colloidal system stability. This occurs when cholesterol secretion into bile increases, bile acid synthesis decreases, phospholipid content reduces, or a combination of these factors occurs 3 .
To uncover the mystery of the relationship between blood and bile lipids in biliary tract diseases, scientists conducted a large-scale study in the village of Cha-Khol, Republic of Tuva.
The study covered 82% of the village population, ensuring data representativeness. Such high coverage in hard-to-reach rural regions is a rarity and special value of this scientific work 2 .
Conducted on 50% random sample (572 people)
Performed on 25% random sample (265 patients)
Conducted on 144 patients for comprehensive lipid profiling
To obtain bile, duodenal intubation was used - a procedure allowing collection of both hepatic and cystic bile portions. This enabled assessment of lipid composition at different levels of the biliary system.
| Study Group | Participants | Studies |
|---|---|---|
| General population coverage | 82% of village population | Clinical-epidemiological examination |
| Ultrasound examination | 572 people | Abdominal ultrasound |
| Blood biochemistry | 265 patients | Total cholesterol, triglycerides, HDL cholesterol |
| Bile analysis | 144 patients | Cholesterol, phospholipids, bile acids in duodenal bile |
Analysis of the obtained data revealed intriguing patterns that shed new light on the mechanisms of biliary pathology development.
Researchers discovered that total cholesterol content in serum was higher in cholelithiasis than in people with hypermotor gallbladder function. This indicates a direct connection between blood cholesterol levels and gallstone formation 2 .
Cholelithiasis patients: 65% higher cholesterol levels
Hypermotor function: 35% higher cholesterol levels
The most interesting discovery was the identification of direct correlation between total cholesterol concentration in serum and its content in bile. Correlation coefficients were statistically significant:
Bile saturation index is a calculated indicator reflecting bile's ability to keep cholesterol in dissolved state. When this index exceeds critical value, bile becomes supersaturated, and cholesterol begins to precipitate.
The discovered correlation between blood cholesterol levels and bile saturation index indicates a unified metabolic process regulating cholesterol content in both biological environments.
| Blood Parameter | Bile Parameter | Correlation (r) |
|---|---|---|
| Total cholesterol | Cholesterol in hepatic bile | 0.47* |
| Total cholesterol | Saturation index (hepatic) | 0.40* |
| Total cholesterol | Cholesterol in cystic bile | 0.51* |
| Total cholesterol | Saturation index (cystic) | 0.53** |
* p<0.05, ** p<0.01
Comparative analysis of Tuva data with research results from other regions revealed interesting patterns. It turned out that indigenous residents of northern and Siberian regions have specific features of lipid metabolism.
Studies conducted among Evenkia peoples showed that prevalence of biliary tract diseases differs between indigenous and non-indigenous residents, despite living in the same area. This indicates the role of genetic factors in lipid metabolism regulation 3 .
The effect of biliary pathology risk factors (female gender, age 50-59) on bile and blood lipid composition is more pronounced in non-indigenous residents than in indigenous population 3 .
Indigenous residents of Tuva and Evenkia maintain a traditional lifestyle including:
All this forms a special metabolic profile affecting lipid composition of blood and bile.
| Parameter | Indigenous Tuva Population | Non-Indigenous Population |
|---|---|---|
| Impact of risk factors (gender, age) | Less pronounced | More pronounced |
| Impact of social factors | More significant | Less significant |
| Biliary pathology prevalence | Specific profile | Higher |
| Sensitivity to lifestyle changes | High | Moderate |
This suggests the presence of certain protective mechanisms in indigenous peoples that may be lost when transitioning to urbanized lifestyle.
Results of studies on serum and bile lipids in indigenous population of Tuva have not only theoretical but also important practical significance.
The identified features require differentiated approach to diagnosis, treatment and prevention of biliary pathology in northern population. Standard schemes may be ineffective for indigenous residents with their specific metabolism 3 .
Based on the obtained data, methodological recommendations "Determination and correction of bile lipid composition in biliary tract diseases" have been developed and implemented in district hospitals of Evenkia and several hospitals in Krasnoyarsk 3 .
The study demonstrates the negative impact of changing traditional lifestyle on bile acid composition and lipids of bile and serum in indigenous peoples. This indicates the need for coordinated approach to socio-economic development and health preservation of indigenous population 3 .
Study of serum and bile lipids in biliary tract diseases in indigenous rural population of Tuva opens new horizons in understanding the mechanisms of biliary pathology development.
The discovered direct correlation between total cholesterol content in serum and its content in bile emphasizes the role of lipid metabolism in pathogenesis of biliary tract diseases in Tuva residents 2 . Further research in this direction will allow development of more effective methods for prevention and treatment of biliary tract diseases considering ethnic and geographical features of lipid metabolism.