Serum Lipid Abnormalities in Pre-malignant and Malignant Lesions of the Gall Bladder

Background: Gallbladder pathology encompasses a spectrum from benign inflammation to aggressive malignancies, with gallbladder cancer (GBC) being one of the most lethal gastrointestinal cancers. Emerging evidence suggests that metabolic dysregulation, particularly lipid abnormalities, may drive carcinogenesis. However, the relationship between serum lipid profiles and gallbladder lesion progression remains poorly characterized. Objective: This study aimed to investigate serum lipid abnormalities across benign (n = 48), premalignant (n = 11), and malignant (n = 12) gallbladder lesions to identify potential metabolic biomarkers for early detection and risk stratification. Methods: A cross-sectional study was conducted on 71 cholecystectomy specimens (benign, premalignant, malignant) from April 2023 to March 2025. Histopathological evaluation categorized lesions, while fasting serum lipid profiles (total cholesterol, triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very-low-density lipoprotein (VLDL)) were analyzed using automated biochemical assays. Statistical analysis included ANOVA and Pearson correlation tests, with significance at p < 0.05. Results: The cohort (mean age: 48.7 ± 14.1 years) showed female predominance (77.5%). Malignant lesions presented at older ages (mean: 55.1 years) and exhibited significant hypertriglyceridemia (301.75 ± 85.69 mg/dL; p = 0.014) and elevated VLDL (54.82 ± 22.74 mg/dL; p = 0.052) compared to benign/premalignant groups. HDL was the lowest in malignancies (37.00 ± 9.05 mg/dL). Conclusion: Progressive lipid derangements - particularly hypertriglyceridemia, elevated VLDL, and reduced HDL - are associated with malignant transformation in gallbladder lesions. Serum lipid profiling may serve as a non-invasive tool for risk stratification and early detection. These findings highlight the potential for metabolic interventions in high-risk populations, though further longitudinal studies are needed to establish causality and therapeutic implications.