Clinical Correlation of Systemic Iron Status and Quantitative Biochemical Composition of Gallstones: A Cross-Sectional Study in Northern India

Background: Cholelithiasis is a major global health concern, with emerging evidence suggesting that iron deficiency may modulate biliary cholesterol saturation and gallbladder motility. This study investigates the overlap between systemic iron status and gallstone composition in a North Indian population. Methods: This cross-sectional study evaluated 60 patients (45 females, 15 males) undergoing cholecystectomy at a tertiary hospital in Amritsar. Systemic iron status was assessed via haemoglobin (Hb), serum iron, and ferritin. Surgically retrieved stones underwent quantitative chemical analysis for cholesterol, bilirubin, and calcium using FTIR spectroscopy. Data were analysed using Python, employing Kruskal-Wallis tests and Spearman’s rank correlation. Results: Anaemia was highly prevalent, affecting 100% of male and 88.9% of female participants. Cholesterol stones were the most frequent morphology (females: 51.1%; males: 60.0%). Quantitative analysis showed cholesterol stones were dominant in cholesterol (137.68±28.41 mg/dL), while pigmented stones had significantly higher bilirubin (5.25±0.55 mg/dL) and calcium (13.41±3.46 mg/dL). A statistically significant positive correlation was identified between haemoglobin levels and stone calcium content (ρ=0.36, p=0.004). However, serum iron and ferritin did not significantly correlate with stone types or primary chemical constituents. Conclusion: Although iron deficiency is highly prevalent in patients with cholelithiasis, systemic iron markers are not independent predictors of gallstone chemical subtypes. The significant association between haemoglobin and calcium content suggests a role for haematological parameters in biliary mineralization, necessitating further longitudinal research into the biochemical mechanisms of stone nucleation.