An Inverse Association of Weight and the Occurrence of Asymptomatic Gallbladder Stone Disease in Hypercholesterolemia Patients: A Case-control Study

Abstract

Background: Despite the fact that the majority of gallstones formed in the gallbladder are mainly composed of cholesterol, as they are formed from cholesterol-supersaturated bile, and hypercholesterolemia is a common metabolic disorder, which is closely related to cardiac, hepatic, renal and other oxidative damage inflammation and necrosis, there is still no consensus regarding the contribution of blood serum lipids in the pathogenesis of gallbladder stone disease (GSD). This study aimed to investigate the relationship between hypercholesterolemia and the risk of new-onset asymptomatic GSD, and to determine the prevalence of factors associated with new-onset asymptomatic GSD in patients with hypercholesterolemia. Methods: In this study, 927 Chinese patients with new-onset asymptomatic gallstone disease and 845 healthy controls were enrolled starting from August 2012. Patients were matched for age, gender, race, occupation, systolic blood pressure, diastolic blood pressure, and fasting blood glucose levels (FBG). Body mass index (BMI), nonalcoholic fatty liver disease (NAFLD) and serum lipids indexes were compared and the relationships between BMI, blood lipid and gallbladder stone hazards were examined by logistic multivariate regression models. Results: The result showed a significantly higher morbidity with GSD in hypercholesterolemia than non-hypercholesterolemia patients (Χ2=17.211, P<0.001). Of hypercholesterolemia patients, low density lipoprotein (OR=1.493, P=0.029) and NAFLD (OR=2.723, P=0.022) were significant risk factors for GSD, while being male (OR=0.244, P=0.033), weight (OR=0.961, P=0.022), high density lipoprotein (OR=0.305, P<0.001), and FBG (OR=0.687, P=0.034) were significantly negatively correlated with GSD in univariate analysis. Multivariate logistic regression indicated weakly positive correlations with NAFLD (OR=3.284, P=0.054), and significant negative correlations with weight (OR=0.930, P=0.018), HDL-c (OR=0.144, P<0.001), and GSD. Conclusion: Hypercholesterolemia acts as an independent risk factor for new-onset asymptomatic GSD, while obesity and NAFLD are synergistic factors. Interestingly, it is first reported that elevated weight was inversely associated with GSD in patients with hypercholesterolemia. The results of this study suggest that effective control of hyperlipidemia is of greater significance than weight loss, which might make the situation worse, in the prevention of GSD in obese patients with hyperlipidemia.

Elevated serum triglyceride levels may be a key independent predicting factor for gallbladder cancer risk in gallbladder stone disease patients: a case–control study

“…Then 3808 individuals who had undergone health check-ups annually in the same healthcare center were performed a complete clinical and analytical evaluation (including any item following), and choose the newest ones were chosen. Finally, 2210 patients and 2210 health controls aged 30 to 80 years, were chosen after excluding those who: 1) consumed more than 20 g/ day of alcohol during the past 12 months (for both men and women) by the diagnostic standard of nonalcoholic fatty liver and the characteristics of Chinese men's drinking habits [12]; 2) BMI < 18.5 kg/m 2 ; 3) any missing data including age, gender, height, weight, systolic pressure (SBP), diastolic pressure (DBP), serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-c), high density lipoprotein (HDL-c), fasting insulin, fasting blood glucose (FBG), retinol binding protein (RBP), or ultrasonographic examination for gallbladder stones and NAFLD; 4) matching failure in any of the following item: age, ethnicity, occupation, and drinking. In additional, we conducted this study in accordance with the Institutional Trial registration: The study may be performed in accordance with the ethical standards provided by the responsible committee of our institution (First Affiliated Hospital of Xi'an Jiaotong University.…”

“…The liver, gallbladder, pancreas and spleen were sequentially examined. GSD and NAFLD were diagnosed as previously reported [12].…”

Elevated Serum Triglyceride Levels May be a Key Independent Predicting Factor for Gallbladder Cancer Risk in Gallbladder Stone Disease Patients: a Case-control Study

“…The liver, gallbladder, pancreas and spleen were sequentially examined. GSD and NAFLD were diagnosed as previously reported (12). Determination of diabetes, hypertension, hypertriglyceridemia and insulin resistance Diabetes diagnosis was completed by a professional endocrinologist according to the latest China diagnostic criteria: for example, the newest diabetes patients were diagnosed by Guideline for prevention and treatment of type 2 diabetes mellitus in China 2020 (13).…”

Low-density lipoprotein cholesterol is an independent risk factor associated with asymptomatic gallbladder stone disease in non-alcoholic fatty liver disease patients in northwest China: a case-control study

“…A Color Doppler ultrasonic instrument (Toshiba, SSA-510A, Japan) was used to evaluate the liver, gallbladder, pancreas, and spleen of patients in the supine position following overnight fasting. GSD and NAFLD were diagnosed as per our previous report [11]. Brie y, NAFLD was de ned by the presence of a minimum of two abnormal liver ndings including diffuse hepatic echogenicity, hepatic echogenicity greater than that of the kidneys, and either hepatic ultrasound signal attenuation with an indistinct diaphragm, or less visible echogenic portal vein walls [12].…”

“…Patient weight and height were measured using a scale from our prior study. BMI was measured as weight (kg) multiplied by height squared (m 2 ) [11]. Patients were grouped by BMI as per expert consensus regarding medical nutrition therapy for overweight/obesity in China [13], with patients being classi ed as normal, overweight, and obese based on BMI values of <23.9 kg/m 2 , 24-27.9 kg/m 2 , and ≥28 kg/m 2 , respectively.…”