Association between metabolically healthy overweight/obesity and gallstones in Chinese adults

Abstract

Background Metabolic syndrome and obesity are risk factors for gallstones. However, these two factors often occur together, and few studies have focused on the association between metabolically healthy overweight/obesity (MHOW/MHO) and gallstones. We hypothesized that MHO individuals would be associated with the prevalence of gallstones. Methods This cross-sectional study included 125,668 participants aged 18–80 years at the Health Promotion Center of Run Run Run Shaw Hospital, Zhejiang University School of Medicine during 2017–2019 years. Each participant underwent a comprehensive health checkup. Gallstones were diagnosed by abdominal ultrasonography. Metabolically health was defined as not meeting the diagnostic criteria for metabolic syndrome (MetS). Obesity was measured by BMI. MetS and weight stratification were combined to classify the metabolism-obesity phenotypes. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% CIs. Results Among 125,668 participants, 5486 (4.4%) had gallstones. 21407 (17.0%) were MHOW individuals, and 3322 (2.6%) were MHO individuals. MHOW (OR 1.40; 95%CI: 1.29–1.53) and MHO (OR 1.80; 95%CI: 1.53–2.12) participants were at higher risk of gallstones and had larger and more numerous gallstones than metabolically healthy normal weight participants. Obesity, MetS, premenopausal women and advanced age were significantly associated with the prevalence of gallstones. Conclusions MHOW/MHO individuals exhibited a higher risk of gallstones. In metabolically healthy individuals, the risk of gallstones increased with increasing BMI. Thus, obesity was associated with the prevalence of gallstones, even in relatively metabolically healthy adults.

Dyslipidemia, Cholangitis and Fatty Liver Disease: The Close Underexplored Relationship: A Narrative Review

“…From this assumption, therefore, a theory has emerged that cholestatic disease with a consequent increase in serum ALP could theoretically protect against a chronic condition that is affected by the accumulation of endotoxins, such as MASLD. The only study dedicated to the pathogenetic correlation between MASLD and PBC is the one by Iluz-Freundlich and colleagues mentioned earlier, which did not establish any causal link between the two examined conditions [6]; some commonalities in gut microbiota alterations in MASLD and PBC are described in the current literature, with changes in the Bacteroidetes to Firmicutes ratio, but this evidence is also found in many other hepatic conditions [66] and, therefore, it is not possible to express a definite opinion on how MASLD and PBC interact and influence each other [67]. A better understanding of this interaction could be developed based on studies describing treatment efficacy.…”

Obesity, dyslipidemia, and diabetes mellitus as risk factors in cholelithiasis

“…The mean BMI for male and female were similar, accounting 25.17 kg/m² for men and 25.80 kg/m² for female. This study was compared to a study conducted in China that participants with gallstones had a higher prevalence of metabolic syndromes (gallstones: 46.3% vs. no gallstones: 30.7%) and higher BMI (gallstones: 24.70 kg/m 2 vs. no gallstones: 23.70 kg/m 2 ) [17].…”

“…Obesity is known to increase the secretion of intra-hepatic cholesterol, which contributes to formation of gallstone [17,18]. Also, body fat distribution was observed to play a role in gallstone formation [18].…”

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