Complex impacts of gallstone disease on metabolic syndrome and nonalcoholic fatty liver disease

Abstract

BackgroundPatients with gallstone disease (GSD) often have highly co-occurrence with metabolic syndrome (MetS) and Nonalcoholic fatty liver disease (NAFLD) both associated with insulin resistance (IR). Meanwhile, highly prevalence of NAFLD was found in patients who received cholecystectomy. However, the associations of GSD with MetS, NAFLD is inconsistent in the published literature. And risk of cholecystectomy on NAFLD is unclear.MethodsWe searched the Medline EMBASE and WOS databases for literature that met our study topic. To be specific, studies with focus on associations between GSD and MetS/NAFLD, and risk evaluation on cholecystectomy and NAFLD incidence were enrolled for further analysis. The random effect model was used to calculate the combined relative ratio (RR) and odds ratio (OR)and 95% confidence interval (CI).ResultsSeven and six papers with focus on connections between GSD and NAFLD/MetS prevalence. Correspondingly, seven papers with focus on risk of cholecystectomy on NAFLD occurrence were also enrolled into meta-analysis. After pooling the results from individual study, patients with GSD had higher risk of MetS (OR:1.45, 95%CI: 1.23-1.67, I2 = 41.1%, P=0.165). Risk of GSD was increased by 52% in NAFLD patients (pooled OR:1.52, 95%CI:1.24-1.80). And about 32% of increment on NAFLD prevalence was observed in patients with GSD (pooled OR: 1.32, 95%CI:1.14-1.50). With regard to individual MetS components, patients with higher systolic blood pressure were more prone to develop GSD, with combined SMD of 0.29 (96%CI: 0.24-0.34, P<0.05). Dose-response analysis found the GSD incidence was significantly associated with increased body mass index (BMI) (pooled OR: 1.02, 95%CI:1.01-1.03) in linear trends. Patients who received cholecystectomy had a higher risk of post-operative NAFLD (OR:2.14, 95%CI: 1.43-2.85), P<0.05). And this impact was amplified in obese patients (OR: 2.51, 95%CI: 1.95-3.06, P<0.05).ConclusionOur results confirmed that controls on weight and blood pressure might be candidate therapeutic strategy for GSD prevention. And concerns should be raised on de-novo NAFLD after cholecystectomy.

Association between cholelithiasis and frailty index in US adults: a population-based epidemiological study

“…With the aging of population and the change in dietary pattern, the incidence of this disorder is gradually increasing. The link between obesity, metabolic syndrome, and cholelithiasis in adults is well-established [36,37]. Agerelated changes in gastrointestinal motility, which are part of the frailty syndrome, can impact bile ow and gallbladder emptying, potentially leading to stone retention.…”

Cholecystohepatic shunt pathway reduces secondary bile acid accumulation to enhance natural killer T cell‐mediated anti‐hepatocellular carcinoma immunity

“…Many individuals who underwent cholecystectomy often presented with a combination of metabolic syndrome issues such as fatty liver, hyperlipidemia, and hyperglycemia, and these metabolic issues were closely related to the development of HCC. 23 Therefore, future studies investigating the relationship between cholecystectomy and liver cancer risk should aim to exclude the influence of these issues on the results.…”

A Machine Learning-Based Method for Detecting Liver Fibrosis

“…They consider medical follow-up necessary after surgery to monitor liver function and prevent long-term complications. Lyu et al [ 75 ] in their systematic review mentioned as a main conclusion that cholecystectomy should be taken into account as a potential risk factor for developing de-novo NAFLD.…”