Impaired Gallbladder Motility and Increased Gallbladder Wall Thickness in Patients with Nonalcoholic Fatty Liver Disease

Abstract

Background/AimsNonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease worldwide. Along with the increase in the incidence of NAFLD and associated obesity, an increase in gallbladder disease (GD) has been noted. This has led to the identification of a new disease entity called fatty GD. There is a gap in the literature on the dynamics of gallbladder function in patients with NAFLD. MethodsAn observational case-control study, a total of 50 patients with biopsy proven NAFLD without gallbladder stone/sludge and 38 healthy comparison subjects were enrolled. Fasting, postprandial gallbladder volumes (PGV), gallbladder ejection fraction (GEF), and fasting gallbladder wall thickness (FGWT) were measured by real-time 2-dimensional ultrasonography. ResultsFasting gallbladder wall thickness, fasting gallbladder volumes and PGV were significantly higher in patients with NAFLD than control subjects (P < 0.001, P = 0.006, and P < 0.001, respectively). Gallbladder ejection fraction was significantly lower in the NAFLD group than the controls (P = 0.008). The presence of NAFLD was an independent predictor for GEF, PGV, and FGWT. Also, steatosis grade was an independent predictor for GEF, and GEF was significantly lower in the nonalcoholic steatohepatitis (NASH) subgroup than the controls. ConclusionsGallbladder dysfunction and increase in gallbladder wall thickness exists in asymptomatic (without stone/sludge and related symptoms) patients with NAFLD and are useful in identifying fatty GD. Measurement of these variables in NAFLD patients may be useful in identifying those at higher risk for GD.

Hepatit B’ye Bağlı Kronik Karaciğer Hastalığında Safra Kesesi Motilitesinin Değerlendirilmesi

“…Ortalama ve maksimum SKEF'ları arasında istatistiksel anlamlı olmadığı gösterilmişti. SKEF' nun zamana göre değişimi incelendiğinde 30, 35, 40.dakikalarda aynı zaman dilimindeki kontrollere göre anlamlı bir fark olmadığı 45 ve 50.dakikalarda ise SKEF'nun aynı zaman dilimindeki kontrollere göre anlamlı yüksek olduğu tesbit edildi 11 . Bu durum sirotik hastalarda safra kesesi gevşeme fonksiyonu ve safra kesesi refillinginin yavaşladığı ve kasılma evresinin uzadığı şeklinde değerlendirildi.…”

“…Çolak Y. ve ark. 'larının NAFLD'lı hastalarda yaptığı çalışmada da benzer şekilde safra kesesi duvar kalınlığında artma, safra kesesi motilitesinde bozulma olduğu gösterildi 11 . Safra kesesi hipomotilitesi ve duvar kalınlık artışında portal hipertansiyon sonucu oluşan hipoalbuminemi ve venöz konjesyon nedeniyle oluşan submukozal ödem ve yapısal değişiklikler de önemli rol oynar.…”

Compartmental model to estimate bile acid concentration in different clinical manifestation

“…The previously developed compartment model explained the essence of gallbladder filling and evacuation in various instances such as food composition, age, and weight of the patient (14) . Supporting the study, we designed the three-compartment model of enterohepatic circulation of bile to better understand the varying concentration of bile acid leading to specific clinical manifestation with the clinical data available (15) . Here in this study, the altered rate constant and pathological state of the intestine and gallbladder is considered to better understand the bile acid concentration in different compartments (16) .…”

Hepatoprotective properties of glycyrrhizic acid

“…Считается, что в основе данной коморбидности лежит системное воспаление, инсулинорезистентность, атерогенная дислипидемия и дисрегуляция ренин-ангиотензиновой системы, усугубляющие макрососудистые осложнения стойкой гипиргликемии [4,[12][13][14].…”