Risk Factors for Cholesterol Polyp Formation In The Gallbladder - Closely Related to Lipid Metabolism

Abstract

Objective The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder. Method This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients receiving cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with diagnosis of pathologically confirmed cholesterol polyps larger than 10mm. Population characteristics and medical data were collected within 24 hours of admission before surgery. The non-polyp group included participants from hospital physical examination center database. They had at least two ultrasound examinations with the interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups. Results A total of 4 714 participants were recruited, including 376 cholesterol polyp patients and 4 338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyp were age, male gender, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), higher aspartate aminotransferase (AST), and alanine aminotransferase (ALT). In multivariate logistic analysis, independent risk factors were age>50 years (OR=3.41, 95% CI 2.61-4.47, p<0.001), LDL>2.89mmol/L (OR=1.45, 95% CI 1.13-1.87, p=0.003), AST>40IU/L (OR=3.58, 95% CI 2.03-6.31, p<0.001) and BMI>25kg/m² (OR=1.62, 95% CI 1.23-2.13, p<0.001). Conclusion Age, LDL, AST and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk of cholesterol polyps.

Risk factors for cholesterol polyps in the gallbladder: a multicenter retrospective case-control study

“…This study identi ed decreased HDL signi cantly related to CPs formation, consistent with the survey of Zheng et al, whereas our ndings showed no direct association between CPs and LDL on multivariate analysis despite LDL being associated with CPs on univariate analysis [14]. HDL plays a vital role in accepting cholesterol from cells and promotes reverse cholesterol transportation (RCT), which is essential for maintaining cholesterol metabolism balance in gallbladders [28].…”

“…Our ndings showed that there was no direct association between CPs and obesity. Abnormal liver function is now discovered as a factor correlated to the development of CPs [14]. Although the speci c mechanisms were unknown, the elevation of AST was supposed as a representation of liver damage due to lipid disorder or high metabolism and may indirectly or directly contribute to CPs formation [32].…”

“…Concerning increased body weight, several studies which set non-polyp subjects as the control group found this to be associated with GPs [14,37,38]. Interestingly, the positive relationship was hardly reported in other studies which compared CPs with neoplastic polyps as controls [12,19,39].…”

“…Given that risk factors and the mechanisms of pathophysiologic mechanisms are quite different in various GPs, pathology-oriented analysis is undoubtedly more convincing [12]. However, so far, there is a paucity of data from high-level studies lucubrating CPs [13,14]. Therefore, it is of great value to explore CPs from the perspective of postoperative pathology based on a large sample size.…”

Loosening of Access Threshold and Downturns in Listed Firms Performance: A Quasi‐Natural Experiment from the “IPO Green Channel” for Poverty Alleviation

“…e law of securities market for many years shows that a large number of companies have deteriorated performance before IPO issuance and during a financial period after IPO listing, which is manifested as a precipitous decline in ROA and ROE [20][21][22]. And this phenomenon is called "performance change" by secondary market participants.…”