The association between gallstone disease and plaque in the abdominopelvic arteries

Abstract

Background:The aim of this study was to assess the atheromatous plaque, in the abdominopelvic arteries as a marker of cardiac risk in patients with or without gallstone disease (GD).Materials and Methods:A total of 136 patients were enrolled in this cross-sectional study. Forty-eight patients had GD and the remaining 88 patients did not. The presence or absence of gallstones was noted during abdominal ultrasonography while vascular risk factors such as plaque formation, intima-media thickness, plaque calcification, mural thrombus, stenosis, aneurysm, and inflammation were recorded during an abdominopelvic computed tomography scan. In addition, percentage of the abdominopelvic aorta surface covered by atheromatous plaque was calculated.Results:The mean age of patients with GD and without GD was 50.81 ± 16.20 and 50.40 ± 12.43, respectively. Patients with GD were more likely to have diabetes mellitus, a higher body mass index (BMI) (P < 0.001), and higher cholesterol (P < 0.01), and low-density lipoprotein-cholesterol (P < 0.02) levels. No significant differences were found between the groups regarding other atherosclerotic risk factors. Patients with GD had significantly higher rates of the vascular risk factors as intima-media thickness, plaque formation, calcification, aneurysm, mural thrombosis, stenosis, and inflammation in all abdominal arterial segments other than aneurysm in the femoral arteries. In addition, patients with GD had severe atheromatous plaques in the abdominal aorta, common iliac, external iliac, and common femoral artery (CFA). In patients with GD, parameters of age, BMI, and systolic and diastolic blood pressure were all correlated with the severity of the atheromatous plaque in abdominal aorta, common iliac, external iliac, and CFA.Conclusion:We demonstrated a direct relationship between GD and abdominopelvic atheromatous plaque, which is a marker for increased cardiovascular risk, for the first time in the literature. Patients with GD exhibit greater abdominopelvic atherosclerosis and therefore, have a higher risk of cardiovascular disease.

The relation between gallstone disease and cardiovascular disease

“…The association between GD and CVD may due to a shared metabolic pathway involving cholesterol and other pathophysiological features. Low HDL level is known to increase risk of CVD morbidity and mortality 32 and has been shown to play a role in the development of GD 33 . One study suggests that insulin-like growth factor one (IGF-1) is involved in gallbladder emptying and may have an anti-atherosclerotic effect, which suggests that low plasma levels of IGF-1 may result in both GD and CHD 34 .…”

“…The explanation for this phenomenon is unknown, but we speculate that it may be related to the following factors. Low HDL levels contribute to the development of GD 33 and CVD, peak total cholesterol levels occur later in men than in women, and HDL levels decrease in postmenopausal women. Diabetes increases the risk of GD 43 and death from CHD 44 , and the incidence of diabetes in women is higher than in men.…”

Risk Factors of Cholelithiasis: A Literature Review

“…In contrast, high HDL serum was found not to contribute to the formation of gallstones. Another study conducted by Serin et al (2017) showed that low HDL levels are known to play a role in the formation of gallstones [35]. Studies in China have also shown that TC, TG, and LDL levels are risk factors for gallstones, while HDL is a protective factor [36].…”

Risk of aortic dissection or aneurysm in patients with gallstone disease: a retrospective cohort study in Taiwan

“…The possible pathogenic mechanisms for AD/AN is similar to that of CVD, such as inflammation, degradation of extracellular matrix and apoptosis of vascular smooth muscle cell. 21–23 GD has been shown positively related to abdominopelvic atherosclerosis, 24 and it can be found in 5%–20% of patients with an abdominal aortic aneurysm. 25 In an old study, gallstones were detected in 42 of 865 patients (4.9%) with abdominal AN.…”