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

Jingting Lyu; Qinghong Lin; Zhongbiao Fang; Zeling Xu; Zhengtao Liu

doi:10.3389/fendo.2022.1032557

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

Front Endocrinol (Lausanne). 2022 Nov 23:13:1032557. doi: 10.3389/fendo.2022.1032557. eCollection 2022.

Authors

Jingting Lyu¹, Qinghong Lin¹, Zhongbiao Fang¹, Zeling Xu¹, Zhengtao Liu^{1

2

3

4}

Affiliations

¹ Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China.
² NHC Key Laboratory of Combined Multi-Organ Transplantation, Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, CAMS, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
³ Key Laboratory of Organ Transplantation, Zhejiang Province, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
⁴ Shulan (Hangzhou) Hospital, Hangzhou, China.

Abstract

Background: Patients 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.

Methods: We 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).

Results: Seven 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).

Conclusion: Our 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.

Keywords: cholecystectomy; gallstone disease; insulin resistance; meta-analysis; metabolic syndrome; nonalcoholic fatty liver disease.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Body Mass Index
Gallstones* / complications
Gallstones* / epidemiology
Gallstones* / surgery
Humans
Metabolic Syndrome* / complications
Metabolic Syndrome* / epidemiology
Non-alcoholic Fatty Liver Disease* / complications
Non-alcoholic Fatty Liver Disease* / epidemiology
Risk Factors