Cojocaru Clementina, Pandele G I
Disciplina de Semiologie Medicală, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi.
Rev Med Chir Soc Med Nat Iasi. 2010 Jul-Sep;114(3):677-82.
Metabolic syndrome is a clustering of cardiovascular risk factors as well as associated co morbidities, including cholesterol gallstones disease.The aim of our study is to prove the association between metabolic syndrome and cholesterol gallstones, to identify the main risk factors for this association and to trace the particularities of the metabolic syndrome in such patients.
Our cohort study enrolled 449 subjects, 312 patients diagnosed with metabolic syndrome and gallstones or cholecystectomy (group 1) and 137 patients diagnosed only with metabolic syndrome (group 2), hospitalized in the Respiratory Rehabilitation Medical Clinic between 2007-2009.
85.25% of the patients with metabolic syndrome and cholesterol gallstones and 79.92% of the patients with metabolic syndrome alone had a body mass index (BMI) > or = 25 Kg/m2. Univariate and multivariate logistic regression were used to calculate the risk of gallstone disease associated with different metabolic syndrome variables. Waist circumference, BMI, fasting glycemia, insulinemia and insulin resistance index (HOMA-IR) registered statistical significant differences between the two study groups and were significantly associated with a higher risk of cholesterol gallstone as well as were blood pressure values > or = 130/85 mmHg. The presence of 4 or 5 components of the metabolic syndrome increased the risk of gallstone disease by 3 times (OR = 3.3, p < 0.001) compared to a 2 times higher risk (OR = 2.1, p = 0.02) in case of increased insulin resistance; there was no statistical significance for any of the lipid parameters.
In our study, cholesterol gallstones appeared strongly associated with anthropometric measurements, fasting glycemia and insulin resistance index, as well as with the presence of metabolic syndrome as defined by the new clinical definition, despite the negative results for the lipidic components. These findings are consistent with the hypothesis that insulin resistance plays an important role in the pathogenesis and that cholesterol gallstone disease belong to metabolic syndrome.
代谢综合征是心血管危险因素以及相关合并症的聚集，包括胆固醇胆结石病。我们研究的目的是证明代谢综合征与胆固醇胆结石之间的关联，确定这种关联的主要危险因素，并追踪此类患者代谢综合征的特点。
我们的队列研究纳入了449名受试者，其中312名被诊断为代谢综合征合并胆结石或已行胆囊切除术的患者（第1组）和137名仅被诊断为代谢综合征的患者（第2组），这些患者于2007年至2009年期间在呼吸康复医疗诊所住院。
患有代谢综合征和胆固醇胆结石的患者中85.25%以及仅患有代谢综合征的患者中79.92%的体重指数（BMI）≥25 Kg/m²。采用单因素和多因素逻辑回归来计算与不同代谢综合征变量相关的胆结石病风险。腰围、BMI、空腹血糖、胰岛素血症和胰岛素抵抗指数（HOMA-IR）在两个研究组之间存在统计学显著差异，并且与胆固醇胆结石风险较高显著相关，血压值≥130/85 mmHg时也是如此。与胰岛素抵抗增加时风险升高2倍（OR = 2.1，p = 0.02）相比，代谢综合征4项或5项组分的存在使胆结石病风险增加3倍（OR = 3.3，p < 0.001）；任何脂质参数均无统计学意义。
在我们的研究中，尽管脂质组分结果为阴性，但胆固醇胆结石似乎与人体测量指标、空腹血糖和胰岛素抵抗指数以及新临床定义所定义的代谢综合征的存在密切相关。这些发现与胰岛素抵抗在发病机制中起重要作用以及胆固醇胆结石病属于代谢综合征这一假设一致。
