Am J Gastroenterol. 2013 Jun;108(6):959-61. doi: 10.1038/ajg.2013.84.
Pathogenesis of nonalcoholic fatty liver (NAFLD) disease and gallbladder (GB) disease secondary to cholesterol gallstones is complex, yet both conditions share similar associated risk factors, most of them related to the metabolic syndrome. Cholecystectomy, the best treatment for GB disease, is one of the most performed abdominal surgeries worldwide. In this issue of the American Journal of Gastroenterology, Ruhl and Everhart, using data from the Third United States National Health and Nutrition Examination Survey (1988-1994), show that NAFLD is associated with cholecystectomy (odds ratio (OR)=2.4; 1.8-3.3), but not with gallstones (OR=1.1; 0.84-1.4). This finding suggests that cholecystectomy may itself represent a risk factor for NAFLD, which is in line with the recently undisclosed role of the GB and bile acids in systemic metabolic regulation. Thus, cholecystectomy may not be innocuous and may have a major impact on public health by contributing to NAFLD development.
非酒精性脂肪性肝病（NAFLD）和胆固醇性胆囊结石继发胆囊疾病的发病机制复杂，但这两种疾病都有相似的相关危险因素，其中大多数与代谢综合征有关。胆囊切除术是治疗胆囊疾病的最佳方法，也是全球开展最多的腹部手术之一。在本期《美国胃肠病学杂志》中，Ruhl 和 Everhart 使用来自第三次美国国家健康和营养调查（1988-1994 年）的数据表明，NAFLD 与胆囊切除术相关（比值比（OR）=2.4；1.8-3.3），但与胆囊结石无关（OR=1.1；0.84-1.4）。这一发现表明，胆囊切除术本身可能是 NAFLD 的一个危险因素，这与最近未公开的胆囊和胆汁酸在全身代谢调节中的作用一致。因此，胆囊切除术可能并非无害，它可能通过促进 NAFLD 的发生对公共健康产生重大影响。
