Sepehrimanesh Masood, Niknam Ramin, Ejtehadi Fardad, Fattahi Mohammad Reza, Safarpour Alireza
Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Diabetes Metab Syndr Obes. 2020 May 1;13:1449-1458. doi: 10.2147/DMSO.S246949. eCollection 2020.
Gallstone disease (GSD), non-alcoholic fatty liver disease (NAFLD), and metabolic syndrome (MetS) are common problems. The aim of this study was to investigate the association between NAFLD, MetS and its components with GSD.
This cross-sectional study was conducted as a part of the Kavar Cohort Study (KCS) affiliated to Shiraz University of Medical Sciences, Shiraz, Iran between January 2012 and January 2018. A total of 2239 participants of the general population of the KCS were selected randomly. Ultrasonography for GSD and NAFLD diagnosis and clinical and laboratory assaying for MetS evaluation were performed for the participants. The National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III) and Criteria for Clinical Diagnosis of MetS in Iranian Adults (CCDMIA) were used for diagnosis of MetS.
Overall, 59 patients with GSD and 177 age- and sex- matched participants without gallstones as a comparison group were enrolled. According to GSD groups, NAFLD was observed in 42.4% and 22.6% of patients with and without GSD, respectively, and the difference between the two groups was statistically significant ( = 0.003). MetS was present in 33.9% and 39.0% of GSD subjects, compared with 32.8% and 33.3% of the non-GSD group, based on NCEP/ATPIII and CCDMIA, respectively. Although the mean of all components of MetS except HDL-cholesterol were higher in the GSD group than in the non-GSD group, the difference was only significant in waist circumference ( = 0.041).
The present study found an obvious association between NAFLD and GSD. This study also showed a significant association between increasing waist circumference and risk of GSD. We recommend that patients with GSD should be evaluated for the likelihood of NAFLD and its treatment in addition to lifestyle changes to gain proper weight. However, further researches are needed to clarify the relationship between the nature of GSD, NAFLD, and obesity.
胆结石病（GSD）、非酒精性脂肪性肝病（NAFLD）和代谢综合征（MetS）是常见问题。本研究旨在探讨NAFLD、MetS及其组分与GSD之间的关联。
本横断面研究作为设拉子医科大学附属的卡瓦尔队列研究（KCS）的一部分，于2012年1月至2018年1月在伊朗设拉子开展。从KCS的普通人群中随机选取2239名参与者。对参与者进行GSD和NAFLD诊断的超声检查以及MetS评估的临床和实验室检测。采用美国国家胆固醇教育计划成人治疗组第三次报告（NCEP/ATP-III）和伊朗成年人代谢综合征临床诊断标准（CCDMIA）进行MetS的诊断。
总体而言，纳入了59例GSD患者和177例年龄及性别匹配的无胆结石参与者作为对照组。根据GSD分组，有和无GSD的患者中分别有42.4%和22.6%观察到NAFLD，两组之间差异有统计学意义（P = 0.003）。基于NCEP/ATPIII和CCDMIA，GSD受试者中分别有33.9%和39.0%存在MetS，而非GSD组分别为32.8%和33.3%。尽管GSD组中除高密度脂蛋白胆固醇外的所有MetS组分均值均高于非GSD组，但差异仅在腰围方面有统计学意义（P = 0.041）。
本研究发现NAFLD与GSD之间存在明显关联。本研究还表明腰围增加与GSD风险之间存在显著关联。我们建议，除了通过改变生活方式适当减重外，还应对GSD患者评估NAFLD的可能性及其治疗。然而，需要进一步研究以阐明GSD、NAFLD和肥胖症之间关系的本质。
