Hung Man-Chen, Chen Chuen-Fei, Tsou Meng-Ting, Lin Hsin-Hui, Hwang Lee-Ching, Hsu Ching-Ping
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
Department of Family Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Diabetes Metab Syndr Obes. 2020 Oct 9;13:3579-3585. doi: 10.2147/DMSO.S266947. eCollection 2020.
The prevalence of gallstone disease (GSD) increases with age, and the elderly have a much higher mortality risk and incidence of surgical comorbidities. The aim of this study was to explore the relationship between GSD and cardiometabolic risk factors in elderly people with non-alcoholic fatty liver disease (NAFLD).
In this cross-sectional study, we analyzed the data of elderly people who underwent annual health check-ups at a Northern Taiwan health examination center. These data were collected from physical examination, blood tests, abdominal ultrasonography, and medical histories. We excluded those with hepatitis B or C infections, heavy alcohol consumption, or cholecystectomy.
The analysis included 3,037 participants with a mean age of 73.6±6.0 years. Over 70% were overweight or obese, and the overall prevalence of GSD was 17.7%. In our univariate analysis, GSD was positively correlated with age, body mass index, metabolic syndrome, diabetes mellitus (DM), hypertension (HTN), and various metabolic factors (fasting plasma glucose [FPG], triglyceride, uric acid, and high-density lipoprotein cholesterol [HDL-C] levels). After adjustment for age, gender, and body mass index, metabolic syndrome showed a positive association with GSD (odds ratio [OR] 1.31 [95% confidence interval [CI], 1.05-1.64]; =0.020). Specific components of metabolic syndrome that increased the risk for GSD in NAFLD elderly include lower levels of HDL-C (OR 1.35 [95% CI, 1.10-1.66]; <0.001) and elevated FPG (OR 1.36 [95% CI, 1.10-1.69]; <0.001).
Our study concluded that GSD is significantly associated with metabolic syndrome in elderly people with NAFLD. Reduced HDL-C and elevated FPG both heighten the risk of developing GSD. Therefore, to lower the risk of GSD in NAFLD patients, their FPG levels and HDL-C levels must be regularly followed-up, and these patients should be educated about the symptoms of GSD if they meet the criteria for metabolic syndrome.
胆结石疾病（GSD）的患病率随年龄增长而增加，老年人手术合并症的死亡风险和发病率要高得多。本研究的目的是探讨非酒精性脂肪性肝病（NAFLD）老年患者中GSD与心脏代谢危险因素之间的关系。
在这项横断面研究中，我们分析了在台湾北部一家健康检查中心接受年度健康检查的老年人的数据。这些数据来自体格检查、血液检查、腹部超声检查和病史记录。我们排除了患有乙型或丙型肝炎感染、大量饮酒或接受过胆囊切除术的患者。
分析纳入了3037名参与者，平均年龄为73.6±6.0岁。超过70%的人超重或肥胖，GSD的总体患病率为17.7%。在我们的单因素分析中，GSD与年龄、体重指数、代谢综合征、糖尿病（DM）、高血压（HTN）以及各种代谢因素（空腹血糖[FPG]、甘油三酯、尿酸和高密度脂蛋白胆固醇[HDL-C]水平）呈正相关。在调整年龄、性别和体重指数后，代谢综合征与GSD呈正相关（比值比[OR]为1.31[95%置信区间[CI]，1.05 - 1.64]；P = 0.020）。NAFLD老年患者中增加GSD风险的代谢综合征具体组成部分包括HDL-C水平降低（OR为1.35[95%CI，1.10 - 1.66]；P < 0.001）和FPG升高（OR为1.36[95%CI，1.10 - 1.69]；P < 0.001）。
我们的研究得出结论，在患有NAFLD的老年人中，GSD与代谢综合征显著相关。HDL-C降低和FPG升高均会增加患GSD的风险。因此，为降低NAFLD患者患GSD的风险，必须定期监测他们的FPG水平和HDL-C水平，如果这些患者符合代谢综合征标准，应告知他们GSD的症状。
