Xie Zhi-Qin, Li Hong-Xia, Tan Wen-Liang, Yang Lei, Ma Xiao-Wu, Li Wen-Xin, Wang Qing-Bin, Shang Chang-Zhen, Chen Ya-Jin
Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Pathology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, China.
Front Med (Lausanne). 2021 Nov 30;8:787777. doi: 10.3389/fmed.2021.787777. eCollection 2021.
Cholecystectomy is the "gold standard" for treating diseases of the gallbladder. In addition, non-alcoholic fatty liver disease (NAFLD), liver fibrosis or cirrhosis, are major causes of morbidity and mortality across the world. However, the association between cholecystectomy and these diseases is still unclear. We assessed the association among US adults and examined the possible risk factors. This cross-sectional study used data from 2017 to 2018 National Health and Nutrition Examination Survey, a population-based nationally representative sample of US. Liver fibrosis and cirrhosis were defined by median stiffness, which was assessed by transient elastography. Furthermore, patients who had undergone cholecystectomy were identified based on the questionnaire. In addition, Propensity Score Matching (PSM, 1:1) was performed based on gender, age, body mass index (BMI) and diabetes. Of the 4,497 included participants, cholecystectomy was associated with 60.0% higher risk of liver fibrosis (OR:1.600;95% CI:1.278-2.002), and 73.3% higher risk of liver cirrhosis (OR:1.733, 95% CI:1.076-2.792). After PSM based on age, gender, BMI group and history of diabetes, cholecystectomy was associated with 139.3% higher risk of liver fibrosis (OR: 2.393;95% CI: 1.738-3.297), and 228.7% higher risk of liver cirrhosis (OR: 3.287, 95% CI: 1.496-7.218). The present study showed that cholecystectomy is positively associated with liver fibrosis and cirrhosis in US adults. The discovery of these risk factors therefore provides new insights on the prevention of NAFLD, liver fibrosis, and cirrhosis.
胆囊切除术是治疗胆囊疾病的“金标准”。此外，非酒精性脂肪性肝病（NAFLD）、肝纤维化或肝硬化是全球发病和死亡的主要原因。然而，胆囊切除术与这些疾病之间的关联仍不明确。我们评估了美国成年人之间的关联，并研究了可能的风险因素。这项横断面研究使用了2017年至2018年美国国家健康和营养检查调查的数据，这是一个基于人群的全国代表性美国样本。肝纤维化和肝硬化通过中位硬度定义，通过瞬时弹性成像进行评估。此外，根据问卷确定接受过胆囊切除术的患者。此外，基于性别、年龄、体重指数（BMI）和糖尿病进行倾向得分匹配（PSM，1:1）。在纳入的4497名参与者中，胆囊切除术与肝纤维化风险高60.0%相关（OR：1.600；95%CI：l.278 - 2.002），与肝硬化风险高73.3%相关（OR：1.733，95%CI：1.076 - 2.792）。在根据年龄、性别、BMI组和糖尿病史进行PSM后，胆囊切除术与肝纤维化风险高139.3%相关（OR：2.393；95%CI：1.738 - 3.297），与肝硬化风险高228.7%相关（OR：3.287，95%CI：1.496 - 7.218）。本研究表明，在美国成年人中，胆囊切除术与肝纤维化和肝硬化呈正相关。因此，这些风险因素的发现为非酒精性脂肪性肝病、肝纤维化和肝硬化的预防提供了新的见解。
