Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Yonsei Med J. 2023 Nov;64(11):658-664. doi: 10.3349/ymj.2023.0182.
Differences in the impact of obesity and metabolic health status on the risk of gallbladder polyp (GBP) remain uncertain. Herein, we aimed to compare the risk of GBP ≥5 mm among individuals with different phenotypes based on obesity and metabolic health status.
A cohort of 253485 asymptomatic adults who underwent abdominal ultrasonography screening were categorized into the following four groups according to obesity and metabolic health status: 1) metabolically healthy non-obese (MHNO), 2) metabolically unhealthy and non-obese (MUNO), 3) metabolically healthy but obese (MHO), and 4) metabolically unhealthy obese (MUO).
The prevalences of GBP ≥5 mm were 2.4%, 3.1%, 3.7%, and 4.0% in the MHNO, MUNO, MHO, and MUO groups, respectively. The multivariable-adjusted odds ratio (OR) values for prevalence of GBP ≥5 mm by comparing the MUNO, MHO, and MUO with the MHNO group were 1.11 [95% confidence interval (CI), 1.04-1.19], 1.30 (95% CI, 1.15-1.47), and 1.37 (95% CI, 1.28-1.45), respectively. The risk of GBP ≥5 mm in the MHO group was significantly higher than that in the MUNO group, but not significantly different from that in the MUO group.
Obesity and metabolic unhealthiness appear to be independent risk factors for the prevalence of GBP, and the impact of obesity is greater than that of metabolic unhealthiness, suggesting that maintaining both normal weight and metabolic health may help reduce the risk of GBP.
肥胖和代谢健康状况对胆囊息肉（GBP）风险的影响存在差异仍不确定。在此，我们旨在比较基于肥胖和代谢健康状况的不同表型个体中 GBP≥5mm 的风险。
对 253485 名接受腹部超声筛查的无症状成年人进行分类，根据肥胖和代谢健康状况分为以下四组：1）代谢健康非肥胖（MHNO），2）代谢不健康非肥胖（MUNO），3）代谢健康肥胖（MHO）和 4）代谢不健康肥胖（MUO）。
MHNO、MUNO、MHO 和 MUO 组 GBP≥5mm 的患病率分别为 2.4%、3.1%、3.7%和 4.0%。通过比较 MUNO、MHO 和 MUO 与 MHNO 组，多变量调整后的 GBP≥5mm 患病率比值比（OR）值分别为 1.11（95%置信区间[CI]，1.04-1.19）、1.30（95%CI，1.15-1.47）和 1.37（95%CI，1.28-1.45）。MHO 组 GBP≥5mm 的风险明显高于 MUNO 组，但与 MUO 组无显著差异。
肥胖和代谢不健康似乎是 GBP 患病率的独立危险因素，肥胖的影响大于代谢不健康，这表明保持正常体重和代谢健康可能有助于降低 GBP 的风险。
