Jiang Guo-Heng, Li Sheng, Li Hong-Yu, Xie Lin-Jun, Li Shi-Yi, Yan Zi-Tong, Yu Wen-Qian, Luo Jing, Bai Xuan, Kong Ling-Xi, Lou Yan-Mei, Zhang Chi, Li Guang-Can, Shan Xue-Feng, Mao Min, Wang Xin
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
World J Gastroenterol. 2024 Dec 14;30(46):4914-4928. doi: 10.3748/wjg.v30.i46.4914.
A body of evidence has suggested bidirectional relationships among gallstone disease (GSD), non-alcoholic fatty liver disease (NAFLD), and kidney stone disease (KSD). However, the results are inconsistent, and studies on this topic in China are relatively few. Our goal is to explore the bidirectional associations among these three diseases through a multicenter study, systematic review, and meta-analysis.
To explore the bidirectional associations among these three diseases through a multicenter study, systematic review, and meta-analysis. The results may help to investigate the etiology of these diseases and shed light on the individualized prevention of these three diseases.
Subjects who participated in physical examinations in Beijing, Tianjin, Chongqing in China were recruited. Multivariable logistic regression was employed to explore the bidirectional relationships among GSD, KSD, and NAFLD. Systematic review and meta-analysis were initiated to confirm the epidemiologic evidence from previous observational studies. Furthermore, trial sequential analysis (TSA) was conducted to evaluate whether the evidence was sufficient and conclusive.
Significant bidirectional associations were detected among the three diseases, independent of potential confounding factors. The pooled results of the systematic review and meta-analysis also corroborated the aforementioned results. The combined evidence from the multicenter study and meta-analysis was significant [pooled odds ratio (OR) = 1.42, 95%CI: 1.16-1.75, KSD → GSD; pooled OR = 1.48, 95%CI: 1.31-1.67, GSD → KSD; pooled OR = 1.31, 95%CI: 1.17-1.47, GSD → NAFLD; pooled OR = 1.37, 95%CI: 1.26-1.50, NAFLD → GSD; pooled OR = 1.28, 95%CI: 1.08-1.51, NAFLD → KSD; pooled OR = 1.21, 95%CI: 1.16-1.25, KSD → NAFLD]. TSA indicated that the evidence was sufficient and conclusive.
The present study presents relatively sufficient evidence for the positive bidirectional associations among GSD, KSD, and NAFLD. The results may provide clues for investigating the etiology of these three diseases and offer a guideline for identifying high-risk patients.
有证据表明胆结石病（GSD）、非酒精性脂肪性肝病（NAFLD）和肾结石病（KSD）之间存在双向关系。然而，结果并不一致，且中国关于该主题的研究相对较少。我们的目标是通过多中心研究、系统评价和荟萃分析来探索这三种疾病之间的双向关联。
通过多中心研究、系统评价和荟萃分析来探索这三种疾病之间的双向关联。研究结果可能有助于探究这些疾病的病因，并为这三种疾病的个体化预防提供思路。
招募在中国北京、天津、重庆参加体检的受试者。采用多变量逻辑回归来探索GSD、KSD和NAFLD之间的双向关系。开展系统评价和荟萃分析以证实先前观察性研究的流行病学证据。此外，进行试验序贯分析（TSA）以评估证据是否充分和确凿。
在这三种疾病之间检测到显著的双向关联，且不受潜在混杂因素的影响。系统评价和荟萃分析的汇总结果也证实了上述结果。多中心研究和荟萃分析的综合证据具有显著性[合并比值比（OR）=1.42，95%置信区间（CI）：1.16 - 1.75，KSD→GSD；合并OR = 1.48，95%CI：1.31 - 1.67，GSD→KSD；合并OR = 1.31，95%CI：1.17 - 1.47，GSD→NAFLD；合并OR = 1.37，95%CI：1.26 - 1.50，NAFLD→GSD；合并OR = 1.28，95%CI：1.08 - 1.51，NAFLD→KSD；合并OR = 1.21，95%CI：1.16 - 1.25，KSD→NAFLD]。TSA表明证据充分且确凿。
本研究为GSD、KSD和NAFLD之间的正向双向关联提供了相对充分的证据。研究结果可能为探究这三种疾病的病因提供线索，并为识别高危患者提供指导。
