An observational study on the association of nonalcoholic fatty liver disease and metabolic syndrome with gall stone disease requiring cholecystectomy

Abstract

ObjectiveRecognition of Non alcoholic fatty liver disease (NAFLD) and metabolic syndrome in patients with gallstones undergoing laparoscopic or open cholecystectomy, along with it we will also study the life style of patients with gall stones.BackgroundPatients with gallstones have associated NAFLD, with concurrent metabolic syndrome and these ailments share similar factors for example obesity, hypertriglyceridemia and diabetes mellitus. Factors like body mass index, gender, raised lipid levels, use of contraceptives and alcohol and having diabetes, physical inactiveness, multiparous women, water with excessive iron content, metabolic syndrome, and NAFLD are accountable factors for gallstones formation.MethodologyThis was a case series done at Surgical Unit 1 of Civil Hospital Karachi. Selective samples of 88 patients were included. Duration was 3 months. We included both sexes with ultrasound proof of gall stone irrespective of cholecystitis. Excluded patients with history of seropositive viral hepatitis, autoimmune and wilson's disease. As these conditions can act as a confounder to our variables.ResultsNafld was present in 62.5%(n = 55) while 28.4% (n = 25) had metabolic syndrome. 26.94% had BMI less than 18, 32.12 had BMI between 18 and 25 and majority had BMI greater than 25 i.e in 40.93%. Of all 46.6% had a family history of cholelithiasis. Gallstone patients with NAFLD reported about their first degree relative being suffering from cholelithiasis at a significant p-value of 0.034 while this was not significant in cases of metabolic syndrome and the p -value was 0.190.ConclusionWe found association of metabolic syndrome with gallstones and NAFLD. Non alcoholic fatty liver was highly prevalent in our study subjects. Huge percentage of first degree relatives of gall stone patients had gallstones and this relation was more pronounced patients who had associated NAFLD.

<p>Association Between Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome with Gallstone Disease, South Iran: A Population-Based Study</p>

“…Although a few previous studies have shown that the overall prevalence of GSD in patients with NAFLD is not significantly different from those with non-NAFLD, 33 many recent studies suggest a significant association between them. 17,18,[34][35][36][37][38] In our study, there was significant association between GSD and NAFLD (Table 6). NAFLD was present in 62% of GSD patients in one observational study by Ahmed et al, 38 which was higher than our report (42.4%), also the level of LFT in their patients was higher in the NAFLD group, which was similar to our study ( Table 5).…”

Nonalcoholic fatty liver was associated with asymptomatic gallstones in a Chinese population

“…[ 10 – 16 ] No associations were found between NAFLD and gallstones in the studies on the US and Korean populations, [ 10 , 13 ] whereas NAFLD was associated with gallstones in the studies on the Pakistani and Taiwanese populations. [ 12 , 15 , 16 ] To the best of our knowledge, only 1 study has been conducted to investigate whether asymptomatic gallstones are related to the risk of NAFLD in a Chinese urban population; that longitudinal cohort study revealed that gallstones are risk factors for NAFLD. However, the correlation between NAFLD and asymptomatic gallstones in a Chinese general population has not been studied.…”

BMI&nbsp;is an Independent Risk Factor for New-onset Asymptomatic Gallbladder Stone Disease in Overweight Population: A Case-control Study in Northwest China

“…Meanwhile, increased denovo lipogenesis is a major driver of hepatic steatosis in the insulin resistance state owing to excessive activation of the lipogenic branch of the insulin signaling pathway in hepatocytes [38,39]. NAFLD is an acquired metabolic disease of the liver, occurring in two phases: (1) triglycerides accumulate in the liver and (2) necrobiotic in ammatory reactions, brosis and cirrhosis take place [40]. Meanwhile, obese individuals are likely to have increased gallbladder volume accompanied by slow gallbladder evacuation and mucosal abnormalities, which are associated with gallstone formation [41].…”