Effect of metabolic syndrome components on the risk of malignancy in patients with gallbladder lesions

Deng, Zheng; Xuan, Yue; Li, Xinxing; Crawford, William; Yuan, Zhiqing; Chen, Zhoukan; Brooks, Anastasia; Song, Yanyan; Wang, Haolu; Liang, Xiaowen; Chen, Tao

doi:10.7150/jca.54617

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…Gallstones can lead to a chronic inflammatory state of tissue damage/regeneration characterized by an imbalance between anti-and pro-inflammatory factors that induce carcinogenic processes in the gallbladder mucosa [6]. In fact, some environmental and lifestyle risk factors may be involved in the development of gallstones and the subsequent GBC formation, such as body mass index (BMI), geographical location, nutritional aspects (high-fat and high-sugar diets), bacterial infections (e.g., Salmonella typhi), chronic diseases (e.g., sclerosing cholangitis, type II diabetes, metabolic syndrome and/or dyslipidemias), parasitic infections, smoking, and alcohol consumption [2,[7][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Environmental and Lifestyle Risk Factors in the Carcinogenesis of Gallbladder Cancer

Pérez-Moreno

Riquelme

García

et al. 2022

JPM

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Gallbladder cancer (GBC) is an aggressive neoplasm that in an early stage is generally asymptomatic and, in most cases, is diagnosed in advanced stages with a very low life expectancy because there is no curative treatment. Therefore, understanding the early carcinogenic mechanisms of this pathology is crucial to proposing preventive strategies for this cancer. The main risk factor is the presence of gallstones, which are associated with some environmental factors such as a sedentary lifestyle and a high-fat diet. Other risk factors such as autoimmune disorders and bacterial, parasitic and fungal infections have also been described. All these factors can generate a long-term inflammatory state characterized by the persistent activation of the immune system, the frequent release of pro-inflammatory cytokines, and the constant production of reactive oxygen species that result in a chronic damage/repair cycle, subsequently inducing the loss of the normal architecture of the gallbladder mucosa that leads to the development of GBC. This review addresses how the different risk factors could promote a chronic inflammatory state essential to the development of gallbladder carcinogenesis, which will make it possible to define some strategies such as anti-inflammatory drugs or public health proposals in the prevention of GBC.

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Section: Introductionmentioning

confidence: 99%

Environmental and Lifestyle Risk Factors in the Carcinogenesis of Gallbladder Cancer

Pérez-Moreno

Riquelme

García

et al. 2022

JPM

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“…[ 14 ] This may be caused by HDL and LDL, which are the main carriers of cholesterol, by affecting the concentration of bile and the metabolism of cholesterol in bile. In addition, Deng et al [ 27 ] noted that dyslipidemia was an independent risk factor for malignancy, as it increased the risk of malignancy 2.674-fold in patients with gallbladder lesions.…”

Section: Risk Factorsmentioning

confidence: 99%

Gallbladder polypoid lesions: Current practices and future prospects

Wang,

Xu,

Xia

et al. 2024

Chinese Medical Journal

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Gallbladder polypoid lesions (GPLs) refer to any elevated lesion of the mucosal surface of the gallbladder wall, and the prevalence is estimated to be between 0.9% and 12.1%. GPLs include benign polyps and malignant polyps. Benign polyps are further classified as non-neoplastic polyps and neoplastic polyps. Cholesterol polyps are the most common benign polyps and adenocarcinoma is the main type of malignant polyp. Hepatitis B virus infection, liver function abnormalities, dyslipidemia, and obesity are the main risk factors for GPLs. Studies of biological mechanisms have focused on malignant gallbladder polyps, the development of which is regulated by hormone levels in vivo, gut microbiota, inflammation, oxidative stress, Salmonella typhimurium, and related molecules. Diagnostic modalities include chemical examination and imaging examination, with imaging examination currently being the mainstay. Treatment of patients with GPLs is based on the presence or absence of symptoms, age, size of the polyps, tendency of the polyp to increase, and risk factors for symptomatic malignancy to determine whether surgery should be performed.

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“…Важно отметить, что ДЛП является независимым фактором риска рака ЖП у пациентов с полипами, увеличивая вероятность его злокачественного поражения в 2,67 раза вне зависимости от наличия других факторов риска и компонентов МС [8].…”

Section: эпидемиологияunclassified

Current perspective on the problem of cholesterol polyps of the gallbladder in patients with nonalcoholic fatty liver disease

Мехтиев

Mekhtievа

Berko³

2022

Medicinskij sovet

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Cholesterol pseudopolyps are the most common variant of gallbladder polyps (GP). Their development is pathogenetically connected with the components of metabolic syndrome, especially with dislipoproteinemia and nonalcoholic fatty liver disease (NAFLD). Lipid metabolism disorder in the form of increased levels of total cholesterol, low-density lipoproteins (LDL), decreased high-density lipoproteins (HDL), as well as steatosis and liver inflammation lead to disorders of enterohepatic circulation (EHC) of bile acids, changes in rheological properties of bile, which, eventually, can lead to uptake of excess bile cholesterol by epithelium of GP in form of micelles. Infiltration of microvilli with bile micelles causes activation of tissue macrophages and triggers subclinical microinflammation of GB wall. When neighboring microvilli, crowded with foamy cells, merge, cholesterol pseudopolyp is formed, which represents a focal form of GB cholesterosis. The main drug that influences the recovery of EHC and physicochemical properties of bile is ursodeoxycholic acid (UDCA). There is also evidence that UDCA can improve parameters of lipid metabolism, liver enzymes, reduce the severity of hepatic steatosis. The use of UDCA in patients with polyposis form of GB cholesterosis has demonstrated positive results against cholesterol polyps. Glycyrrhizic acid (GA), which has anti-inflammatory, antioxidant, antifibrotic, and other beneficial properties, can improve the effectiveness of therapy for GB polyps by acting on the subclinical microinflammation component of the GB wall. In a prospective observational study, the use of fixed combination of UDCA with GA in patients with cholesterol polyps of GB and NAFLD for 3 months resulted in reduction of polyp number and size in more than 50% of patients, which was accompanied by significant improvement of lipid spectrum and liver enzymes parameters. Further studies of UDCA+GA combination in the combination of these pathologies are required.

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Effect of metabolic syndrome components on the risk of malignancy in patients with gallbladder lesions

Cited by 3 publications

References 33 publications

Environmental and Lifestyle Risk Factors in the Carcinogenesis of Gallbladder Cancer

Environmental and Lifestyle Risk Factors in the Carcinogenesis of Gallbladder Cancer

Gallbladder polypoid lesions: Current practices and future prospects

Current perspective on the problem of cholesterol polyps of the gallbladder in patients with nonalcoholic fatty liver disease

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