Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects

Abstract

OBJECTIVE: To investigate whether total body fat mass or fat distribution and associated metabolic disturbances in glucose and lipid metabolism in¯uence the well known gallstone pathogenetic factors in obese subjects in order to explain why some obese subjects develop gallstones and some do not. DESIGN: Cross sectional study of gallstone pathogenetic factors, body composition, fat distribution, glucose and lipid metabolism. SUBJECTS: 57 healthy overweight subjects (aged 26±64 y, body mass index (BMI) 30±45 kg/m 2 ). MEASUREMENTS: Total and intra-abdominal fat masses were measured by dual X-ray absorptiometry and abdominal CT scanning, respectively. The lithogenic index was measured in aspirated bile. The gallbladder volume was determined by ultrasound and the gallbladder ejection fraction% by dynamic cholescintigraphy. Plasma cholecystokinin (CCK) concentrations during a meal were measured with a speci®c radioimmunoassay. Insulin sensitivity was measured by the Minimal Model and glucose tolerance by an oral glucose tolerance test (OGTT). Serum lipid concentrations were measured by standard methods. RESULTS: The gallbladder volume in the fasting state increased with increasing intra-abdominal fat mass (P 0.006) and was increased in subjects with impaired glucose tolerance (41 vs 27 ml, P 0.001). The lithogenic index was b 1 in all subjects and correlated with total fat mass (P 0.04). CONCLUSION: Gallstone pathogenesis in obesity seems to be in¯uenced by the total body fat mass and its regional distribution possibly via mutual association with the glucose tolerance.

Sonographic evaluation of gallbladder volume and ejection fraction in obese women without gallstones

“…2,4,6,[25][26][27] In contrast, only a few studies have focused on the association between gallbladder motility and body weight, BMI, body fat distribution, and serum lipid levels, and results have been conflicting. 1,7,8,17,18,28 Petroni 1 and Acalovschi and Badea 7 reported good correlations between fasting gallbladder volumes in obese subjects and body weight and BMI. Masclee et al 8 also reported correlations between fasting gallbladder volumes and BMI; we found a positive correlation in the present study.…”

“…Gallstone disease has been reported to be significantly associated with BMI, waist-to-hip circumference ratio, high triglyceride level, and low high-density lipoprotein cholesterol level. 2,4,6,[25][26][27][28] In studies evaluating only small gallstones, which may have been newly formed, a positive association between gallstones and both low-density lipoprotein cholesterol and total cholesterol levels has been reported. 2,4,6,[25][26][27] In contrast, only a few studies have focused on the association between gallbladder motility and body weight, BMI, body fat distribution, and serum lipid levels, and results have been conflicting.…”

Bone density testing in clinical practice

“…They concluded that subcutaneous fat as a component of central adiposity is also an important independent marker of insulin resistance in obesity. A relationship between fat distribution, glucose tolerance, and gallstone pathogenic factors was also demonstrated in obesity with the direct measurements of fat mass by DXA (56). Therefore, DXA is a practical, widely available and precise tool for the measurement of body composition.…”

Acute Cholecystitis after Screening Colonoscopy

“…Contractility of gallbladder is known to be decreased in fatty gallbladder disease [7,9]. This is induced by abnormal wall structure and decreased response of gallbladder to the neurotransmitter associated with oxidative stress and insulin resistance [10][11][12].…”