Gallstone Disease and Increased Risk of Ischemic Heart Disease

Targher, Giovanni; Byrne, Christopher D.

doi:10.1161/atvbaha.115.306339

Cited by 10 publications

(10 citation statements)

References 20 publications

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“…The association between IR and GSD is concordant with the observation that gallstones prevalence directly correlates with the frequency and severity of NAFLD. 83,84 Similar findings have been reported for atherogenic dyslipidaemia 85 and atherosclerotic coronary artery disease, 86,87 both conditions pathophysiologically related to IR.…”

Section: The Role Of Hepatic Ir On the Pathogenesis Of Gsdsupporting

confidence: 77%

“…The association between IR and GSD is concordant with the observation that gallstones prevalence directly correlates with the frequency and severity of NAFLD . Similar findings have been reported for atherogenic dyslipidaemia and atherosclerotic coronary artery disease, both conditions pathophysiologically related to IR. In a cohort of 19 503 nondiabetic Korean men, it was found that systemic IR, regardless obesity status, was an independent predictor of GSD and that various IR manifestations were more frequent in subjects with GSD, supporting a bidirectional relationship between GSD and IR.…”

Section: The Role Of Hepatic Ir On the Pathogenesis Of Gsdmentioning

confidence: 94%

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Pathophysiological connections between gallstone disease, insulin resistance, and obesity

2019

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Summary Obesity and cholesterol gallstone disease (GSD) are frequently coexisting diseases; therefore and considering the current worldwide obesity epidemics, a precise understanding of the pathophysiological relationships between GSD and insulin resistance (IR) is important. Classically, obesity has been understood as a risk factor for GSD and the gallbladder (GB) viewed as a simple bile reservoir, with no metabolic roles whatsoever. However, consistent evidence has showed that both GSD and cholecystectomy associates with fatty liver and IR, raising the possibility that the GB is indeed an organ with metabolic regulatory roles. Herein, we review the pathophysiological mechanisms by which GSD, IR, and obesity are interconnected, with emphasis in the actions of the GB as a regulator of bile acids kinetics and a hormone secreting organ, with metabolic actions at the systemic level. We also examine the relationships between increased hepatic lipogenic in IR states and GSD pathogenesis. We propose a model in which GSD and hepatic IR mutually interact to determine a state of dysregulated lipid and energy metabolism that potentiate the metabolic dysregulation of obesity.

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Section: The Role Of Hepatic Ir On the Pathogenesis Of Gsdsupporting

confidence: 77%

Section: The Role Of Hepatic Ir On the Pathogenesis Of Gsdmentioning

confidence: 94%

Pathophysiological connections between gallstone disease, insulin resistance, and obesity

2019

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“…10 At the same time, gut microbiota dysbiosis is found to be linked to a wide range of metabolic disturbances, including an increased risk of obesity and CVD. 11–13, 28–30 Of note, the bacterial link may be a targeted pathway through which diets influence both diseases. For example, circulating TMAO, which is a gut flora-generated metabolite of red meat intakes, inhibits bile acid transporters in mouse liver and at the same time promotes atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

“…30 Patients with gallstone disease should be recommended a multidisciplinary program based on a careful assessment of coexisting cardiometabolic risk factors. Statins have been shown to dissolve cholesterol gallstones, suggesting their potential for a pharmacological therapy for gallstones beyond their well-known benefits on CHD prevention.…”

Section: Discussionmentioning

confidence: 99%

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Gallstones and Risk of Coronary Heart Disease

Zheng

et al. 2016

ATVB

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Objective Gallstone disease has been related to cardiovascular risk factors; however, whether presence of gallstones predicts coronary heart disease (CHD) is not well established. Approach and Results We followed 269,142 participants who were free of cancer and cardiovascular disease at baseline from 3 U.S. cohorts: the Nurses’ Health Study (NHS; 112,520 women; 1980–2010), NHS II (112,919 women; 1989–2011) and the Health Professionals Follow-up Study (HPFS; 43,703 men; 1986–2010), and documented 21,265 incident CHD cases. After adjustment for potential confounders, the hazard ratio for the participants with a history of gallstone disease compared with those without was 1.15 (95% confidence interval [CI] 1.10–1.21) in NHS, 1.33 (1.17–1.51) in NHS II, and 1.11 (1.04–1.20) in HPFS. The associations appeared to be stronger in individuals who were not obese, not diabetic, or were normotensive, compared to their counterparts. We identified 4 published prospective studies by searching PUBMED and EMBASE up to October 2015, coupled with our 3 cohorts, involving 842,553 participants and 51,123 incident CHD cases. The results from meta-analysis revealed a history of gallstone disease was associated with a 23% (15–33%) increased CHD risk. Conclusions Our findings support that a history of gallstone disease is associated with increased CHD risk, independently of traditional risk factors.

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