Gallstone Disease Does Not Predict Liver Histology in Nonalcoholic Fatty Liver Disease

Abstract

Background/AimsWe sought to examine whether the presence of gallstone disease (GD) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) is associated with liver fibrosis and histological nonalcoholic steatohepatitis (NASH) score.MethodsWe included 441 Turkish patients with biopsy-proven NAFLD. GD was diagnosed in the presence of sonographic evidence of gallstones, echogenic material within the gallbladder with constant shadowing and little or no visualization of the gallbladder or absence of gallbladder at ultrasonography, coupled with a history of cholecystectomy.ResultsFifty-four patients (12.2%) had GD (GD+ subjects). Compared with the GD- subjects, GD+ patients were older, had a higher body mass index and were more likely to be female and have metabolic syndrome. However, GD+ patients did not have a higher risk of advanced fibrosis or definite NASH on histology. After adjustment for potential confounding variables, the prevalence of GD in NAFLD patients was not associated with significant fibrosis (≥2) (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.53 to 2.21; p=0.68) or definite NASH (OR, 1.03; 95% CI, 0.495 to 2.12; p=0.84).ConclusionsThe presence of GD is not independently associated with advanced fibrosis and definite NASH in adult Turkish patients with biopsy-proven NAFLD.

Promotional effect of nonalcoholic fatty liver disease on Gallstone disease: A systematic review and meta-analysis

“…Heterogeneity was significant among these data (p=0.059, I 2 =59.7%). Heterogeneity disappeared when the study of Yilmaz et al (27) was omitted (p=0.408, I 2 =0%). The above conclusion persisted for the pooled results of the other three studies (OR=1.60, 95% CI: 1.30-1.97, fixedeffects model).…”

“…Three studies (26,27,32) discussed the effects of advanced age and high TC level on the prevalence of GD in NAFLD patients. In these three studies, older NAFLD patients (WMD: 6.61, 95% CI: 3.80-9.42, p<0.000; random-effects model) had a higher chance of suffering from GD (Figure 6a).…”

“…Ten studies (19,21,(26)(27)(28)(30)(31)(32)(33)(34) that involved a total of 39,602 patients discussed GD prevalence in NAFLD patients with a range of 8%-47%. The pooled result was 17% (95% CI: 0.12-0.23), as shown in Figure 2.…”

“…Four studies (20,26,27,32) analyzed the effect of the female sex on GD occurrence in NAFLD patients. The association between the female sex and GD is statistically significant.…”

“…Liver biopsy was used to define NAFLD in three studies (26)(27)(28), ultrasonography in seven studies (19)(20)(21)(29)(30)(31)(32), biochemistry in one study (33), and all three methods were used in one study (34). Study origins included two from North America (USA) (21,34), five from Europe (Slovakia, Italy, and Hungary) (26,(30)(31)(32)(33), and five from Asia (China, Turkey, and Korea) (20,(27)(28)(29).…”