Long-standing effect of cholecystectomy in patients with metabolic-associated fatty liver disease

Abstract

Objective The role of cholecystectomy as a risk factor in patients with metabolic-associated fatty liver disease (MAFLD) remains unclear. This study aimed to investigate if long-standing cholecystectomy is associated with advanced liver fibrosis and cirrhosis in patients with recently diagnosed MAFLD. Methods A retrospective observational study was performed in four hospitals in Mexico including patients with recently diagnosed MAFLD and a history of cholecystectomy. Subjects were divided into those with cholecystectomy ≥6 months before MAFLD diagnosis (ChBM), and those with cholecystectomy at the time of MAFLD diagnosis (ChAM). Odds ratios (OR) for the association of advanced liver fibrosis and cirrhosis with the timing of cholecystectomy were calculated. Results Mean age of 211 participants was 49.06 ± 15.12 years and the majority were female (72.5%). Patients from the ChBM (n = 70) group were significantly older (53.14 vs. 47.03 years; P = 0.003), had higher BMI (30.54 vs. 28.52 kg/m2; P = 0.011) and lower platelet count (236.23 vs. 266.72 × 103/µL; P = 0.046) compared with patients from ChAM group (n = 141). In multivariable-adjusted analysis, age (OR = 2.37; P = 0.024), dyslipidemia (OR = 4.28; P = 0.005) and severe liver fibrosis (OR = 4.68; P = 0.0) were independent risk factors associated with long-standing cholecystectomy. Conclusion Patients with long-standing cholecystectomy (≥6 months) are at increased risk of severe liver fibrosis and cirrhosis at the time of MAFLD diagnosis compared to those with recently done cholecystectomy. Advanced age (>50 years) and dyslipidemia are also commonly found in these subjects.

Associations of cholecystectomy with metabolic health changes and incident cardiovascular disease: a retrospective cohort study

“…Furthermore, the risk of cardiovascular disease has decreased after 2 years in patients who underwent cholecystectomy, suggesting that cholecystectomy-associated elevation of cardiovascular disease risk may be ameliorated 2 years after cholecystectomy. Although there were concerns that cholecystectomy might have harmful effects in the past in metabolic indicators, such as cholesterol 12 , the results of this study suggest that there are more beneficial results.…”

A Machine Learning-Based Method for Detecting Liver Fibrosis

“…Only one similar study was found. However, it employed the MAFLD definition [ 40 ]. In this study, long-standing cholecystectomy, defined as a period exceeding 6 months, patients were at risk of advanced liver fibrosis, especially when they presented an age over 50 years and dyslipidaemia.…”

“…A database from a multicentre retrospective cross-sectional study of 4 hospitals in Mexico that was performed from 2014 to 2020 was analysed for this study. This database can be found in the Harvard Dataverse [ 40 ]. These hospitals were: Medica Sur Clinic and Foundation, Central Military Hospital, General Hospital of Mexico “Dr Eduardo Liceaga” and Star Médica Hospital.…”

Molecular Mechanisms Involved in MAFLD in Cholecystectomized Patients: A Cohort Study

“…Through the analysis of previous studies and reviews, we have discussed the association between cholelithiasis and MAFLD, specifically what happens in patients who have undergone a cholecystectomy [2,[7][8][9]16,34]. Figure 3 illustrates our hypothesis about the possible roles of FXR1 and FGFR4 in MAFLD pathogenesis and progression.…”

“…These alterations, which occur in multiple organs such as the intestine, adipose tissue and muscle, contribute to the development of metabolic disorders, such as metabolic syndrome and MAFLD [14,15]. A recent study showed that patients with long-standing cholecystectomies (≥6 months) are at increased risk of severe liver fibrosis and cirrhosis at the time of MAFLD diagnosis, compared to patients with cholecystectomies performed recently [16]. Additionally, a meta-analysis demonstrated that cholecystectomy is associated with a 1.63 fold increase in the risk of liver disease, particularly MAFLD [12].…”