Metabolic Syndrome: An Indicator of Complicated Gall Stone Disease?

Abstract

BackgroundGallstone disease is a common surgical entity worldwide and accounts for a major portion of hospital admissions and surgeries. Metabolic syndrome is diagnosed when three of the following medical conditions are positive: central obesity, high blood pressure, increased fasting glucose levels, low high-density lipoprotein (HDL) levels and high serum triglycerides.ObjectiveTo compare the frequency of metabolic syndrome in patients with uncomplicated gallstone disease and complicated gallstone disease.Study designObservational, cross-sectional study.MethodologyA total of 104 patients, above age 18 years, visiting the outpatient department (OPD) or the emergency department, diagnosed as having gallstone disease. The study was conducted in surgical unit VI, civil hospital Karachi from June 2014 to June 2015. Patients’ demographics, abdominal waist circumference, blood pressure, serum fasting blood sugar, triglyceride level and HDL levels were recorded. Final outcome was labeled as presence or absence of metabolic syndrome. Presence of metabolic syndrome was compared in patients with complicated gallstone disease as well as in patients with uncomplicated gallstone disease. Chi square test was used to detect statistical significance and a p-value of <0.05 was taken as significant.ResultsThe ages were comparable between the two groups, that is, the complicated and uncomplicated gallstone disease at 42.42 +/- 12.15 years in the former and 39.24 +/- 10.41 years in the latter group. Metabolic syndrome was more predominant in the complicated arm 40.38% when compared to uncomplicated arm 25% but it was not significant statistically with a p-value of 0.2.ConclusionMetabolic syndrome is associated with complicated gallstone disease though this study failed to reach statistical significance due to small sample size, it re-enforces the findings of previous studies. It is an easily assessable and useful measure to predict complications associated with gall stone disease.

Association of metabolic syndrome with complicated gall stone disease: our experience

“…Metabolic syndrome was more predominant in CGSD in compare to UGSD. 20,21 We found that presence of metabolic syndrome (p<.05) is an independent predictor of CGSD after applying logistic regression analysis and Wald criteria. Metabolic syndrome was presented in 58.2% patient of CGSD group and 21.8% patients of UGSD patients, which was statistically significant (OR 4.986, CI 2.763-8.995, p value <0.001) Sanchez NM et al, studied that total metabolic syndrome was associated with a more than three-fold risk of gallstone disease (OR = 3.20; 95%CI, 1.71-6.01; P = 0.0001).…”

Modern views on development mechanisms and tactics for treatment of patients with gallbladder disease associated with metabolic syndrome

“…Длительное время среди врачей существовало мнение о том, что золотым стандартом лечения ЖКБ является лапароскопическая холецистэктомия. В мировой практике по числу оперативных вмешательств холецистэктомия, проведенная по поводу ЖКБ, занимает второе место после аппендэктомии [1,5]. В США выполняется более 700 тысяч таких операций ежегодно [4].…”

“…Но, несмотря на это, даже при адекватном и рациональном отборе пациентов эффективность лечения ЖКБ с использованием УДХК достигает 70 % [3,4,5,32]. Учитывая тот факт, что сама терапия является длительной и дорогостоящей, особо актуальным представляется вопрос об уточнении показаний к ее проведению, а также о разработке способов прогнозирования эффективности предстоящего консервативного лечения.…”

“…При этом ключевая роль в формировании патологии желчного пузыря отводится нарушениям липидного обмена, опосредованными печенью. В настоящее время доказана и не подвергается сомнению патофизиологическая взаимосвязь неалкогольной жировой болезни печени (НАЖБ) с ЖКБ [2,4,5]. С одной стороны, функционально измененные гепатоциты при НАЖБП синтезируют неполноценные желчные мицеллы с повышенным содержанием холестерина (ХС), что усиливает литогенность желчи [6,7].…”