Silent Gallbladder Stone Associated with Nonalcoholic Fatty Liver Disease in a Scenario of Insulin Resistance in Young Adults

Abstract

Nonalcoholic fatty liver disease (NAFLD) is considered as the hepatic expression of insulin resistance. The high occurrence of obesity and dyslipidaemia in insulin resistant condition favours NAFLD.The hepatic effect of insulin resistance are diverse including increased hepatic cholesterol secretion, biliary cholesterol supersaturation and decreased biliary motility all of which leads to gallstone formation.NAFLD and gallstone disease (GSD) shares common pathological factors like hyperinsulinemia, dyslipidaemia. As all the factors are common association with Insulin resistance there could be common occurrence of NAFLD and GSD in patients with insulin resistance.During a study two patients with insulin resistance were found to have both NAFLD and GSD. Both the patients were found to be dyslipidemic and on sonography one was found to have multiple gall bladder stones and the other with a single gall bladder stone.