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Gallstones in obesity and weight loss.

Abstract

The prevalence of cholesterol gallstones is increased in obese persons. The risk is especially high in those with the highest body mass index (relative risk 5-6). Weight loss further increases the risk of gallstones: the prevalence of new gallstones reaches 10-12% after 8-16 weeks of low-calorie diet and more than 30% within 12-18 months after gastric by-pass surgery. About one-third of the stones are symptomatic. The increased prevalence of stones is mostly due to supersaturation of bile with cholesterol, because of an increased synthesis by the liver and secretion into bile. Saturation is further increased during weight loss. It returns toward normal after weight stabilization at a lower level, allowing spontaneous stone dissolution in some cases. Identified risk factors for gallstones during weight loss are a relative loss of weight greater than 24% of initial body weight, a rate of weight loss greater than 1.5 kg per week, a very low calorie diet with no fat, a long overnight fast period and a high serum triglyceride level. Ursodeoxycholic acid decreases cholesterol saturation of bile and gallstone incidence during weight loss. Other preventive measures include a control of weight loss rate, a reduction of the length of overnight fast, and maintenance of a small amount of fat in the diet.

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  • Authors+Show Affiliations

    Service d'Hépatologie and INSERM U-481, H pital Beaujon, France. serge.erlinger@bjn.ap-hop-paris

    Source

    MeSH

    Body Mass Index
    Cholelithiasis
    Comorbidity
    Diet, Fat-Restricted
    Female
    Humans
    Male
    Obesity
    Prevalence
    Prognosis
    Risk Assessment
    Weight Loss

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    11192327

    Citation

    Erlinger, S. "Gallstones in Obesity and Weight Loss." European Journal of Gastroenterology & Hepatology, vol. 12, no. 12, 2000, pp. 1347-52.
    Erlinger S. Gallstones in obesity and weight loss. Eur J Gastroenterol Hepatol. 2000;12(12):1347-52.
    Erlinger, S. (2000). Gallstones in obesity and weight loss. European Journal of Gastroenterology & Hepatology, 12(12), pp. 1347-52.
    Erlinger S. Gallstones in Obesity and Weight Loss. Eur J Gastroenterol Hepatol. 2000;12(12):1347-52. PubMed PMID: 11192327.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gallstones in obesity and weight loss. A1 - Erlinger,S, PY - 2001/2/24/pubmed PY - 2001/4/6/medline PY - 2001/2/24/entrez SP - 1347 EP - 52 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 12 IS - 12 N2 - The prevalence of cholesterol gallstones is increased in obese persons. The risk is especially high in those with the highest body mass index (relative risk 5-6). Weight loss further increases the risk of gallstones: the prevalence of new gallstones reaches 10-12% after 8-16 weeks of low-calorie diet and more than 30% within 12-18 months after gastric by-pass surgery. About one-third of the stones are symptomatic. The increased prevalence of stones is mostly due to supersaturation of bile with cholesterol, because of an increased synthesis by the liver and secretion into bile. Saturation is further increased during weight loss. It returns toward normal after weight stabilization at a lower level, allowing spontaneous stone dissolution in some cases. Identified risk factors for gallstones during weight loss are a relative loss of weight greater than 24% of initial body weight, a rate of weight loss greater than 1.5 kg per week, a very low calorie diet with no fat, a long overnight fast period and a high serum triglyceride level. Ursodeoxycholic acid decreases cholesterol saturation of bile and gallstone incidence during weight loss. Other preventive measures include a control of weight loss rate, a reduction of the length of overnight fast, and maintenance of a small amount of fat in the diet. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/11192327/full_citation L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=11192327.ui DB - PRIME DP - Unbound Medicine ER -