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Cholelithiasis and markers of nonalcoholic fatty liver disease in patients with metabolic risk factors.
Scand J Gastroenterol 2012; 47(2):197-203SJ

Abstract

Cholelithiasis and nonalcoholic fatty liver disease (NAFLD) share the same risk factors. The aim of our study was to explore the relationship between these two conditions and to identify independent predictors of both diseases in a cohort of patients with metabolic risk factors. Consecutive patients with metabolic risk factors referred to the outpatient clinic during a one-year period were included. Cholelithiasis was defined by the presence of gallstones on abdominal ultrasound examination at inclusion or previously performed cholecystectomy. NAFLD was defined by the presence of at least one surrogate marker such as elevated alanine aminotransferase and/or gamma-glutamyl transpeptidase and/or ultrasound signs of fatty liver. Other common liver diseases were thoroughly excluded. The prevalence of cholelithiasis among patients with and without NAFLD was determined and clinical and laboratory parameters were identified as predictors of NAFLD by multivariate logistic regression. In total, 482 consecutive patients were included: mean age 61 years; 61% were women; 52% of patients had more than 2 metabolic risk factors (obesity, type 2 diabetes, hypertension, hypertriglyceridemia, or low HDL cholesterol). NAFLD and cholelithiasis were present in 41% and 34% of all patients, respectively. Significantly higher prevalence of cholelithiasis was found among patients with NAFLD compared with patients without NAFLD (47% vs. 26%, respectively; p < 0.0001). In multivariate logistic regression model, type 2 diabetes (odds ratio (OR) = 1.99), BMI above 25 kg/m(2) (OR = 1.78), and cholelithiasis (OR = 1.77) were identified as independent predictors of NAFLD. Fifty six percent of patients with cholelithiasis had NAFLD compared with 33% of patients without cholelithiasis (p < 0.0001). Multivariate logistic regression identified age above 50 years (OR = 3.46), NAFLD (OR = 1.92), triglycerides above 1.7 mmol/l (OR = 1.91), BMI above 25 kg/m(2) (OR = 1.84), and total cholesterol concentration (OR = 0.711) as independent predictors of cholelithiasis. In conclusion, patients with metabolic risk factors and cholelithiasis suffer significantly more often from NAFLD compared with the reference group. Cholelithiasis represents an independent risk factor of NAFLD in addition to metabolic risk factors and could be regarded as an additional risk factor of liver damage in patients with NAFLD. Furthermore, NAFLD is an independent risk factor for cholelithiasis and might represent a pathogenetic link between the metabolic syndrome and cholelithiasis.

Authors+Show Affiliations

5th Internal Medicine Department, Comenius University Medical School, University Hospital Bratislava, Bratislava, Slovakia. koller.tomas@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22182015

Citation

Koller, Tomas, et al. "Cholelithiasis and Markers of Nonalcoholic Fatty Liver Disease in Patients With Metabolic Risk Factors." Scandinavian Journal of Gastroenterology, vol. 47, no. 2, 2012, pp. 197-203.
Koller T, Kollerova J, Hlavaty T, et al. Cholelithiasis and markers of nonalcoholic fatty liver disease in patients with metabolic risk factors. Scand J Gastroenterol. 2012;47(2):197-203.
Koller, T., Kollerova, J., Hlavaty, T., Huorka, M., & Payer, J. (2012). Cholelithiasis and markers of nonalcoholic fatty liver disease in patients with metabolic risk factors. Scandinavian Journal of Gastroenterology, 47(2), pp. 197-203. doi:10.3109/00365521.2011.643481.
Koller T, et al. Cholelithiasis and Markers of Nonalcoholic Fatty Liver Disease in Patients With Metabolic Risk Factors. Scand J Gastroenterol. 2012;47(2):197-203. PubMed PMID: 22182015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cholelithiasis and markers of nonalcoholic fatty liver disease in patients with metabolic risk factors. AU - Koller,Tomas, AU - Kollerova,Jana, AU - Hlavaty,Tibor, AU - Huorka,Martin, AU - Payer,Juraj, Y1 - 2011/12/19/ PY - 2011/12/21/entrez PY - 2011/12/21/pubmed PY - 2012/5/23/medline SP - 197 EP - 203 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 47 IS - 2 N2 - Cholelithiasis and nonalcoholic fatty liver disease (NAFLD) share the same risk factors. The aim of our study was to explore the relationship between these two conditions and to identify independent predictors of both diseases in a cohort of patients with metabolic risk factors. Consecutive patients with metabolic risk factors referred to the outpatient clinic during a one-year period were included. Cholelithiasis was defined by the presence of gallstones on abdominal ultrasound examination at inclusion or previously performed cholecystectomy. NAFLD was defined by the presence of at least one surrogate marker such as elevated alanine aminotransferase and/or gamma-glutamyl transpeptidase and/or ultrasound signs of fatty liver. Other common liver diseases were thoroughly excluded. The prevalence of cholelithiasis among patients with and without NAFLD was determined and clinical and laboratory parameters were identified as predictors of NAFLD by multivariate logistic regression. In total, 482 consecutive patients were included: mean age 61 years; 61% were women; 52% of patients had more than 2 metabolic risk factors (obesity, type 2 diabetes, hypertension, hypertriglyceridemia, or low HDL cholesterol). NAFLD and cholelithiasis were present in 41% and 34% of all patients, respectively. Significantly higher prevalence of cholelithiasis was found among patients with NAFLD compared with patients without NAFLD (47% vs. 26%, respectively; p < 0.0001). In multivariate logistic regression model, type 2 diabetes (odds ratio (OR) = 1.99), BMI above 25 kg/m(2) (OR = 1.78), and cholelithiasis (OR = 1.77) were identified as independent predictors of NAFLD. Fifty six percent of patients with cholelithiasis had NAFLD compared with 33% of patients without cholelithiasis (p < 0.0001). Multivariate logistic regression identified age above 50 years (OR = 3.46), NAFLD (OR = 1.92), triglycerides above 1.7 mmol/l (OR = 1.91), BMI above 25 kg/m(2) (OR = 1.84), and total cholesterol concentration (OR = 0.711) as independent predictors of cholelithiasis. In conclusion, patients with metabolic risk factors and cholelithiasis suffer significantly more often from NAFLD compared with the reference group. Cholelithiasis represents an independent risk factor of NAFLD in addition to metabolic risk factors and could be regarded as an additional risk factor of liver damage in patients with NAFLD. Furthermore, NAFLD is an independent risk factor for cholelithiasis and might represent a pathogenetic link between the metabolic syndrome and cholelithiasis. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/22182015/Cholelithiasis_and_markers_of_nonalcoholic_fatty_liver_disease_in_patients_with_metabolic_risk_factors_ L2 - http://www.tandfonline.com/doi/full/10.3109/00365521.2011.643481 DB - PRIME DP - Unbound Medicine ER -