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Cholecystectomy is independently associated with nonalcoholic fatty liver disease in an Asian population.
World J Gastroenterol 2015; 21(20):6287-95WJ

Abstract

AIM

To investigate the relationship between gallstone disease and nonalcoholic fatty liver disease (NAFLD) in a large Asian population.

METHODS

A cross-sectional study including 17612 subjects recruited from general health check-ups at the Seoul National University Hospital, Healthcare System Gangnam Center between January 2010 and December 2010 was conducted. NAFLD and gallstone disease were diagnosed based on typical ultrasonographic findings. Subjects who were positive for hepatitis B or C, or who had a history of heavy alcohol consumption (> 30 g/d for men and > 20 g/d for women) or another type of hepatitis were excluded. Gallstone disease was defined as either the presence of gallstones or previous cholecystectomy, and these two entities (gallstones and cholecystectomy) were analyzed separately. Clinical parameters including body mass index, waist circumference, hypertension, diabetes, smoking status, and regular physical activity were reviewed. Laboratory parameters, including serum levels of gamma-glutamyl transpeptidase, alanine aminotransferase, aspartate aminotransferase, fasting glucose, fasting insulin, total cholesterol, triglycerides, and high-density lipoprotein, were also reviewed.

RESULTS

The mean age of the subjects was 48.5 ± 11.3 years, and 49.3% were male. Approximately 30.3% and 6.1% of the subjects had NAFLD and gallstone disease, respectively. The prevalence of gallstone disease (8.3% vs 5.1%, P < 0.001), including both the presence of gallstones (5.5% vs 3.4%, P < 0.001) and a history of cholecystectomy (2.8% vs 1.7%, P < 0.001), was significantly increased in the NAFLD group. In the same manner, the prevalence of NAFLD increased with the presence of gallstone disease (41.3% vs 29.6%, P < 0.001). Multivariate regression analysis showed that cholecystectomy was associated with NAFLD (OR = 1.35, 95%CI: 1.03-1.77, P = 0.028). However, gallstones were not associated with NAFLD (OR = 1.15, 95%CI: 0.95-1.39, P = 0.153). The independent association between cholecystectomy and NAFLD was still significant after additional adjustment for insulin resistance (OR = 1.45, 95%CI: 1.01-2.08, P = 0.045).

CONCLUSION

This study shows that cholecystectomy, but not gallstones, is independently associated with NAFLD after adjustment for metabolic risk factors. These data suggest that cholecystectomy may be an independent risk factor for NAFLD.

Authors+Show Affiliations

Min-Sun Kwak, Donghee Kim, Goh Eun Chung, Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 135-984, South Korea.Min-Sun Kwak, Donghee Kim, Goh Eun Chung, Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 135-984, South Korea.Min-Sun Kwak, Donghee Kim, Goh Eun Chung, Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 135-984, South Korea.Min-Sun Kwak, Donghee Kim, Goh Eun Chung, Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 135-984, South Korea.Min-Sun Kwak, Donghee Kim, Goh Eun Chung, Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 135-984, South Korea.Min-Sun Kwak, Donghee Kim, Goh Eun Chung, Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 135-984, South Korea.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26034364

Citation

Kwak, Min-Sun, et al. "Cholecystectomy Is Independently Associated With Nonalcoholic Fatty Liver Disease in an Asian Population." World Journal of Gastroenterology, vol. 21, no. 20, 2015, pp. 6287-95.
Kwak MS, Kim D, Chung GE, et al. Cholecystectomy is independently associated with nonalcoholic fatty liver disease in an Asian population. World J Gastroenterol. 2015;21(20):6287-95.
Kwak, M. S., Kim, D., Chung, G. E., Kim, W., Kim, Y. J., & Yoon, J. H. (2015). Cholecystectomy is independently associated with nonalcoholic fatty liver disease in an Asian population. World Journal of Gastroenterology, 21(20), pp. 6287-95. doi:10.3748/wjg.v21.i20.6287.
Kwak MS, et al. Cholecystectomy Is Independently Associated With Nonalcoholic Fatty Liver Disease in an Asian Population. World J Gastroenterol. 2015 May 28;21(20):6287-95. PubMed PMID: 26034364.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cholecystectomy is independently associated with nonalcoholic fatty liver disease in an Asian population. AU - Kwak,Min-Sun, AU - Kim,Donghee, AU - Chung,Goh Eun, AU - Kim,Won, AU - Kim,Yoon Jun, AU - Yoon,Jung-Hwan, PY - 2014/12/03/received PY - 2015/02/09/revised PY - 2015/04/03/accepted PY - 2015/6/3/entrez PY - 2015/6/3/pubmed PY - 2016/1/27/medline KW - Cholelithiasis KW - Fatty liver KW - Gallbladder KW - Gallbladder removal KW - Hepatic steatosis SP - 6287 EP - 95 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 21 IS - 20 N2 - AIM: To investigate the relationship between gallstone disease and nonalcoholic fatty liver disease (NAFLD) in a large Asian population. METHODS: A cross-sectional study including 17612 subjects recruited from general health check-ups at the Seoul National University Hospital, Healthcare System Gangnam Center between January 2010 and December 2010 was conducted. NAFLD and gallstone disease were diagnosed based on typical ultrasonographic findings. Subjects who were positive for hepatitis B or C, or who had a history of heavy alcohol consumption (> 30 g/d for men and > 20 g/d for women) or another type of hepatitis were excluded. Gallstone disease was defined as either the presence of gallstones or previous cholecystectomy, and these two entities (gallstones and cholecystectomy) were analyzed separately. Clinical parameters including body mass index, waist circumference, hypertension, diabetes, smoking status, and regular physical activity were reviewed. Laboratory parameters, including serum levels of gamma-glutamyl transpeptidase, alanine aminotransferase, aspartate aminotransferase, fasting glucose, fasting insulin, total cholesterol, triglycerides, and high-density lipoprotein, were also reviewed. RESULTS: The mean age of the subjects was 48.5 ± 11.3 years, and 49.3% were male. Approximately 30.3% and 6.1% of the subjects had NAFLD and gallstone disease, respectively. The prevalence of gallstone disease (8.3% vs 5.1%, P < 0.001), including both the presence of gallstones (5.5% vs 3.4%, P < 0.001) and a history of cholecystectomy (2.8% vs 1.7%, P < 0.001), was significantly increased in the NAFLD group. In the same manner, the prevalence of NAFLD increased with the presence of gallstone disease (41.3% vs 29.6%, P < 0.001). Multivariate regression analysis showed that cholecystectomy was associated with NAFLD (OR = 1.35, 95%CI: 1.03-1.77, P = 0.028). However, gallstones were not associated with NAFLD (OR = 1.15, 95%CI: 0.95-1.39, P = 0.153). The independent association between cholecystectomy and NAFLD was still significant after additional adjustment for insulin resistance (OR = 1.45, 95%CI: 1.01-2.08, P = 0.045). CONCLUSION: This study shows that cholecystectomy, but not gallstones, is independently associated with NAFLD after adjustment for metabolic risk factors. These data suggest that cholecystectomy may be an independent risk factor for NAFLD. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/26034364/Cholecystectomy_is_independently_associated_with_nonalcoholic_fatty_liver_disease_in_an_Asian_population_ L2 - http://www.wjgnet.com/1007-9327/full/v21/i20/6287.htm DB - PRIME DP - Unbound Medicine ER -