Prevalence of cholelithiasis according to alcoholic liver disease: a possible role of apolipoproteins AI and AII.
Moderate alcohol intakes decreases the risk of gallstones; in contrast, the prevalence of gallstones is increased in patients with alcoholic cirrhosis. The aims of this prospective study were to assess the prevalence of cholelithiasis among drinkers according to the histological severity of liver disease, and to estimate the importance of serum apolipoproteins AI and apolipoprotein AII as risk factors for gallstones. Among the 320 drinkers included, 53 patients had cholelithiasis. The prevalence increased (p < 0.0001) from 5% in patients with normal liver (1 of 22) and 6% in patients with steatosis only (3 of 47) to 13% in patients with fibrosis (7 of 54), reaching 27% among patients with biopsy-proven cirrhosis (28 of 103). Among patients with clinically obvious cirrhosis on whom biopsy was not performed mainly because of the severity of liver disease, the prevalence of cholelithiasis reached a maximum of 46% (6 of 13). Among drinkers with nonsevere liver disease, patients with cholelithiasis were older (59 +/- 9 years, mean +/- SD vs. 45 +/- 11, p = 0.003) with lower apolipoprotein AI (118 +/- 37 vs. 163 +/- 45 mg/dl; p = 0.002) and apolipoprotein AII (30 +/- 12 vs. 53 +/- 20 mg/dl; p = 0.0002) in comparison with patients without cholelithiasis. These differences persisted after considering by multiple logistic regression analysis, sex, and ideal body weight. Alcohol consumption during the last 5 years was lower in patients with cholelithiasis (83 g/day) in comparison with patients without cholelithiasis (142 g/day; p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)
Poynard
T
T
Service d'Hépato-Gastroentérologie, Groupe Hospitalier Pitié Salpetrière, Paris, France.
Lonjon
I
I
Mathurin
P
P
Abella
A
A
Musset
D
D
Bedossa
P
P
Aubert
A
A
Naveau
S
S
Chaput
J C
JC
D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects*; D016632:Apolipoprotein A-I / Q000097:blood; D016633:Apolipoprotein A-II / Q000097:blood; D001706:Biopsy; D002769:Cholelithiasis / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008055:Lipids / Q000097:blood; D008099:Liver / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
D016632:Apolipoprotein A-I; D016633:Apolipoprotein A-II; D008055:Lipids