title: Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects.
abstract: OBJECTIVE
  To investigate whether total body fat mass or fat distribution and associated metabolic disturbances in glucose and lipid metabolism influence the well known gallstone pathogenetic factors in obese subjects in order to explain why some obese subjects develop gallstones and some do not.
  
  
  METHODS
  Cross sectional study of gallstone pathogenetic factors, body composition, fat distribution, glucose and lipid metabolism.
  
  
  METHODS
  57 healthy overweight subjects (aged 26-64y, body mass index (BMI) 30-45 kg/m2).
  
  
  METHODS
  Total and intra-abdominal fat masses were measured by dual X-ray absorptiometry and abdominal CT scanning, respectively. The lithogenic index was measured in aspirated bile. The gallbladder volume was determined by ultrasound and the gallbladder ejection fraction% by dynamic cholescintigraphy. Plasma cholecystokinin (CCK) concentrations during a meal were measured with a specific radioimmunoassay. Insulin sensitivity was measured by the Minimal Model and glucose tolerance by an oral glucose tolerance test (OGTT). Serum lipid concentrations were measured by standard methods.
  
  
  RESULTS
  The gallbladder volume in the fasting state increased with increasing intra-abdominal fat mass (P=0.006) and was increased in subjects with impaired glucose tolerance (41 vs 27 ml, P=0.001). The lithogenic index was > 1 in all subjects and correlated with total fat mass (P=0.04).
  
  
  CONCLUSIONS
  Gallstone pathogenesis in obesity seems to be influenced by the total body fat mass and its regional distribution possibly via mutual association with the glucose tolerance.
authors.affiliation: Department of Clinical Physiology, Hvidovre Hospital, Copenhagen, Denmark.
authors.forename: H W
authors.initials: HW
authors.lastname: Hendel
authors.forename: L
authors.initials: L
authors.lastname: Højgaard
authors.forename: T
authors.initials: T
authors.lastname: Andersen
authors.forename: B H
authors.initials: BH
authors.lastname: Pedersen
authors.forename: L I
authors.initials: LI
authors.lastname: Paloheimo
authors.forename: J F
authors.initials: JF
authors.lastname: Rehfeld
authors.forename: A
authors.initials: A
authors.lastname: Gotfredsen
authors.forename: M H
authors.initials: MH
authors.lastname: Rasmussen
mesh_terms: D000005:Abdomen; D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000033:anatomy & histology; D000328:Adult; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D001823:Body Composition / Q000502:physiology*; D002766:Cholecystokinin / Q000097:blood; D002769:Cholelithiasis / Q000209:etiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004041:Dietary Fats / Q000008:administration & dosage; D005215:Fasting / Q000502:physiology; D005260:Female; D005704:Gallbladder / Q000033:anatomy & histology / Q000502:physiology*; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008055:Lipids / Q000097:blood* / Q000145:classification; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed
chemical_list: D001786:Blood Glucose; D004041:Dietary Fats; D007328:Insulin; D008055:Lipids; D002766:Cholecystokinin