Gallstone disease in non-alcoholic fatty liver: prevalence and associated factors.
BACKGROUND
Insulin resistance is a risk factors for non-alcoholic fatty liver disease (NAFLD) and for gallstone disease (GD). Aims of the present study were to assess the prevalence of and factors associated with GD in unselected patients with NAFLD.


METHODS
A total of 161 consecutive patients with NAFLD diagnosed through compatible ultrasonography in the absence of known etiologies of liver disease (in all patients) and/or confirmed histologically (in 61 patients), was studied. Gallstone disease was diagnosed through ultrasound scanning or on the basis of previous cholecystectomy. Anthropometric and biochemical variables and concurrent diseases were compared in 32 NAFLD-GD patients and in 129 NAFLD patients without GD (controls) according to gender.


RESULTS
The overall prevalence of GD was 19.88%, higher in female patients (P < 0.05), who were older (P < 001). The overall percentage of GD increased with age (P < 0.05). The GD patients had higher uric acid (men), total cholesterol and apolipoprotein B (apo-B) serum concentrations (women; P < 0.05); women also had a higher prevalence of hypertriglyceridemia (P < 0.05). The age-corrected odds ratio of having GD by tertiles increased significantly with increasing uric acid (men) and with increasing total cholesterol, triglycerides and apo-B (women). At univariate continuous analysis GD was associated with insulin 120 min and uric acid in male patients; and with body mass index, insulin 120 min, apo-B, total cholesterol and triglycerides in female patients. On multivariate analysis it was found that among these factors only uric acid in men and apo-B in women were independently associated with GD in NAFLD.


CONCLUSIONS
The prevalence of GD in NAFLD is more elevated than reported in the general population. The factors independently associated with GD in NAFLD are different from those reported in the general population and vary according to the gender.
Loria
Paola
P
Department of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy. Loria.Paola@unimore.it
Lonardo
Amedeo
A
Lombardini
Silvia
S
Carulli
Lucia
L
Verrone
Annamaria
A
Ganazzi
Dorval
D
Rudilosso
Antonia
A
D'Amico
Roberto
R
Bertolotti
Marco
M
Carulli
Nicola
N
D000367:Age Factors; D001055:Apolipoproteins B / Q000097:blood; D001706:Biopsy; D041761:Cholecystolithiasis / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D005234:Fatty Liver / Q000150:complications* / Q000378:metabolism; D005260:Female; D005704:Gallbladder / Q000378:metabolism / Q000473:pathology; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications; D007333:Insulin Resistance; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D014527:Uric Acid / Q000032:analysis
D001055:Apolipoproteins B; D014527:Uric Acid; D002784:Cholesterol