title: Gallbladder disease is associated with insulin resistance in a high risk Hispanic population.
abstract: OBJECTIVE
  We tested whether cholesterol gallstone disease (GS) is associated to insulin resistance and serum C-reactive protein (CRP) in a high risk population.
  
  
  METHODS
  This was a nested case-control study on 881 Chilean subjects that included clinical examination, abdominal ultrasound and blood chemistries. Insulin resistance was determined by the homeostasis model assessment index (IR-HOMA).
  
  
  RESULTS
  Compared to controls (n = 582), age and sex adjusted median IR-(HOMA) was significantly elevated in subjects with GS (n = 299) (P < 0.001). Risks of GS in subjects with insulin resistance and different body mass index (BMI) were: BMI < 25, 2.2 (1.1-4.7); BMI 25-30, 1.5 (0.9-2.5) and BMI > 30, 1.7 (1.0-2.9). Risk of GS in subjects with metabolic syndrome was 1.7 (CI, 1.2-2.5) and with fatty liver, 1.5 (1.1-2.2). Risk of GS in subjects with CRP > 1 mg/dL was 1.0 (0.7-1.7).
  
  
  CONCLUSIONS
  GS is associated to insulin resistance, fatty liver and to metabolic syndrome, but not to serum CRP in a high risk Hispanic population. Insulin resistance could have a major role in the pathogenesis of GS favoring the production of cholesterol supersaturated bile and altering gallbladder function.
authors.affiliation: Departmento de Gastroenterología, Pontificia Universidad Católica de Chile, 367 Marcoleta, Casilla 114-D, Santiago, Chile. fnervi@med.puc.cl
authors.forename: Flavio
authors.initials: F
authors.lastname: Nervi
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Miquel
authors.forename: Manuel
authors.initials: M
authors.lastname: Alvarez
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
authors.forename: María José
authors.initials: MJ
authors.lastname: García-Zattera
authors.forename: Robinson
authors.initials: R
authors.lastname: González
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Pérez-Ayuso
authors.forename: Attilio
authors.initials: A
authors.lastname: Rigotti
authors.forename: Luís
authors.initials: L
authors.lastname: Villarroel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002677:Chile / Q000453:epidemiology; D005260:Female; D005705:Gallbladder Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D007328:Insulin; D002097:C-Reactive Protein