title: The metabolic syndrome is associated with complicated gallstone disease.
abstract: BACKGROUND
  Gallstone disease (GD) is a common condition worldwide. Several studies demonstrated that the presence of gallstones is strongly associated with cardiovascular disease. The metabolic syndrome is a highly prevalent cardiovascular condition.
  
  
  OBJECTIVE
  To examine the relationship between complicated GD (CGD) and the metabolic syndrome or its components.
  
  
  METHODS
  Two hundred seventeen patients with gallstones were examined. All patients underwent biliary ultrasonography after a complete medical history and laboratory examination. Data collection for the diagnosis of metabolic syndrome included measurements of waist circumference, blood pressure and lipids, and biochemical tests.
  
  
  RESULTS
  Of the 217 patients examined, 115 patients (53%) had CGD and 102 patients (47%) had uncomplicated GD (UCGD). There was a significant difference between the number of patients with large gallstones in the CGD and UCGD groups (n=14 [12%] versus n=2 [2%], respectively; P=0.004). Metabolic syndrome, diabetes mellitus and large waist circumference were more prevalent in the CGD group than in the UCGD group. Homeostatic model assessment of insulin resistance scores were higher in the CGD group than in UCGD group (2.51 [95% CI 0.57 to 23.90] versus 2.20 [95% CI 0.09 to 8.87], respectively; P=0.032). Logistic regression analysis revealed that the presence of metabolic syndrome (OR 1.434; 95% CI 1.222 to 1.846, P=0.014), diabetes mellitus (OR 1.493; 95% CI 1.255 to 1.953; P=0.035) and large gallstones (OR 1.153; 95% CI 1.033 to 1.714; P=0.017) were independent predictors of CGD.
  
  
  CONCLUSIONS
  Results of the present study demonstrated that metabolic syndrome, diabetes and gallstone size were associated with CGD. Further prospective studies are needed to understand the clinical importance of this association.
authors.affiliation: Department of Internal Medicine, Kecioren Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Naim
authors.initials: N
authors.lastname: Ata
authors.forename: Metin
authors.initials: M
authors.lastname: Kucukazman
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Yavuz
authors.forename: Hakan
authors.initials: H
authors.lastname: Bulus
authors.forename: Kursad
authors.initials: K
authors.lastname: Dal
authors.forename: Derun Taner
authors.initials: DT
authors.lastname: Ertugrul
authors.forename: Ahmet Arif
authors.initials: AA
authors.lastname: Yalcin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Polat
authors.forename: Numan
authors.initials: N
authors.lastname: Varol
authors.forename: Kadir Okhan
authors.initials: KO
authors.lastname: Akin
authors.forename: Aral
authors.initials: A
authors.lastname: Karabag
authors.forename: Yasar
authors.initials: Y
authors.lastname: Nazligul
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D042882:Gallstones / Q000453:epidemiology*; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged