Gallstone disease does not predict liver histology in nonalcoholic fatty liver disease.
OBJECTIVE
We sought to examine whether the presence of gallstone disease (GD) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) is associated with liver fibrosis and histological nonalcoholic steatohepatitis (NASH) score.


METHODS
We included 441 Turkish patients with biopsy-proven NAFLD. GD was diagnosed in the presence of sonographic evidence of gallstones, echogenic material within the gallbladder with constant shadowing and little or no visualization of the gallbladder or absence of gallbladder at ultrasonography, coupled with a history of cholecystectomy.


RESULTS
Fifty-four patients (12.2%) had GD (GD+ subjects). Compared with the GD- subjects, GD+ patients were older, had a higher body mass index and were more likely to be female and have metabolic syndrome. However, GD+ patients did not have a higher risk of advanced fibrosis or definite NASH on histology. After adjustment for potential confounding variables, the prevalence of GD in NAFLD patients was not associated with significant fibrosis (≥2) (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.53 to 2.21; p=0.68) or definite NASH (OR, 1.03; 95% CI, 0.495 to 2.12; p=0.84).


CONCLUSIONS
The presence of GD is not independently associated with advanced fibrosis and definite NASH in adult Turkish patients with biopsy-proven NAFLD.
Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey.
Yusuf
Y
Yilmaz
Department of Gastroenterology, Uludag University Medical School, Bursa, Turkey.
Talat
T
Ayyildiz
Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey.
Hakan
H
Akin
Department of Gastroenterology, Istanbul Medeniyet University Medical Faculty, Istanbul, Turkey.
Yasar
Y
Colak
Department of Gastroenterology, Istanbul Medeniyet University Medical Faculty, Istanbul, Turkey.
Oguzhan
O
Ozturk
Department of Gastroenterology, Dicle University School of Medicine, Diyarbakir, Turkey.
Ebubekir
E
Senates
Department of Gastroenterology, Istanbul Medeniyet University Medical Faculty, Istanbul, Turkey.
Ilyas
I
Tuncer
Department of Gastroenterology, Uludag University Medical School, Bursa, Turkey.
Enver
E
Dolar
D001706:Biopsy; D005234:Fatty Liver / Q000473:pathology; D005260:Female; D005704:Gallbladder / Q000473:pathology; D042882:Gallstones / Q000150:complications / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000473:pathology*; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
Fibrosis; Gallstone disease; Non-alcoholic fatty liver disease; Nonalcoholic steatohepatitis