title: Moderate to severe, but not mild, nonalcoholic fatty liver disease associated with increased risk of gallstone disease.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GSD) share some of the same risk factors. The association between NAFLD and GSD was inconsistent. Moreover, there are no studies on the association between GSD and the severity of NAFLD in the literature. The aim of this study was to determine the relationship between the severity of NAFLD and GSD in a Taiwanese population.
  
  
  METHODS
  A total of 12,033 subjects were enrolled. The diagnoses of GSD and NAFLD were based on the finding of abdominal ultrasonography. The severity of NAFLD was divided into mild, moderate, and severe.
  
  
  RESULTS
  Compared with the non-GSD group, the GSD one was older and had a higher BMI, blood pressure, fasting plasma glucose, cholesterol, triglyceride, and higher prevalence of diabetes and hypertension, but they had a lower eGFR and HDL-C level and less prevalence of current smoking and alcohol drinking. There was a significant difference in the severity of NAFLD between subjects with and without GSD. Based on logistic regression, age ≥65 versus <40 years, 40-64.9 versus <40 years, female, current alcohol drinking, diabetes, hypertension, HDL-C level and moderate to severe NAFLD, but not mild NAFLD, were the independently associated risk factors of GSD.
  
  
  CONCLUSIONS
  Moderate to severe, but not mild, NAFLD was associated with an increased risk of GSD, independent of the traditional cardio-metabolic risk factor. Age, female, diabetes, and hypertension were also related to a higher risk of GSD, but HDL-C level and moderate alcohol drinking showed a lower risk.
authors.affiliation: Department of Family Medicine, National Cheng Kung University Hospital , Tainan City , Taiwan.
authors.forename: Yen-Chun
authors.initials: YC
authors.lastname: Lee
authors.forename: Jin-Shang
authors.initials: JS
authors.lastname: Wu
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Yang
authors.forename: Chin-Sung
authors.initials: CS
authors.lastname: Chang
authors.forename: Feng-Hwa
authors.initials: FH
authors.lastname: Lu
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D015992:Body Mass Index; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects; D013624:Taiwan / Q000453:epidemiology; D014463:Ultrasonography
keywords: gallstone disease; nonalcoholic fatty liver disease; severity; taiwanese