title: Abdominal visceral fat accumulation measured by computed tomography associated with an increased risk of gallstone disease.
abstract: OBJECTIVE
  Visceral adiposity is a strong determinant of insulin resistance, which decreases cholecystokinin response sensitivity, and increases cholesterol saturation in the gallbladder bile; thus, it potentially relates to gallstone disease development. We aimed to investigate whether visceral fat measured by computed tomography (CT) is a risk factor for gallstone disease.
  
  
  METHODS
  A cohort of 717 participants undergoing CT and ultrasonography was analyzed. The associations between body mass index (BMI), visceral adipose tissue (VAT) area, subcutaneous adipose tissue (SAT) area, and gallstone disease were analyzed adjusted for age, sex, hypertension, diabetes, and dyslipidemia.
  
  
  RESULTS
  In multivariate analysis, gallstone disease was significantly associated with VAT and SAT areas for both categorical data and trend (P for trend < 0.001, 0.009), but not body mass index (BMI). Among patients with BMI < 25, gallstone disease remained significantly associated with VAT area (P for trend 0.021) and SAT area (P for trend 0.005). Interactions between the obesity indices and being elderly on the risk of gallstone disease were found; specifically BMI (P = 0.005), SAT (P < 0.001), and VAT (P = 0.154). A significant association between all obesity indices and gallstone disease was seen in patients aged < 65 but not among those aged ≥ 65. However, no significant association was noted between the obesity indices and sex.
  
  
  CONCLUSIONS
  CT-measured adipose tissue, rather than BMI, was a better predictor for risk of gallstone disease. This finding applies to younger people or even those with normal body weight, suggesting the importance of abdominal visceral fat accumulation in the development of gallstone disease.
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Katsunori
authors: K
authors: Sekine
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Naoyoshi
authors: N
authors: Nagata
authors: Diagnostic Radiology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Kayo
authors: K
authors: Sakamoto
authors: Diagnostic Radiology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Tomohiro
authors: T
authors: Arai
authors: Clinical Research and Informatics, International Clinical Research Center Research Institute, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Takuro
authors: T
authors: Shimbo
authors: Diagnostic Radiology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Masafumi
authors: M
authors: Shinozaki
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Hidetaka
authors: H
authors: Okubo
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Kazuhiro
authors: K
authors: Watanabe
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Koh
authors: K
authors: Imbe
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Shintaro
authors: S
authors: Mikami
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Yuichi
authors: Y
authors: Nozaki
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Toshiyuki
authors: T
authors: Sakurai
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Chizu
authors: C
authors: Yokoi
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Yasushi
authors: Y
authors: Kojima
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Masao
authors: M
authors: Kobayakawa
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Mikio
authors: M
authors: Yanase
authors: Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Junichi
authors: J
authors: Akiyama
authors: Diabetes Research Center, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Mitsuhiko
authors: M
authors: Noda
authors: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.
authors: Naomi
authors: N
authors: Uemura
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014463:Ultrasonography
keywords: Asian country; abdominal visceral obesity; gallstone disease; visceral adipose tissue