Gallstones associated with nonalcoholic steatohepatitis (NASH) and metabolic syndrome

Department of Surgery, Göztepe Training and Research Hospital, İstanbul.
The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology (Impact Factor: 0.78). 12/2010; 21(4):411-5. DOI: 10.4318/tjg.2010.0128
Source: PubMed


We aimed to evaluate the prevalence of non-alcoholic steatohepatitis and metabolic syndrome in patients with symptomatic gallstones undergoing laparoscopic or open cholecystectomy.
A study of 95 patients was performed. Simultaneous liver biopsies were taken during cholecystectomy between 2006 and 2007. There were no postoperative complications. Patients with significant alcohol intake, hepatitis B or C (virus-positive), autoimmune diseases, and Wilson's disease were excluded. Demographics, liver function tests, lipid profile, and ultrasound findings of patients with and without non-alcoholic steatohepatitis were compared.
A total of 95 patients completed the study. The mean age was 52.15 years, and 29 patients were male and 66 female. Fifty-two patients (55%) had biopsies compatible with non-alcoholic steatohepatitis.
Fifty-five percent of patients with gallbladder stones had associated non-alcoholic steatohepatitis. Awareness of this association may result in an earlier diagnosis. The high prevalence of non-alcoholic steatohepatitis in patients with gallbladder stone may justify routine liver biopsy during cholecystectomy to establish the diagnosis and stage and possibly direct therapy.

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    • "Our results indicated that NAFLD was associated with incident GSD after adjustment for confounding factors.The association between NAFLD and GSD is based upon associated risk factors and metabolic derangements that are common to both conditions. From the preventive medicine viewpoint, modifiable risk factors for GSD and NAFLD include obesity and metabolic syndrome, both of which can be addressed with weight loss, exercise and dietary modifications such as a low-fat, low-sugar diet [26]. "
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