Gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease.
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) are both highly prevalent in the general population and associated with obesity and insulin resistance. We aimed to evaluate the prevalence of GD in a cross sectional study of NAFLD patients and to define whether the pre...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3405067?pdf=render |
| _version_ | 1818296452267376640 |
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| author | Anna Ludovica Fracanzani Luca Valenti Maurizio Russello Luca Miele Cristina Bertelli Alessandro Bellia Chiara Masetti Consuelo Cefalo Antonio Grieco Giulio Marchesini Silvia Fargion |
| author_facet | Anna Ludovica Fracanzani Luca Valenti Maurizio Russello Luca Miele Cristina Bertelli Alessandro Bellia Chiara Masetti Consuelo Cefalo Antonio Grieco Giulio Marchesini Silvia Fargion |
| author_sort | Anna Ludovica Fracanzani |
| collection | DOAJ |
| description | BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) are both highly prevalent in the general population and associated with obesity and insulin resistance. We aimed to evaluate the prevalence of GD in a cross sectional study of NAFLD patients and to define whether the presence of GD is associated with diabetes and predicts more severe liver disease. METHODOLOGY/PRINCIPAL FINDINGS: We merged databases of four Liver Units, comprising 524 consecutive biopsy-proven NAFLD (373 males) observed between January 2003 and June 2010. GD was diagnosed in 108 (20%), and 313 cases (60%) were classified by liver biopsy as nonalcoholic steatohepatitis (NASH). The GD subgroup was characterized by a significantly higher prevalence of females, prediabetes/diabetes, abdominal obesity and metabolic syndrome, older age, higher BMI, fasting glucose, HOMA-IR and lower ALT. The prevalence of GD progressively increased with advancing fibrosis and with the severity of necroinflammatory activity (p for trend = 0.0001 and = 0.01, respectively), without differences in the severity of steatosis. At multivariate analysis GD was associated with female gender (OR 1.37, 95% CI 1.04-1.8), age (OR 1.027, 95% CI1.003-1.05), fasting glucose (OR 1.21, 95% CI 1.10-1.33) and NASH (OR 1.40,95% CI 1.06-1.89), whereas ALT levels were associated with a lower GD risk (OR 0.98, 95% CI 0.97-0.99). When subjects with cirrhosis were excluded from analysis, the association between GD and fasting glucose, female gender, and NASH was maintained. CONCLUSION: Patients with NAFLD have a high prevalence of GD, which characterizes subjects with altered glucose regulation and more advanced liver disease. |
| first_indexed | 2024-12-13T04:03:46Z |
| format | Article |
| id | doaj.art-40d15bf4a9ee4e22b36d9a02e83f46e7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T04:03:46Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-40d15bf4a9ee4e22b36d9a02e83f46e72022-12-22T00:00:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0177e4118310.1371/journal.pone.0041183Gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease.Anna Ludovica FracanzaniLuca ValentiMaurizio RusselloLuca MieleCristina BertelliAlessandro BelliaChiara MasettiConsuelo CefaloAntonio GriecoGiulio MarchesiniSilvia FargionBACKGROUND: Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) are both highly prevalent in the general population and associated with obesity and insulin resistance. We aimed to evaluate the prevalence of GD in a cross sectional study of NAFLD patients and to define whether the presence of GD is associated with diabetes and predicts more severe liver disease. METHODOLOGY/PRINCIPAL FINDINGS: We merged databases of four Liver Units, comprising 524 consecutive biopsy-proven NAFLD (373 males) observed between January 2003 and June 2010. GD was diagnosed in 108 (20%), and 313 cases (60%) were classified by liver biopsy as nonalcoholic steatohepatitis (NASH). The GD subgroup was characterized by a significantly higher prevalence of females, prediabetes/diabetes, abdominal obesity and metabolic syndrome, older age, higher BMI, fasting glucose, HOMA-IR and lower ALT. The prevalence of GD progressively increased with advancing fibrosis and with the severity of necroinflammatory activity (p for trend = 0.0001 and = 0.01, respectively), without differences in the severity of steatosis. At multivariate analysis GD was associated with female gender (OR 1.37, 95% CI 1.04-1.8), age (OR 1.027, 95% CI1.003-1.05), fasting glucose (OR 1.21, 95% CI 1.10-1.33) and NASH (OR 1.40,95% CI 1.06-1.89), whereas ALT levels were associated with a lower GD risk (OR 0.98, 95% CI 0.97-0.99). When subjects with cirrhosis were excluded from analysis, the association between GD and fasting glucose, female gender, and NASH was maintained. CONCLUSION: Patients with NAFLD have a high prevalence of GD, which characterizes subjects with altered glucose regulation and more advanced liver disease.http://europepmc.org/articles/PMC3405067?pdf=render |
| spellingShingle | Anna Ludovica Fracanzani Luca Valenti Maurizio Russello Luca Miele Cristina Bertelli Alessandro Bellia Chiara Masetti Consuelo Cefalo Antonio Grieco Giulio Marchesini Silvia Fargion Gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease. PLoS ONE |
| title | Gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease. |
| title_full | Gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease. |
| title_fullStr | Gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease. |
| title_full_unstemmed | Gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease. |
| title_short | Gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease. |
| title_sort | gallstone disease is associated with more severe liver damage in patients with non alcoholic fatty liver disease |
| url | http://europepmc.org/articles/PMC3405067?pdf=render |
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