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. Materials and 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. Conclusion. 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.

Key Words::

• gallstone disease
• nonalcoholic fatty liver disease
• severity
• taiwanese

Acknowledgment

This work was supported by Grant NCKUHFM-101-001 from the Department of Family Medicine, National Cheng-Kung University Hospital. Any affiliations with or financial involvement in the materials discussed in the manuscript are disclosed. There are no conflicts of interest. The contribution is the following: Yen-chun Lee, Jin-shang Wu, Yi-ching Yang, and Chih-jen Chang made contributions to conception and design of the study, statistical analyses, research data interpretation, discussion, and critical manuscript review. Chin-sung Chang and Feng-hwa Lu contributed with suggestions and advice. All authors were involved in the acquisition of data. Yen-Chun Lee drafted the article and all authors revised and approved the final version.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.