Relationship Between Gallstone Disease and Cardiometabolic Risk Factors in Elderly People with Non-Alcoholic Fatty Liver Disease

Abstract

Background

The prevalence of gallstone disease (GSD) increases with age, and the elderly have a much higher mortality risk and incidence of surgical comorbidities. The aim of this study was to explore the relationship between GSD and cardiometabolic risk factors in elderly people with non-alcoholic fatty liver disease (NAFLD).

Methods

In this cross-sectional study, we analyzed the data of elderly people who underwent annual health check-ups at a Northern Taiwan health examination center. These data were collected from physical examination, blood tests, abdominal ultrasonography, and medical histories. We excluded those with hepatitis B or C infections, heavy alcohol consumption, or cholecystectomy.

Results

The analysis included 3,037 participants with a mean age of 73.6±6.0 years. Over 70% were overweight or obese, and the overall prevalence of GSD was 17.7%. In our univariate analysis, GSD was positively correlated with age, body mass index, metabolic syndrome, diabetes mellitus (DM), hypertension (HTN), and various metabolic factors (fasting plasma glucose [FPG], triglyceride, uric acid, and high-density lipoprotein cholesterol [HDL-C] levels). After adjustment for age, gender, and body mass index, metabolic syndrome showed a positive association with GSD (odds ratio [OR] 1.31 [95% confidence interval [CI], 1.05–1.64]; P=0.020). Specific components of metabolic syndrome that increased the risk for GSD in NAFLD elderly include lower levels of HDL-C (OR 1.35 [95% CI, 1.10–1.66]; P<0.001) and elevated FPG (OR 1.36 [95% CI, 1.10–1.69]; P<0.001).

Conclusion

Our study concluded that GSD is significantly associated with metabolic syndrome in elderly people with NAFLD. Reduced HDL-C and elevated FPG both heighten the risk of developing GSD. Therefore, to lower the risk of GSD in NAFLD patients, their FPG levels and HDL-C levels must be regularly followed-up, and these patients should be educated about the symptoms of GSD if they meet the criteria for metabolic syndrome.

Keywords:

• gallstone disease
• cardiometabolic risk factors
• metabolic syndrome

Abbreviations

ALT, alanine transaminase; AST, aspartate transaminase; BMI, body mass index; CI, confidence interval; DM, diabetes mellitus; FPG, fasting plasma glucose; GSD, gallstone disease; HDL-C, high-density lipoprotein cholesterol; HTN, hypertension; LDL-C, low-density lipoprotein cholesterol; MetS, metabolic syndrome; NAFLD, non-alcoholic fatty liver disease; OR, odds ratio.

Data Sharing Statement

The data supporting the results are from the Health Evaluation Center of MacKay Memorial Hospital.

Ethics Approval and Informed Consent

This study was conducted in accordance with the Declaration of Helsinki, and that verbal informed consent from the patients was approved by the Mackay Memorial Hospital, Taipei, Taiwan (approval ID: 18MMHIS137). Consent for publication: Verbal consent was witnessed and formally recorded.

Acknowledgment

The authors thank all members of the Department of Family Medicine, MacKay Memorial Hospital for help rendered for this study.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This research received no specific grant from any funding agency, commercial or not-for-profit sectors.