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Cheng S, Zhang Y, Jiang L, Li J, Jiang R, Wang F. The association between inflammatory biomarkers and gallstones in Americans under 50 years old. BMC Gastroenterol 2025; 25:393. [PMID: 40399796 PMCID: PMC12096754 DOI: 10.1186/s12876-025-03994-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2025] [Accepted: 05/14/2025] [Indexed: 05/23/2025] Open
Abstract
BACKGROUND This study aimed to assess the link between inflammatory biomarkers (like the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammatory index (SII), and systemic inflammation response index (SIRI)) and gallstones in American individuals aged under 50 years. METHODS This study utilized data from the National Health and Nutrition Examination Survey (NHANES) covering 2017 to 2020, centering on individuals under 50 years with comprehensive data on NLR, SII, SIRI, and gallstones. It employed a weighted multiple logistic regression approach to investigate the link between inflammatory biomarkers and gallstones. Furthermore, dose-response relationships and threshold effects were evaluated utilizing restricted cubic spline (RCS) methods and segmented linear regression models. Subgroup examinations and interaction assessments were conducted, too. RESULTS The investigation encompassed a total of 3,295 individuals. Upon comprehensive adjustment for variables, multivariate logistic regression revealed a positive relationship between inflammatory biomarkers and gallstones: ln-NLR (OR = 1.68, 95% CI: 1.06-2.66, p = 0.033), ln-SII (OR = 1.79, 95% CI: 1.08-2.98, p = 0.032), and ln-SIRI (OR = 1.46, 95% CI: 1.07-1.99, p = 0.025). A non-linear association, shaped like an inverse "U", was noted between ln-SIRI and gallstones. To the left of the inflection point (ln-SIRI = 0.35, SIRI = 1.42), a positive link existed between ln-SIRI and gallstones (OR = 2.45, 95% CI: 1.20-5.03); whereas, to the right of the inflection point, the association was statistically insignificant (OR = 0.60, 95% CI: 0.21-1.73). CONCLUSION ln-NLR and ln-SII exhibited a linear and positive relationship with the likelihood of developing gallstones. ln-SIRI demonstrated a nonlinear dose-response relationship with gallstone risk, characterized by an inverted "U" shape.
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Affiliation(s)
- Shuqin Cheng
- First Central Hospital of Tianjin Medical University, Tianjin, 300070, China
| | - Yaping Zhang
- The Third Central Clinical College of Tianjin Medical University, Tianjin, 300170, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary Disease, Nankai University Affiliated Third Central Hospital, Tianjin, 300072, China
| | - Lu Jiang
- First Central Hospital of Tianjin Medical University, Tianjin, 300070, China
| | - Jiana Li
- First Central Hospital of Tianjin Medical University, Tianjin, 300070, China
- Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer, Tianjin First Central Hospital, No. 24 Fukang Road, Nankai District, Tianjin, 300192, China
| | - Runci Jiang
- First Central Hospital of Tianjin Medical University, Tianjin, 300070, China
- Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer, Tianjin First Central Hospital, No. 24 Fukang Road, Nankai District, Tianjin, 300192, China
| | - Fengmei Wang
- Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer, Tianjin First Central Hospital, No. 24 Fukang Road, Nankai District, Tianjin, 300192, China.
- Department of Gastroenterology and Hepatology, Tianjin First Central Hospital, Tianjin, 300192, China.
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Delgado LM, Pompeu BF, Pasqualotto E, Martins GHA, Moraes CDJ, Guedes LSDSP, Poli de Figueiredo SM. Primary Closure Versus T-Tube Drainage on Common Bile Duct Exploration for Choledocholithiasis: An Updated Systematic Review and Meta-Analysis. J Laparoendosc Adv Surg Tech A 2025. [PMID: 40323738 DOI: 10.1089/lap.2025.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2025] Open
Abstract
Introduction: Laparoscopic common bile duct exploration (LCBDE) is a critical procedure for managing choledocholithiasis, with primary closure (PC) and T-tube drainage (TTD) as common methods for common bile duct closure. However, the substantial number of new studies comparing PC and TTD underscores the need for an updated meta-analysis. Therefore, this study aims to compare surgery-related outcomes in PC and TTD for biliary duct closure following LCBDE. Methods: We searched PubMed, Embase, and Cochrane Library databases on June 20, 2024. Mean differences (MDs) and risk ratios with 95% confidence intervals (CIs) were pooled for continuous and binary outcomes, respectively. Heterogeneity was assessed with I2 statistics. Statistical analysis was performed using Software R, version 4.3.3. Results: A total of 31 studies comprising 4432 patients were included. A total of 2301 (51.9%) were submitted to PC and 2131 (48.1%) were submitted to TTD. The mean age of patients ranged from 39 to 69.8 years and 44.3% were male. Compared with TTD, PC significantly reduced retained stones (odds ratio [OR] 0.57; 95% CI 0.35-0.93; P = .02; I2 = 0%), biliary peritonitis (OR 0.22; 95% CI 0.08-0.60; P < .01; I2 = 0%), operative time (MD -21.07 minutes; 95% CI -27.68-14.46; P <. 01; I2 = 97%) and postoperative hospital stay (MD -2.20 days; 95% CI -2.80-1.60; P <. 01; I2 = 96%). However, there were no significant differences between the groups in recurrent stones (OR 0.57; 95% CI 0.32-1.02; P = .06; I2 = 0%), bile leakage (OR 0.89; 95% CI 0.65-1.23; P = .49; I2 = 0%), bile duct stricture (OR 2.08; 95% CI 0.36-12.11; P = .42; I2 = 0%), pneumonia (OR 1.38; 95% CI 0.66-2.88; P = .39; I2 = 0%), and pancreatitis (OR 0.64; 95% CI 0.29-1.38; P = .25; I2 = 0%). Conclusion: In this meta-analysis, PC was associated with decreased retained stones, biliary peritonitis, operative time, and postoperative hospital stay. However, no significant differences were observed for the other outcomes. These findings underscore PC as a safe and reliable method for bile duct closure following LCBDE.
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Affiliation(s)
| | - Bernardo Fontel Pompeu
- Department of General Surgery, Heliopolis Hospital, São Paulo, Brazil
- Universidade Municipal de São Caetano do Sul (USCS), São Paulo, Brazil
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Wang L, Cao S, Song G. The role of relative fat mass in gallstone risk assessment: findings from the NHANES 2017-2020 survey. Front Nutr 2025; 12:1575524. [PMID: 40370800 PMCID: PMC12075137 DOI: 10.3389/fnut.2025.1575524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2025] [Accepted: 04/10/2025] [Indexed: 05/16/2025] Open
Abstract
Background Gallstones are a prevalent condition that can lead to significant morbidity and healthcare costs. Relative fat mass (RFM), as a potential marker of body fat distribution, may offer insights beyond traditional metrics like body mass index (BMI) and waist circumference. This study aims to investigate the association between RFM and gallstone prevalence in the U.S. population. Methods The study cohort comprised 6,881 participants obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2017 and 2020. Participants were stratified into quartiles (Q1-Q4) based on their RFM. To evaluate the associations, multivariable logistic regression analyses were employed to assess odds ratios (OR) for gallstone risk across different quartiles of RFM. Additionally, restricted cubic spline analysis was conducted to ascertain the relationship trend while subgroup analyses examined interactions based on age, sex, race, education level, and lifestyle factors. Results The analysis revealed significant associations for participants within the higher RFM quartiles (Q3 and Q4), with ORs of 2.58 (95% CI: 1.65, 4.04) and 6.30 (95% CI: 3.63, 10.93), respectively, compared to Q1. The findings consistently indicated that RFM, particularly in Q4, is a strong predictor of gallstone risk, demonstrating superior predictive performance relative to waist circumference and BMI, as evidenced by an AUC of 0.702. Conclusion Elevated RFM is a noteworthy predictor of gallstone risk in the studied population, suggesting its potential utility in clinical risk assessment frameworks. Future research should focus on elucidating the underlying mechanisms driving this association and exploring RFM's applicability as a pragmatic tool in clinical practice for gallstone risk stratification.
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Affiliation(s)
- Li Wang
- Department of Gastrointestinal Surgery, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Shan Cao
- Department of Respiratory, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Guodong Song
- Department of Gastrointestinal Surgery, The Second Hospital of Tianjin Medical University, Tianjin, China
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Li C, He Q. Association between osteoporosis and gallstone based on the National Health and Nutrition Examination Survey (NHANES) 2017-2020: a cross-sectional study. Front Public Health 2025; 13:1562984. [PMID: 40265049 PMCID: PMC12011783 DOI: 10.3389/fpubh.2025.1562984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2025] [Accepted: 03/21/2025] [Indexed: 04/24/2025] Open
Abstract
Background Osteoporosis and gallstones are both common conditions in older adults, yet the association between them remains unclear. This study investigates the relationship between osteoporosis and gallstones in a large, nationally representative sample of U.S. adults using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020. Methods 7,766 participants aged 50 years or older with complete osteoporosis questionnaire or bone mineral density (BMD) data included in the study. Osteoporosis status was determined based on self-reported physician diagnosis and femoral neck BMD measurements. Logistic regression models were used to examine the association between osteoporosis and gallstone risk, adjusting for sociodemographic, lifestyle, and health-related covariates. Generalized additive models (GAM) and smoothing curve fitting were used to explore the non-linear relationship between femoral neck T-scores and gallstone prevalence. Mediation analysis was performed to investigate the roles of serum calcium and phosphorus in mediating the osteoporosis-gallstone association. Results Our analysis revealed a significant association between osteoporosis and an increased risk of gallstones, particularly among individuals aged 65 and older, non-Hispanic whites, those with a college education or higher, and those with comorbid conditions such as hypertension and diabetes. In multivariate logistic regression models, individuals with osteoporosis had a higher risk of gallstones compared to those without osteoporosis (OR: 1.52, 95% CI: 1.15-1.99, p < 0.001). Further analysis based on femoral neck BMD indicated that osteoporosis (T-score ≤ -2.5) was significantly associated with an increased risk of gallstones (OR: 1.67, 95% CI: 1.11-2.46, p = 0.01). Generalized additive model analyses revealed a nonlinear relationship between femoral neck T-scores and gallstone prevalence. Mediation analysis indicated that serum calcium and phosphorus partially mediated the association between osteoporosis and gallstones. Conclusion This study demonstrates a significant association between osteoporosis and an increased risk of gallstones in older adults. Our findings highlight the importance of routine gallstone screening for individuals with osteoporosis, particularly those with additional risk factors. Femoral neck BMD may serve as a more effective marker of gallstone risk than lumbar spine BMD.
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Affiliation(s)
- Chuang Li
- Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qifan He
- Department of Radiology, Haining People’s Hospital, Jiaxing, China
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Dong H, Zhang Z, Fu C, Guo M, Zhang H, Cai X, Cheng H. Association between fibrosis-4 index (FIB-4) and gallstones: an analysis of the NHANES 2017-2020 cross-sectional study. BMC Gastroenterol 2025; 25:229. [PMID: 40197261 PMCID: PMC11977908 DOI: 10.1186/s12876-025-03809-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2025] [Accepted: 03/20/2025] [Indexed: 04/10/2025] Open
Abstract
BACKGROUND Gallstones are a common digestive disorder, yet the association between the fibrosis-4 index (FIB-4) and gallstone formation remains poorly understood. This study explores the link between FIB-4 levels and gallstone prevalence among US adults. METHODS This study was based on data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES), which included 7,771 participants. The association between FIB-4 and gallstone risk was analyzed using multivariate logistic regression with restricted cubic spline (RCS) analysis to assess nonlinear correlations, and threshold effects analysis to identify inflection points. Robustness checks included subgroup analysis. RESULTS The weighted prevalence of gallstones in this study was 11%. Multiple logistic regression analysis showed that FIB-4 levels were significantly and positively associated with the risk of gallstones. In the fully adjusted model, each unit increase in FIB-4 as a continuous variable increased the risk of gallstones by 19% (OR = 1.19, 95% CI: 1.10, 1.29). When FIB-4 was grouped by quartiles, the risk of gallstones was increased by 60% (OR = 1.60, 95% CI: 1.25, 2.03) in the Q4 group compared to the Q1 group. RCS analysis further revealed a nonlinear positive correlation between FIB-4 and gallstones (P for nonlinear = 0.015) with an inflection point at 2.43, (P for log likelihood ratio test = 0.001). Bonferroni-corrected subgroup analyses showed that the association of FIB-4 with gallstones was statistically significant among non-Hispanic whites, those without heart failure, those without coronary heart disease, alcohol drinkers, and smokers (P < 0.00217). CONCLUSION In this study, we found that elevated levels of FIB-4 were significantly and positively association with the risk of gallstones, and showed a non-linear trend. FIB-4 may have a potential application in the risk assessment of gallstones.
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Affiliation(s)
- Huqiang Dong
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Zufa Zhang
- Department of Urology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, 116001, China
| | - Chang Fu
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Mixue Guo
- School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Haifeng Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Xintian Cai
- Heart, Lung and Vessels Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610072, China.
| | - Hongping Cheng
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, Hubei, 442000, China.
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Liu Y, Fu B, He Q, Bai X, Fan Y. DNA methylation of POU5F1 by DNMT1 and DNMT3B triggers apoptosis in interstitial Cajal-like cells via c-kit/SCF inhibition during cholesterol gallstone formation. Biochim Biophys Acta Mol Basis Dis 2025; 1871:167689. [PMID: 39899939 DOI: 10.1016/j.bbadis.2025.167689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 12/31/2024] [Accepted: 01/20/2025] [Indexed: 02/05/2025]
Abstract
We have previously reported that inactivation of c-kit and stem cell factor (SCF) might reduce interstitial Cajal-like cells (ICLCs) density, leading to gallbladder motility impairment and cholesterol gallstone (CG) formation. Based on bioinformatics prediction, this study explores the possible role of POU class 5 homeobox 1 (POU5F1) in c-kit/SCF regulation and investigates their function in ICLC activity and CG development. POU5F1 was identified as a transcription factor targeting both c-kit and SCF for transcription activation. They were poorly expressed in mice fed a lithogenic diet (LD) and mouse ICLCs treated with cholesterol. Upregulation of POU5F1 alleviated ICLC apoptosis, contraction dysfunction, and CG formation in the gallbladder wall of mice. Similarly, the POU5F1 upregulation enhanced the viability of ICLCs in vitro while reducing cell apoptosis. However, these effects were blocked by either c-kit or SCF knockdown. Furthermore, DNA methyltransferase 1 (DNMT1) and DNMT3B were identified as two important regulators suppressing POU5F1 transcription through DNA methylation. Knockdown of either DNMT1 or DNMT3B restored POU5F1 and c-kit/SCF levels, therefore reducing ICLC apoptosis and CG formation. In conclusion, this study demonstrates that DNMT1/DNMT3B-mediated DNA methylation of POU5F1 induces c-kit/SCF downregulation, thus promoting apoptosis of ICLCs and CG formation.
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Affiliation(s)
- Yingyu Liu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, PR China
| | - Beibei Fu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, PR China
| | - Quanrun He
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, PR China
| | - Xuesong Bai
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, PR China
| | - Ying Fan
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, PR China.
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Dinçer B, Ömeroğlu S, Tufan AE, Uzun MA. Evaluation of Risk Factors Leading to Conversion from Laparoscopic Cholecystectomy to Open Surgery: A Retrospective Controlled Study. J Laparoendosc Adv Surg Tech A 2025; 35:204-209. [PMID: 39992726 DOI: 10.1089/lap.2024.0366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2025] Open
Abstract
Background: Laparoscopic cholecystectomy (LC) is one of the most frequently performed operations in surgical practice. Despite increasing experience and technological advances, conversion to open surgery is still necessary in some cases. Although several studies have identified factors associated with increased risk of conversion, debates continue in the literature. This study aimed to evaluate the factors affecting the risk of conversion to open cholecystectomy. Materials and Methods: Patients who underwent surgery for cholelithiasis between 2020 and 2023 were analyzed retrospectively. Patients who underwent open cholecystectomy, those who had cholecystectomy as part of another surgical procedure, and patients with gallbladder malignancy (except incidental cases) were excluded from the study. Patients were analyzed based on demographic, clinical, laboratory, radiological, and histopathological data. This study was registered at ClinicalTrials.gov (NCT06244589). Results: A total of 1695 patients were included in the study. The median age was 50 years, and 66.6% of patients were female. Conversion from LC to open surgery occurred in 44 patients (2.6%). Multivariate analysis identified male sex, a history of major abdominal surgery, the need for emergency surgery due to acute cholecystitis, an elevated leukocyte count, and gallbladder wall thickening on abdominal ultrasonography as independent risk factors for conversion to open cholecystectomy. Conclusion: Male gender, previous major abdominal surgery, emergency surgery due to acute cholecystitis, high leukocyte count, and gallbladder wall thickening on abdominal ultrasonography are independent risk factors for conversion from LC to open surgery. It should be kept in mind in the treatment of patients planned for LC.
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Affiliation(s)
- Burak Dinçer
- Department of Surgical Oncology, Ankara Oncology Training and Research Hospital, Ankara, Turkiye
| | - Sinan Ömeroğlu
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkiye
| | - Aydın Eray Tufan
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkiye
| | - Mehmet Ali Uzun
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkiye
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Huo X, Yu Z, Zhao F, Chen Y, Chen P, Xing L, Qiao Y, Peng Y, Tian M, Zhou M, Wu F, Wang Y, Wang C, Tian X, Lv D, Zhang B, Shi L, Ma X, Ma T. Hepatocyte aquaporin 8-mediated water transport facilitates bile dilution and prevents gallstone formation in mice. J Hepatol 2025; 82:464-479. [PMID: 39326676 DOI: 10.1016/j.jhep.2024.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 09/09/2024] [Accepted: 09/17/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND & AIMS Although water channel aquaporin-8 (AQP8) has been implicated in hepatic bile formation and liver diseases associated with abnormal bile flow in human and animal studies, direct evidence of its involvement in bile secretion is still lacking. This study aimed to determine the role of AQP8 in bile secretion and gallstone formation. METHODS We generated various transgenic knock-in and knockout mouse models and assessed liver AQP8 expression by immunostaining and immunoblotting, hepatic bile secretion by cannulation of the common bile duct, cholesterol gallstone formation by feeding a high-fat lithogenic diet, and identified regulatory small molecules by screening the organic fractions of cholagogic Chinese herbs and performing biochemical characterization. RESULTS We identified a novel expression pattern of AQP8 protein in the canalicular membrane of approximately 50% of the liver lobules. AQP8-deficient mice exhibited impaired hepatic bile formation, characterized by the secretion of concentrated bile with a lower flow rate and higher levels of bile lipids than that of wild-type littermates. Aqp8-/- mice showed accelerated gallstone formation, which was rescued by AAV-mediated hepatic expression of AQP8 or AQP1. Moreover, we identified a small molecule, scutellarin, that upregulates hepatocyte AQP8 expression in vitro and in vivo. In Aqp8+/+ mice, scutellarin significantly increased bile flow, decreased bile lipid concentrations, and prevented gallstone formation compared to Aqp8-/- mice. Molecular studies revealed that scutellarin promoted the ubiquitination and degradation of HIF-1α, a negative transcriptional regulator of AQP8, by disrupting its interactions with HSP90. CONCLUSIONS AQP8 plays a crucial role in facilitating water transport and bile dilution during hepatic bile formation, thereby mitigating gallstone formation in mice. Small-molecule intervention validated hepatocyte AQP8 as a promising drug target for gallstone therapy. IMPACT AND IMPLICATIONS The incidence of gallstone disease is high, and current drug treatments for gallstones are very limited, necessitating the identification of novel drug targets for therapeutic development with universal applicability. To our knowledge, this is the first study to provide direct evidence that the hepatic water channel AQP8 plays a key role in bile dilution and gallstone formation. Modulation of hepatic water transport may provide a universal therapeutic strategy for all types of gallstone diseases.
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Affiliation(s)
- Xiaokui Huo
- Pharmaceutical Research Center, Second Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Zhenlong Yu
- Dalian Key Laboratory of Metabolic Target Characterization and Traditional Chinese Medicine Intervention, College of Basic Medical Sciences, Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Feng Zhao
- Dalian Key Laboratory of Metabolic Target Characterization and Traditional Chinese Medicine Intervention, College of Basic Medical Sciences, Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Yang Chen
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Peng Chen
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lina Xing
- Dalian Key Laboratory of Metabolic Target Characterization and Traditional Chinese Medicine Intervention, College of Basic Medical Sciences, Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Yanling Qiao
- Pharmaceutical Research Center, Second Affiliated Hospital, Dalian Medical University, Dalian, China; Harbin Medical University, Harbin, China
| | - Yulin Peng
- Dalian Key Laboratory of Metabolic Target Characterization and Traditional Chinese Medicine Intervention, College of Basic Medical Sciences, Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Manman Tian
- Pharmaceutical Research Center, Second Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Meirong Zhou
- Pharmaceutical Research Center, Second Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Fan Wu
- Pharmaceutical Research Center, Second Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Yan Wang
- Dalian Key Laboratory of Metabolic Target Characterization and Traditional Chinese Medicine Intervention, College of Basic Medical Sciences, Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Chao Wang
- Dalian Key Laboratory of Metabolic Target Characterization and Traditional Chinese Medicine Intervention, College of Basic Medical Sciences, Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Xiangge Tian
- Pharmaceutical Research Center, Second Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Dongyue Lv
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Bo Zhang
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lei Shi
- Dalian Key Laboratory of Metabolic Target Characterization and Traditional Chinese Medicine Intervention, College of Basic Medical Sciences, Institute of Integrative Medicine, Dalian Medical University, Dalian, China.
| | - Xiaochi Ma
- Pharmaceutical Research Center, Second Affiliated Hospital, Dalian Medical University, Dalian, China; Dalian Key Laboratory of Metabolic Target Characterization and Traditional Chinese Medicine Intervention, College of Basic Medical Sciences, Institute of Integrative Medicine, Dalian Medical University, Dalian, China.
| | - Tonghui Ma
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
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Jebur MA, Ismaeel GL, Salim HM, Ahmed AH, Naser IH. Dietary phytochemical index and the risk of gallstone disease: a case-control study. BMC Gastroenterol 2025; 25:52. [PMID: 39901128 PMCID: PMC11792193 DOI: 10.1186/s12876-025-03622-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2024] [Accepted: 01/16/2025] [Indexed: 02/05/2025] Open
Abstract
BACKGROUNDSː: Dietary phytochemical index (DPI) is an inexpensive method for estimating the amounts of phytochemicals in foods. No study has investigated the association between DPI and gallstones disease (GSD). Therefore, we conducted a case-control study in adults to assess the relationship between DPI and the risk of gallstones. METHODS The study was conducted at the general surgical consultation departments of two major multispecialty hospitals in Baghdad: Al-Yarmook and Al Karama Teaching Hospitals. It involved 250 patients with gallstones and 250 controls. DPI was calculated based on data collected from a 168-item validated food frequency questionnaire. Sociodemographic data, physical activity, and anthropometric measures were determined. RESULTS In the initial analysis, the highest tertile of total PI compared to the lowest tertile was found to be associated with a lower risk of galleston (OR and 95% CI = 0.61 (0.41-0.93), p for trend = 0.027). This significant association remained even after adjusting for age and sex, and the odds ratio slightly strengthened. In the final adjusted model, which accounted for additional confounders such as physical activity, BMI, smoking, socioeconomic status (SES), and dietary intake of energy, participants in the highest tertile of total PI still had a lower risk of gallston compared to those in the lowest tertile (OR and 95% CI = 0.51 (0.28-0.90), p for trend = 0.031. CONCLUSION We found evidence of a negative relationship between the dietary phytochemical index and the risk of gallstones, even after accounting for potential confounding variables. As a result, it may be advisable to include more phytochemical-rich foods in dietary approaches aimed at preventing gallstones. However, additional studies are needed to confirm the link between the dietary phytochemical index and gallstone.
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Affiliation(s)
- Mohammad Abdulmohsin Jebur
- College of Medicine, department of pathology and forensic medicine, Mustansiriyah University, Baghdad, Iraq.
| | - Ghufran Lutfi Ismaeel
- Department of Pharmacology, College of Pharmacy, University of Al-Ameed, Karbala, Iraq
| | - Haitham Mukhklif Salim
- Family physician specialist, head of the health, promotion departments, Ministry of health, Baghdad, Iraq
| | - Ammar Hussein Ahmed
- Department of Radiology and Sonar, College of medical techniques, Al-Farahidi University, Baghdad, Iraq
| | - Israa Habeeb Naser
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, 51001, Iraq
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Wang J, Cao L, Xue K, Qi P, Mao Q, Cui M, Ju H, He B, Cao B. Endoscopic Papillary Large Balloon Dilatation With or Without Endoscopic Sphincterotomy in the Treatment of Common Bile Duct Stones. Dig Dis Sci 2025; 70:478-493. [PMID: 39708261 DOI: 10.1007/s10620-024-08797-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Accepted: 12/09/2024] [Indexed: 12/23/2024]
Abstract
PURPOSE OF REVIEW Endoscopic papillary large balloon dilation (EPLBD) has been proved to have better efficacy and safety in removing common bile duct stones. Conventional endoscopic sphincterotomy (EST) is usually performed before EPLBD. However, EPLBD without EST has recently reported short-term outcomes similar to those of EPLBD with EST. This article summarizes the latest research advances in EPLBD with or without EST for the treatment of large common bile duct stones (CBDS) as a way to provide further evidence to support the ERCP surgeon's choice of which technique to use for the treatment of large CBDS. FINDINGS EPLBD alone is recommended in cases of anatomical abnormalities or bleeding tendencies. EPLBD with EST is recommended in patients with stenosis of the duodenal papilla or distal common bile duct or with periportal diverticula. Most clinical studies have shown that the clinical efficacy and incidence of adverse events associated with ESLBD are comparable to those of standalone EPLBD. However, further large-scale prospective randomized controlled trials are needed to confirm these findings.
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Affiliation(s)
- Jia Wang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong Province, China
| | - Lichao Cao
- Health Care Management Master of Science, Johns Hopkins University, Baltimore, MD, USA
| | - Kuijin Xue
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong Province, China
| | - Peng Qi
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong Province, China
| | - Qingdong Mao
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong Province, China
| | - Mingjuan Cui
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong Province, China
| | - Hui Ju
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong Province, China
| | - Baoguo He
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong Province, China
| | - Bin Cao
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong Province, China.
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11
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Mittal N, Oza VM, Muniraj T, Kothari TH. Diagnosis and Management of Acute Pancreatitis. Diagnostics (Basel) 2025; 15:258. [PMID: 39941188 PMCID: PMC11816589 DOI: 10.3390/diagnostics15030258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 01/14/2025] [Accepted: 01/16/2025] [Indexed: 02/16/2025] Open
Abstract
Acute pancreatitis is an inflammatory condition of the exocrine pancreas that is a common indication for hospital admission and has had an increasing incidence in the last few decades. The diagnosis of acute pancreatitis requires the satisfaction of two out of three criteria: (1) abdominal pain radiating to the back, (2) serum lipase or amylase levels three or more times the upper limit of the normal level, and (3) findings indicating pancreatitis obtained via a computed tomography (CT) scan or magnetic resonance imaging (MRI). The different etiologies include gallstones, autoimmune disorders, alcohol abuse, smoking, hypertriglyceridemia, obesity, drugs, and post-endoscope retrograde cholangiopancreatography (ERCP). The initial investigation includes serum amylase and lipase analysis, a lipid panel including triglycerides, analysis of immunoglobulins, a full blood count, electrolyte analysis, a hemoglobin A1c test, a complete metabolic panel, and transabdominal ultrasound. The initial therapy includes oxygen supplementation, the provision of intravenous fluids, pain control, and a nutrition regime. Early oral feeding is encouraged if tolerated; if not, liquid supplement provision or enteral tube feeding within 48 h of admission has shown better outcomes. Some complications of acute pancreatitis are necrosis, infection, insulin resistance leading to diabetes mellitus, and pancreatic exocrine insufficiency requiring enzyme supplementation. Patients need to attend regular follow-ups and abstain from alcohol and smoking (if warranted) to prevent the recurrence of acute pancreatitis. The mortality rate of acute pancreatitis has decreased in the past few decades because of better management skills, but the recent rise in acute pancreatitis episodes is concerning. Sustained endeavors through clinical trials are required to establish a broad variety of drugs that can be used for acute pancreatitis episodes.
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Affiliation(s)
- Nitish Mittal
- Department of Internal Medicine, The University of Texas Health Sciences Center, Houston, TX 77030, USA (V.M.O.)
| | - Veeral M. Oza
- Department of Internal Medicine, The University of Texas Health Sciences Center, Houston, TX 77030, USA (V.M.O.)
- Section of Digestive Disease, Edward via College of Osteopathic Medicine and Bon Secours Mercy Health Medical Center, Greenville, SC 29673, USA
| | - Thiruvengadam Muniraj
- Section of Digestive Disease, Yale University School of Medicine, New Haven, CT 06520, USA;
| | - Truptesh H. Kothari
- Section of Digestive Disease, University of Rochester Medical Center, Rochester, NY 14642, USA
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12
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Yuan S, Lu Y, Xiao Z, Ma S. Body Mass Index mediates the relationship between estimated glucose disposal rate and gallstones. Sci Rep 2025; 15:2214. [PMID: 39825101 PMCID: PMC11742381 DOI: 10.1038/s41598-025-86708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Accepted: 01/13/2025] [Indexed: 01/20/2025] Open
Abstract
This study examined the relationship between gallstones and estimated glucose disposal rate (eGDR) in people in the United States and the possible mediating function of body mass index (BMI). Data came from the National Health and Nutrition Examination Survey (NHANES), conducted between 2017 and March 2020. Logistic regression, subgroup analysis, smoothed curve fitting, and causal mediation studies were among the statistical techniques used to examine the participant data. There were 595 subjects with a gallstone diagnosis out of 5,656 total. A significant negative association between eGDR and gallstones was observed by fully adjusted multivariate logistic regression analysis with an OR of 0.90 and a 95% confidence interval (CI) of (0.83, 0.98). The mediation analysis indicated that BMI accounted for 58.58% of the relationship between eGDR and the occurrence of gallstones. This study identified a substantial non-linear negative relationship between the occurrence of gallstones and eGDR levels, with BMI acting as a mediating factor. A fresh viewpoint on gallstone therapy and prevention is offered by these findings.
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Affiliation(s)
- Shuaipeng Yuan
- Department of Digestive Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China
| | - Yuexia Lu
- Department of Digestive Diseases, Guang 'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Zhun Xiao
- Department of Digestive Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China
| | - Suping Ma
- Department of Digestive Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China.
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Wang J, Cao L, Cong Y, Huang Y, Wang L, Wang W, Xue K, Mao Q, Qi P, Ju H, He B, Cao B. Comparative efficacy and safety of 3 endoscopic techniques for the treatment of large common bile duct stones (≥15 mm): long-term follow-up. Gastrointest Endosc 2024:S0016-5107(24)03829-X. [PMID: 39716537 DOI: 10.1016/j.gie.2024.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 11/30/2024] [Accepted: 12/15/2024] [Indexed: 12/25/2024]
Abstract
BACKGROUND AND AIMS The effectiveness of endoscopic papillary large balloon dilation (EPLBD) alone versus EPLBD combined with endoscopic sphincterotomy (EST) in treating large common bile duct stones (CBDSs; ≥15 mm) remains unclear. This study aimed to evaluate the safety and treatment outcomes of EPLBD combined with limited or large EST versus EPLBD alone in removing large CBDSs. METHODS Between January 2013 and September 2024, total of 408 patients underwent EPLBD, either alone or in combination with EST, to treat large CBDSs (≥15 mm). Patients were divided into 3 groups: EPLBD alone (n = 92), EPLBD with limited EST (n = 124), and EPLBD with large EST (n = 192). The study compared the first-session stone clearance rate, overall stone success rate, mechanical lithotripsy use, and adverse event rate. RESULTS Compared with the EPLBD alone group, the EPLBD with limited EST and the EPLBD with large EST groups exhibited higher initial stone clearance rates, required fewer endoscopic procedures for complete stone removal, and had lower rates of mechanical lithotripsy use and CBDS recurrence. Compared with the EPLBD with limited EST group, the EPLBD with large EST group showed a higher initial stone clearance rate, fewer endoscopic procedures required for complete CBDS removal, and no significant differences in adverse events. The multivariate analysis showed that the endoscopic technique and number of endoscopic operations were strongly associated with CBDS recurrence. CONCLUSIONS EPLBD combined with large EST may represent a more rational endoscopic technique for treating large CBDSs.
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Affiliation(s)
- Jia Wang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Lichao Cao
- Health Care Management Master of Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yuchen Cong
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yining Huang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Lei Wang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenjing Wang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Kuijin Xue
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Qingdong Mao
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Peng Qi
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hui Ju
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Baoguo He
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Bin Cao
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
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Liu B, Jin L, Nan B, Sun Z, Chen F, Zhou Y, Sa Q, Feng Y, Men A, Wang W, Feng X, Zhang W. Positive association between advanced lung cancer inflammation index and gallstones, with greater impact on women: a cross-sectional study of the NHANES database. Front Nutr 2024; 11:1506477. [PMID: 39758317 PMCID: PMC11695217 DOI: 10.3389/fnut.2024.1506477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Accepted: 12/12/2024] [Indexed: 01/07/2025] Open
Abstract
Background Previous studies have shown that inflammation is crucial in gallstone formation. The Advanced Lung Cancer Inflammation Index (ALI) is a comprehensive measure that reflects inflammation and nutritional condition. However, there are no studies examining the relationship between ALI and gallstones. This study aimed to analyze this association in US adults. Methods This study used a cross-sectional research design with in-depth analyses using data from the National Health and Nutrition Examination Survey (NHANES). The association between gallstones and ALI was systematically assessed by logistic regression analysis, subgroup analysis, basic participant characteristics, and smooth curve fits. Results 5,646 people participated in the study. ALI was converted into Quartile 1 (-1.47-1.00), Quartile 2 (1.00-1.34), Quartile 3 (1.34-1.69), and Quartile 4 (1.69-4.38). In the fully adjusted model, gallstone prevalence increased by 45% in participants in the highest quartile compared to those in the lowest quartile (OR = 1.45; 95% CI: 1.12-1.87; p = 0.005), and ALI was positively correlated with gallstones (OR = 1.22; 95% CI: 1.03-1.45; p = 0.0232). Smooth curve fits provided evidence in favor of this finding. Significant gender differences were found in the relationship between gallstones and ALI by subgroup analysis (OR = 1.43; 95% CI: 1.16-1.76; p for interaction = 0.0204). Conclusion The study concluded that ALI and gallstones had a positive correlation, with ALI having a higher effect on women's gallstone prevalence.
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Affiliation(s)
- Bailiang Liu
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Luyuan Jin
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Boyuan Nan
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Zhongyi Sun
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Fengyang Chen
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Yinghui Zhou
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Qila Sa
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Yingnan Feng
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Ao Men
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Wenxin Wang
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Xiaodong Feng
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Wei Zhang
- Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China
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15
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Xiao Y, Zhao W, Zhao Q, Pang K, Gao Q, Yang X, Chen H, Xu H. Exploring the association between life's essential 8 and gallstone disease in the US adult population: a population-based study utilizing NHANES data from 2017-2018. BMC Gastroenterol 2024; 24:453. [PMID: 39695408 DOI: 10.1186/s12876-024-03545-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Accepted: 11/28/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Gallstones are a prevalent health issue, with established risk factors such as diet body mass index (BMI) and physical activity. However, the role of Life's Essential 8 (LE8), a composite measure of health behaviors and biological markers, in predicting gallstone risk remains unclear. This study aims to examine the association between LE8 scores and gallstone prevalence in a U.S. adult population. METHODS A cross-sectional analysis was conducted on 2836 adults. LE8 scores were categorized into tertiles, and multivariable logistic regression models assessed the relationship between LE8 and gallstones, with additional nonlinear assessment using restricted cubic spline analysis. RESULTS Gallstones prevalence was 10.37%, decreasing with higher LE8 scores. The multivariable analysis showed participants in higher LE8 tertiles had significantly lower gallstone risks compared to the lowest tertile. The spline analysis confirmed a significant nonlinear inverse association between LE8 and gallstone risk. CONCLUSIONS Higher LE8 scores correlate with a lower prevalence of gallstones, suggesting the potential of LE8 as a predictor of gallstone risk. This emphasizes the value of promoting LE8 components in public health initiatives to reduce gallstone prevalence and medical burden.
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Affiliation(s)
- Yi Xiao
- Department of Hepatobiliary Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China
| | - Wenting Zhao
- Development Planning Department, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China
| | - Qiuchan Zhao
- Department of Breast Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China
| | - Kangfeng Pang
- Department of Hepatobiliary Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China
| | - Qiaoping Gao
- Department of Hepatobiliary Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China
| | - Xiaoqu Yang
- Department of Hepatobiliary Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China
| | - Huadi Chen
- Department of Hepatobiliary Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China.
| | - Hao Xu
- Department of Hepatobiliary Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People's Republic of China.
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Zhong X, Wu F, Gao W, Hu J, Shen B, Zhong K, Peng J, Zhang C, Zhang C. Effects of Extracellular Matrix Changes Induced by a High-Fat Diet on Gallbladder Smooth Muscle Dysfunction. FRONT BIOSCI-LANDMRK 2024; 29:401. [PMID: 39735983 DOI: 10.31083/j.fbl2912401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 09/12/2024] [Accepted: 09/20/2024] [Indexed: 12/31/2024]
Abstract
BACKGROUND Gallstone formation is a common digestive ailment, with unclear mechanisms underlying its development. Dysfunction of the gallbladder smooth muscle (GSM) may play a crucial role, particularly with a high-fat diet (HFD). This study aimed to investigate the effects of an HFD on GSM and assess how it alters contractility through changes in the extracellular matrix (ECM). METHODS Guinea pigs and C57BL/6 mice were fed either an HFD or normal diet (ND). Primary cultures of their (guinea pigs) gallbladder smooth muscle cells (GSMCs) were used for in vitro experiments. Histological stains, RNA-sequencing, bioinformatics analysis, three-dimensional tissue culture, real-time polymerase chain reaction (PCR), Western blot, atomic force microscopy, and muscle tension measurements were performed. RESULTS Histological evidence indicated structural changes in the gallbladder muscle layer and ECM collagen deposition in the HFD group. The HFD group also showed increased expression of collagen, integrin family, and matrix metalloproteinase (MMP) and the phosphoinositide 3-kinase (PI3K)-protein kinase B (PKB/Akt) signaling pathway. Compared with GSMCs cultured on Matrigel containing 1 mg/mL of collagen I, those cultured with 2 mg/mL showed a phenotype change from contractile to synthetic cells. Consistent with these findings, the HFD group also demonstrated increased ECM stiffness and decreased smooth muscle contractility. CONCLUSIONS Our findings reveal a mechanism by which an HFD alters the ECM composition of the gallbladder muscle, activating the integrin/PI3K-Akt/MMP signaling pathway, thereby impacting GSMC phenotype and contractility. These insights enhance the understanding of gallstone formation mechanism and provide potential therapeutic targets to treat gallbladder dysfunction.
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Affiliation(s)
- Xingguo Zhong
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, 230022 Hefei, Anhui, China
- Department of General Surgery, Anhui No. 2 Provincial People's Hospital, 230041 Hefei, Anhui, China
| | - Feiyang Wu
- Department of General Surgery, Anhui No. 2 Provincial People's Hospital, 230041 Hefei, Anhui, China
- Graduate School, Bengbu Medical University, 233030 Bengbu, Anhui, China
| | - Weicheng Gao
- Department of General Surgery, Anhui No. 2 Provincial People's Hospital, 230041 Hefei, Anhui, China
- Graduate School, Bengbu Medical University, 233030 Bengbu, Anhui, China
| | - Jinlong Hu
- Department of General Surgery, Anhui No. 2 Provincial People's Hospital, 230041 Hefei, Anhui, China
| | - Bing Shen
- Dr. Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, 999078 Taipa, Macao SAR, China
| | - Kaiyuan Zhong
- College of Medical Technology, Qiqihar Medical University, 161003 Qiqihar, Heilongjiang, China
| | - Junbin Peng
- Medical School, Anhui University of Science & Technology, 232001 Huainan, Anhui, China
| | - Chong Zhang
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, 230022 Hefei, Anhui, China
| | - Chao Zhang
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, 230022 Hefei, Anhui, China
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Gong Y, He Y, Wan M, Chen H. Risk Factors for Gallstones in Crohn's Disease: A Systematic Review and Meta-Analysis. Dig Dis Sci 2024; 69:4187-4202. [PMID: 39322804 DOI: 10.1007/s10620-024-08597-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 08/15/2024] [Indexed: 09/27/2024]
Abstract
BACKGROUND Crohn's disease (CD) have an increased risk of gallstone disease. We aimed to systematically evaluate the prevalence rate and relevant risk factors of gallstones in CD patients. METHODS A comprehensive search of PubMed, Embase, and Web of Science databases from inception to September 10, 2023, identified studies investigating risk factors for gallstone development among CD patients. Gender, age, body mass index, disease duration, disease site, stenosis, prior surgery, hospitalization times, corticosteroids, immunomodulators, and total parenteral nutrition (TPN) were assessed as potential risk factors. Odds ratios (OR) and confidence intervals (CI) were calculated. RESULT Among 1184 articles, 11 observational studies (3588 patients) were included. The prevalence of CD patients with gallstones was approximately 14.7%. Factors significantly associated with increased gallstone risk included Age ≥ 40 years old (OR 3.06, 95% CI 2.09- 4.48), disease duration > 15 years (OR 3.01, 95% CI 2.06-4.42), lifetime surgery(OR 2.50, 95% CI 1.99-3.12), disease located in ileocolon (OR 1.38, 95% CI 1.04-1.83) and ileocecal(OR 1.93, 95% CI 1.16-3.21), multiple hospitalizations(OR 4.26, 95% CI 2.43-7.46), corticosteroid treatments(OR 2.65, 95% CI 1.52-4.63), immunomodulator therapy(OR 1.94, 95% CI 1.12-3.38), and TPN use(OR 2.66, 95% CI 1.29-5.51). Sex, stenosis, overweight, or low weight did not significantly increase the risk of gallstone developing. CONCLUSION Age, long disease duration, specific disease locations (ileocolon, ileocecal), surgery, number of hospitalizations, corticosteroids, immunomodulator therapy, and TPN were identified as factors that increased the risk of gallstones in CD patients. About 14.7% of CD patients experience gallstones, so raising awareness and implementing prevention are needed. REGISTRATION PROSPERO (CRD42023449299).
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Affiliation(s)
- Yan Gong
- School of Medicine, Southeast University, Nanjing, China
- Department of Gastroenterology, Zhongda Hospital of Southeast University, HuNan Street, GuLou District, Nanjing, China
| | - Yishu He
- School of Medicine, Southeast University, Nanjing, China
- Department of Gastroenterology, Zhongda Hospital of Southeast University, HuNan Street, GuLou District, Nanjing, China
| | - Mengting Wan
- School of Medicine, Southeast University, Nanjing, China
- Department of Gastroenterology, Zhongda Hospital of Southeast University, HuNan Street, GuLou District, Nanjing, China
| | - Hong Chen
- School of Medicine, Southeast University, Nanjing, China.
- Department of Gastroenterology, Zhongda Hospital of Southeast University, HuNan Street, GuLou District, Nanjing, China.
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18
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Wang B, Xiong Y, Li R, Zhang S. Depression increases the risk of gallstone: A cross-sectional study and Mendelian randomization analysis. J Affect Disord 2024; 362:606-614. [PMID: 39029662 DOI: 10.1016/j.jad.2024.07.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/28/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Gallstone, a common digestive disorder, poses a significant public health burden. Concurrently, depression is acknowledged as a health risk. However, limited information exists on depression's impact on gallstone formation. This study investigates depression's causal effect on gallstone risk. METHODS Using National Health and Nutrition Examination Survey (NHANES) data, we conducted an observational study. The severity of depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Multivariable logistic regression and subgroup analyses explored the correlation between depression and gallstone risk. Mendelian Randomization (MR) analysis, leveraging Genome-Wide Association Studies (GWAS) data, reduced observational bias and elucidated causality. Inverse Variance Weighting (IVW) was the primary method, with sensitivity analyses validating results. RESULTS In the observational study (7707 participants), gallstone risk was elevated in mild (OR: 1.58, 95 % CI 1.31-1.90, P < 0.001), moderate (OR: 2.07, 95 % CI 1.59-2.67, P < 0.001), and severe (OR: 2.41, 95 % CI 1.70-3.34, P < 0.001) depression groups (P for trend <0.001). Subgroup analyses revealed a stronger association in those under 65, females, non-Hispanic Black, individuals with obesity, smokers, and those with college education or higher. Mendelian Randomization indicated a causal link between genetically predicted depression and higher cholelithiasis risk (OR: 2.06, 95 % CI 1.34-3.17, P = 0.001), validated through sensitivity analyses and multi-cohort verification. CONCLUSION Depression independently increases gallstone risk, particularly in those under 65, females, non-Hispanic Black, individuals with obesity, smokers, and those with college education or higher. Further validation is needed through multi-center, prospective cohort studies.
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Affiliation(s)
- Bo Wang
- Department of Geriatric Digestive Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yongqiang Xiong
- Department of Geriatric Digestive Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ren Li
- Department of Geriatric Digestive Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shu Zhang
- Department of Geriatric Digestive Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Experimental Teaching Center for Clinical Skills, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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19
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Teng F, Tang Y, Lu Z, Chen K, Chen Z. Investigating causal links between gallstones, cholecystectomy, and 33 site-specific cancers: a Mendelian randomization post-meta-analysis study. BMC Cancer 2024; 24:1192. [PMID: 39333915 PMCID: PMC11437614 DOI: 10.1186/s12885-024-12906-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 09/05/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND AND AIM The association between gallstones/cholecystectomy and cancer remains inconclusive in the current literature. This study aimed to explore the causal connections between gallstones/cholecystectomy and cancer risk by utilizing a bidirectional two-sample multivariable Mendelian randomization approach with Genome-Wide Association Studies data. METHODS Utilizing Genome-Wide Association Studies data from the UK Biobank and FinnGen, this research employed multivariable Mendelian randomization analyses to explore the impact of gallstones and cholecystectomy on the risk of 33 distinct cancer types. Instrumental variables for gallstones and cholecystectomy were carefully selected to ensure robust analyses, and sensitivity and heterogeneity tests were conducted to verify the findings' validity. RESULTS Multivariable Mendelian randomization analysis, incorporating data from more than 450,000 individuals for gallstones and cholecystectomy, revealed nuanced associations with cancer risk. Cholecystectomy was associated with a significantly increased risk of nonmelanoma skin cancer (OR = 1.59, 95% CI: 1.21 to 2.10, P = 0.001), while gallstones were linked to a decreased risk of the same cancer type (OR = 0.63, 95% CI: 0.47 to 0.84, P = 0.002). Interestingly, the analysis also suggested that cholecystectomy may lower the risk of small intestine tumors (OR = 0.18, 95% CI: 0.043 to 0.71, P = 0.015), with gallstones showing an inverse relationship, indicating an increased risk (OR = 6.41, 95% CI: 1.48 to 27.80, P = 0.013). CONCLUSIONS The multivariable Mendelian randomization analysis highlights the differential impact of gallstones and cholecystectomy on cancer risk, specifically for nonmelanoma skin cancer and small intestine tumors. These results underscore the importance of nuanced clinical management strategies and further research to understand the underlying mechanisms and potential clinical implications of gallstone disease and cholecystectomy on cancer risk.
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Affiliation(s)
- Fei Teng
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, China
| | - Youyin Tang
- Division of Vascular Surgery, Department of General Surgery, West China Hospital of Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, China
| | - Zhangyu Lu
- West China School of Medicine, Sichuan University, No. 17 South Renming Road, Chengdu, 610094, China
| | - Kefei Chen
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, China.
| | - Zheyu Chen
- Division of Vascular Surgery, Department of General Surgery, West China Hospital of Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, China.
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Cheng Q, Wang Z, Zhong H, Zhou S, Liu C, Sun J, Zhao S, Deng J. Association of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and gallstones among US adults aged ≤ 50 years: a cross-sectional study from NHANES 2017-2020. Lipids Health Dis 2024; 23:265. [PMID: 39175030 PMCID: PMC11340038 DOI: 10.1186/s12944-024-02262-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 08/16/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND The chronic digestive condition gallstones is quite common around the world, the development of which is closely related to oxidative stress, inflammatory response and abnormalities of lipid metabolism. In the last few years, as a novel biomarker of lipid metabolism, the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) has garnered significant interest. However, its relationship with gallstones has not been studied yet. METHODS 3,772 people, all under 50, were included in this study, and their full data came from the National Health and Nutrition Examination Survey (NHANES) database for the years 2017-2020. Information on gallstones was obtained through self-reported questionnaires. Smoothed curve fitting multifactorial logistic regression was utilized to evaluate the connection of NHHR with gallstone formation incidence. Subsequently, subgroup analysis and interaction tests were applied. Finally, to create a prediction model, logistic regression and feature screening by last absolute shrinkage and selection operator (LASSO) were used. The resulting model was displayed using a nomogram. RESULTS In multivariate logistic regression that accounted for all factors, there was a 77% increase in the likelihood of gallstones for every unit rise in lnNHHR (OR 1.77 [CI 1.11-2.83]). Following NHHR stratification, the Q4 NHHR level was substantially more linked to the risk of gallstones than the Q1 level (OR 1.86 [CI 1.04-3.32]). This correlation was stronger in women, people under 35, smokers, abstainers from alcohol, non-Hispanic White people, those with excessively high cholesterol, people with COPD, and people without diabetes. After feature screening, a predictive model and visualized nomogram for gallstones were constructed with an AUC of 0.785 (CI 0.745-0.819), which was assessed by DCA to be clinically important. CONCLUSION In the group of people ≤ 50 years of age, elevated NHHR levels were substantially linked to a higher incidence of gallstones. This correlation was stronger in several specific groups such as females, under 35 years of age, smokers, and so on. Predictive models constructed using the NHHR have potential clinical value in assessing gallstone formation.
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Affiliation(s)
- Quankai Cheng
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ziming Wang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Haicheng Zhong
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Sheng Zhou
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chang Liu
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jingjing Sun
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Sihai Zhao
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jie Deng
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Wang X, Yu W, Jiang G, Li H, Li S, Xie L, Bai X, Cui P, Chen Q, Lou Y, Zou L, Li S, Zhou Z, Zhang C, Sun P, Mao M. Global Epidemiology of Gallstones in the 21st Century: A Systematic Review and Meta-Analysis. Clin Gastroenterol Hepatol 2024; 22:1586-1595. [PMID: 38382725 DOI: 10.1016/j.cgh.2024.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND & AIMS Gallstones are common and associated with substantial health and economic burden. We aimed to comprehensively evaluate the prevalence and incidence of gallstones in the 21st century. METHODS We systematically searched PubMed and Embase to identify studies reporting the prevalence and/or incidence of gallstones between January 1, 2000, and November 18, 2023. Pooled prevalence and incidence were calculated using DerSimonian and Laird's random-effects model. We performed subgroup analyses and meta-regression based on age, sex, geographic location, population setting, and modality of detection to examine sources of heterogeneity. RESULTS Based on 115 studies with 32,610,568 participants, the pooled prevalence of gallstones was 6.1% (95% CI, 5.6-6.5). Prevalence was higher in females vs males (7.6% vs 5.4%), in South America vs Asia (11.2% vs 5.1%), in upper-middle-income countries vs high-income countries (8.9% vs 4.0%), and with advancing age. On sensitivity analysis of population-based studies, the prevalence of gallstones was 5.5% (95% CI, 4.1-7.4; n = 44 studies), and when limiting subgroup analysis to imaging-based detection modalities, the prevalence was 6.7% (95% CI, 6.1-7.3; n = 101 studies). Prevalence has been stable over the past 20 years. Based on 12 studies, the incidence of gallstones was 0.47 per 100 person-years (95% CI, 0.37-0.51), without differences between males and females, and with increasing incidence in more recent studies. CONCLUSIONS Globally, 6% of the population have gallstones, with higher rates in females and in South America. The incidence of gallstones may be increasing. Our findings call for prioritizing research on the prevention of gallstones.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Wenqian Yu
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Guoheng Jiang
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Hongyu Li
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Shiyi Li
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Linjun Xie
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Xuan Bai
- Department of Epidemiology and Biostatistics, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China; West China-PUMC C.C. Chen Institute of Health, West China School of Public Health, West China Fourth Hospital, Sichuan University, Wuhou District, Chengdu, China
| | - Ping Cui
- Department of Public Health, Jining Medical University, Jining, China
| | - Qi Chen
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, China
| | - Li Zou
- Department of Nursing, Luzhou People's Hospital, Luzhou, China
| | - Sulian Li
- Department of Nursing, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Zhongfang Zhou
- Preventive Medical of TCM & Physical Examination Center of The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Chi Zhang
- Department of Prevention, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Peng Sun
- Department of Gastrointestinal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Shenzhen Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Shenzhen, China
| | - Min Mao
- The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University, School of Life Sciences of Fudan University, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China.
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Srikanth MVVS, Arumugaswamy PR, Rathore YS, Chumber S, Yadav R, Maitra S, Bhattacharjee HK, Aggarwal S, Asuri K, Kataria K, Ranjan P, Singh D, Singh A, Khan MA, Das SK. Comparison of inflammatory markers in low-pressure pneumoperitoneum with deep neuromuscular block versus standard pressure pneumoperitoneum among patients undergoing laparoscopic cholecystectomy for gallstone disease: a randomized control trial. Surg Endosc 2024; 38:4648-4656. [PMID: 38977504 DOI: 10.1007/s00464-024-11026-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/30/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Low-pressure pneumoperitoneum (LPP) is an attempt to improve laparoscopic surgery. Lower pressure causes lesser inflammation and better hemodynamics. There is a lack of literature comparing inflammatory markers in LPP with deep NMB to standard pressure pneumoperitoneum (SPP) with moderate NMB in laparoscopic cholecystectomy. METHODOLOGY This was a single institutional prospective randomized control trial. Participants included all patients undergoing laparoscopic cholecystectomy for symptomatic gall stone disease. Participants were divided into 2 groups group A and B. Group A-Low-pressure group in which pneumoperitoneum pressure was kept low (8-10 mmHg) with deep Neuromuscular blockade (NMB) and Group B-Normal pressure group (12-14 mmHg) with moderate NMB. A convenience sample size of 80 with 40 in each group was selected. Lab investigations like CBC, LFT, RFT and serum IL-1, IL-6, IL-17, TNF alpha levels were measured at base line and 24 h after surgery and compared using appropriate statistical tests. Other parameters like length of hospital stay, post-operative pain score, conversion rate (low-pressure to standard pressure), and complications were also compared. RESULTS Eighty participants were analysed with 40 in each group. Baseline characteristics and investigations were statistically similar. Difference (post-operative-pre-operative) of inflammatory markers were compared between both groups. Numerically there was a slightly higher rise in most of the inflammatory markers (TLC, ESR, CRP, IL-6, TNFα) in Group B compared to Group A but not statistically significant. Albumin showed significant fall (p < 0.001) in Group B compared to Group A. Post-operative pain was also significantly less (p < 0.001) in Group A compared to Group B at 6 h and 24 h. There were no differences in length of hospital stay and incidence of complications. There was no conversion from low-pressure to standard pressure. CONCLUSION Laparoscopic cholecystectomy performed under low-pressure pneumoperitoneum with deep NMB may have lesser inflammation and lesser post-operative pain compared to standard pressure pneumoperitoneum with moderate NMB. Future studies with larger sample size need to be designed to support these findings.
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Affiliation(s)
| | - Prasanna Ramana Arumugaswamy
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Yashwant Singh Rathore
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | - Sunil Chumber
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Rajkumar Yadav
- Department of Physiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Souvik Maitra
- Department of Anaesthesia, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Hemanga Kumar Bhattacharjee
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Sandeep Aggarwal
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Krishna Asuri
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Kamal Kataria
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Piyush Ranjan
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Devender Singh
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Ankita Singh
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - M A Khan
- Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Sumit Kumar Das
- Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
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23
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Li Y, Wang M, Du W, Qi L, Liu X, Fan X. The correlation between urinary iodine levels and gallstone risk: elevated iodine intake linked to gallstone occurrence. Front Nutr 2024; 11:1412814. [PMID: 39114128 PMCID: PMC11303756 DOI: 10.3389/fnut.2024.1412814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024] Open
Abstract
Background Essential trace elements are vital for human growth and development. Nevertheless, excessive intake can pose risks. As of yet, no research has looked at the possibility of a relationship between the prevalence of gallstones and urinary concentrations of nickel, molybdenum, and iodine. Objectives The purpose of this study was to examine the correlation between urinary levels of iodine, molybdenum, and nickel and the occurrence of gallstones in a U.S. population and to verify whether excessive iodine intake is associated with the occurrence of gallstones. Methods Data from 2,734 participants that were gathered between 2017 and 2020 were examined. Employing inductively coupled plasma mass spectrometry (ICP-MS), the levels of nickel (Ni), iodine (I), and molybdenum (Mo) in the urine were determined. Gallstones presence was determined using a standardized questionnaire. Restricted cubic spline analysis, subgroup analysis, and logistic regression analysis were used to evaluate the relationship between the occurrence of gallstones and urinary essential trace elements. Results The logistic regression analysis indicated an increased risk of gallstone development in Quartiles 2, Quartiles 3, and Quartiles 4 groups in comparison to the Quartiles 1 group, based on urinary iodine levels (OR = 1.69, 95% CI: 1.11-2.56; OR = 1.68, 95% CI: 1.10-2.55; OR = 1.65, 95% CI: 1.09-2.51). Urinary iodine levels were nonlinearly positively linked with the development of gallstones, according to restricted cubic spline analysis (P-Nonlinear = 0.032). Subgroup analyses showed that high levels of urinary iodine were associated with a high risk of gallstones in different populations, and were more pronounced in adults aged 60 years and older, in women, with a BMI ≥ 25, and in diabetic patients. Conclusion Our research revealed a correlation between an increased risk of gallstones and increasing urinary iodine levels. Urinary iodine levels serve as indicators of the body's iodine status, thus suggesting that excessive iodine intake may be linked to an elevated risk of gallstone formation.
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Affiliation(s)
- Yunfan Li
- Department of General Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Minchen Wang
- Department of General Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Wenyi Du
- Department of General Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Liuyao Qi
- Department of General Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Xiaopeng Liu
- Department of General Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Xin Fan
- Department of General Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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24
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Wang J, Li H, Hu J, Shi R, Qin C, Chen X, Chen S, Zeng X, Luo H, Luo H, Zhou Y, Yang P, Wang D. Relationship of triglyceride-glucose index to gallstone prevalence and age at first gallstone surgery in American adults. Sci Rep 2024; 14:16749. [PMID: 39033195 PMCID: PMC11271289 DOI: 10.1038/s41598-024-67883-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 07/17/2024] [Indexed: 07/23/2024] Open
Abstract
The triglyceride-glucose (TyG) index is a novel marker of insulin resistance that has been strongly associated with many diseases related to metabolic disorders, such as diabetes, coronary heart disease, myocardial infarction, obesity, nonalcoholic fatty liver disease, and stroke. However, whether the TyG index is associated with the prevalence of gallstones has not been determined. Therefore, the purpose of this study was to evaluate the relationship between the TyG index and the prevalence of gallstones in American adults, as well as the age at which adults in America undergo their first gallstone surgery. We selected individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to March 2020. Based on the goal of our study, comprehensive inclusion and exclusion criteria were created. A logistic regression analysis, dose-response curve, and subgroup analysis were computed to assess the relationship between the TyG index and gallstone prevalence and age at first surgery for gallstone. A total of 3905 participants aged > 20 years were included in our study, of whom 421 had a self-reported history of gallstones. A total of 1884 (48.2%) males and 2021 (51.8%) females were included. After confounders adjustment, it was found single-unit increases in the TyG index were linked with a 25.0% increase in gallstone prevalence (odds ratio [OR] = 1.25, 95% confidence interval [95%CI]: 1.04, 1.51). After conversion of the TyG index values from continuous to categorical variables with tertiles, a marked 48% increase in gallstone incidence was found in tertile 3 relative to tertile 1 (OR = 1.48, 95% CI: 1.09, 1.99). The dose-response curve results indicated positive associations between gallstone prevalence and the TyG index, while the latter was negatively associated with age at first gallstone surgery. Based on subgroup analysis, the positive association between TyG index and high-incidence of gallstones was more significant in females (OR = 1.39, 95% CI: 1.09, 1.77), age < 40 years (OR = 2.02, 95% CI: 1.23, 3.29), and other race (OR = 1.46, 95% CI: 1.06, 2.02). A higher TyG index is associated with a higher incidence of gallstones and may lead to an earlier age of first gallstone surgery. However, a causal relationship between TyG and gallstones cannot be established.
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Affiliation(s)
- Jianjun Wang
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Han Li
- Department of Cardiology, The Fifth Hospital of Wuhan, Wuhan, 430050, China
| | - Junchao Hu
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Ruizi Shi
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Chuan Qin
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Xi Chen
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Sirui Chen
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Xintao Zeng
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Hua Luo
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Huiwen Luo
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Yulong Zhou
- Department of General Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Pei Yang
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China.
| | - Decai Wang
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China.
- Department of Urology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China.
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Li L, Liu C, Xia T, Li H, Yang J, Pu M, Zhang S, Ma Y, Zhang T. Association between plant-based dietary index and gallstone disease: A cross sectional study from NHANES. PLoS One 2024; 19:e0305822. [PMID: 38917153 PMCID: PMC11198842 DOI: 10.1371/journal.pone.0305822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The relationship between plant-based diets and gallstone disease has been debated. This study aimed to shed light on the association between plant-based dietary index and the risk of developing gallstone disease. METHODS Eligible participants were selected from National Health and Nutrition Examination Survey (NHANES) 2017-2020. Three plant-based diet indexes (PDI, healthy PDI, unhealthy PDI) were calculated using data from two NHANES 24-h dietary recall interviews. Restricted Cubic Spline and multivariate logistic regression were used to analyze the associations. Subgroup analysis was adopted to make the results more robust. RESULTS A total of 5673 eligible participants were analyzed. After adjusting for various confounding variables, uPDI was positively associated with gallstone disease (OR = 1.53, 95%CI: 1.02-2.29). No association was found between PDI/hPDI and gallstone disease (p > 0.05). The results of subgroup analysis did not show any positive association between uPDI and gallstones in specific groups. CONCLUSION Our study shows that the elevated uPDI are linked to a higher risk of gallstone disease.
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Affiliation(s)
- Luyang Li
- Postgraduate Training Base of Air Force Medical Center, China Medical University, Beijing, China
| | - Chengli Liu
- Postgraduate Training Base of Air Force Medical Center, China Medical University, Beijing, China
- Department of Hepatobiliary Surgery, Air Force Medical Center, Air Force Medical University, Beijing, China
- Graduate School of Hebei North University, Zhangjiakou, Hebei, China
| | - Tian Xia
- Graduate School of Hebei North University, Zhangjiakou, Hebei, China
| | - Haoming Li
- Postgraduate Training Base of Air Force Medical Center, China Medical University, Beijing, China
| | - Jun Yang
- Postgraduate Training Base of Air Force Medical Center, China Medical University, Beijing, China
| | - Meng Pu
- Department of Hepatobiliary Surgery, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Shuhan Zhang
- Department of Hepatobiliary Surgery, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Yingbo Ma
- Department of Hepatobiliary Surgery, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Tao Zhang
- Department of Hepatobiliary Surgery, Air Force Medical Center, Air Force Medical University, Beijing, China
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Xie L, Xu M, Lei Y, Li J, Xie J. The causal relationship between diet habits and cholelithiasis: a comprehensive Mendelian randomization (MR) study. Front Nutr 2024; 11:1377631. [PMID: 38933877 PMCID: PMC11203601 DOI: 10.3389/fnut.2024.1377631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Background Epidemiological studies show dietary habits can have an impact on the risk of cholelithiasis, but the relationship is still unclear. We used a comprehensive Mendelian randomization (MR) study to explore the relationship between dietary habits and cholelithiasis. Methods The 18 dietary habits were divided into six categories: meat foods, cereals, vegetables, fruits, dairy products, beverages, and condiments. Cholelithiasis data came from a GWAS meta-analysis and the FinnGen consortium. The inverse variance weighted (IVW), the weighted median (WM), and MR-Egger approaches were used as the main MR analysis methods. In addition, multiple sensitivity analysis and meta-analysis were performed to verify the robustness of the results. Results Dried fruit intake [odds ratio (OR) = 0.568; 95% confidence interval (CI), 0.405-0.797; p = 0.001] was discovered to reduce the risk of cholelithiasis. The sensitivity analysis and meta-analysis showed reliable results for the relationship between dried fruit intake and cholelithiasis. Conclusion Our study found that dried fruit intake is a protective factor in the development of cholelithiasis. However, the mechanisms of action need to be further explored.
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Affiliation(s)
- Lin Xie
- The Seventh Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Mingzhi Xu
- The Seventh Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Yahan Lei
- The Seventh Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Juan Li
- The Seventh Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Jiajia Xie
- Shenzhen Bao’an Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
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Zhao Z, Yang Y, Wu S, Yao D. Role of Secretory Mucins in the Occurrence and Development of Cholelithiasis. Biomolecules 2024; 14:676. [PMID: 38927079 PMCID: PMC11201413 DOI: 10.3390/biom14060676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/19/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Cholelithiasis is a common biliary tract disease. However, the exact mechanism underlying gallstone formation remains unclear. Mucin plays a vital role in the nuclear formation and growth of cholesterol and pigment stones. Excessive mucin secretion can result in cholestasis and decreased gallbladder activity, further facilitating stone formation and growth. Moreover, gallstones may result in inflammation and the secretion of inflammatory factors, which can further increase mucin expression and secretion to promote the growth of gallstones. This review systematically summarises and analyses the role of mucins in gallstone occurrence and development and its related mechanisms to explore new ideas for interventions in stone formation or recurrence.
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Affiliation(s)
| | | | | | - Dianbo Yao
- Department of General Surgery, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Heping District, Shenyang 110004, China; (Z.Z.); (Y.Y.); (S.W.)
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Ma P, Li R, Zeng L, Hong C, Li Y, Liang S, Zhu H, Cui H, Wang J, He J, Li Z, Xu J, Liu L, Xiao L. Association between sarcopenia-related markers and cholelithiasis: A prospective and Mendelian randomization study. ENVIRONMENTAL TOXICOLOGY 2024; 39:3473-3480. [PMID: 38450827 DOI: 10.1002/tox.24215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 03/08/2024]
Abstract
Cholelithiasis is a common digestive disease that drives a myriad of adverse complications. The correlation between sarcopenia and various digestive disorders has been extensively researched, whereas its association with cholelithiasis remains unreported. We aimed to investigate the association through prospective and Mendelian randomization (MR) analyses and establish a quantitative score reflecting the impact of sarcopenia-related markers on cholelithiasis. The prospective study involved 448 627 participants from the UK Biobank. Cox proportional hazard models were employed to investigate the correlation between sarcopenia-related markers and cholelithiasis. To quantitatively assess cholelithiasis risk, the SARCHO score was derived from a multivariable Cox model. Bidirectional two-sample MR analysis was conducted to validate the causal association. A total of 16 738 individuals developed cholelithiasis during a median follow-up of 12 years. Hazard ratios (HRs) of cholelithiasis decreased stepwise over skeletal muscle index tertiles (highest tertile: reference; middle tertile: 1.23, p < .001; lowest tertile: 1.33, p < .001). The tertiles of grip strength showed a similar pattern. Individuals with slow walking pace had a higher risk of cholelithiasis compared to those with normal walking pace (HR 1.23; p < .001). Our SARCHO score better quantifies the risk of cholelithiasis. MR analysis showed a causal relationship between muscle mass and cholelithiasis (OR 0.81; p < .001). No causal effect of cholelithiasis on lean mass was observed. Prospective and MR analyses have consistently demonstrated an increased risk of cholelithiasis in individuals with decreased muscle mass. Additionally, SARCHO score further quantified the cholelithiasis occurrence risk. These findings provide compelling evidence for muscle strengthening in preventing cholelithiasis.
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Affiliation(s)
- Pengcheng Ma
- School of Public Health, Southern Medical University, Guangzhou, China
- School of Health Management, Southern Medical University, Guangzhou, China
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ruining Li
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lin Zeng
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chang Hong
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yan Li
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shengxing Liang
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Hongbo Zhu
- Department of Medical Oncology, the First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Hao Cui
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiaren Wang
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jingzhe He
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zeyang Li
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jun Xu
- School of Public Health, Southern Medical University, Guangzhou, China
- School of Health Management, Southern Medical University, Guangzhou, China
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Li Liu
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Big Data Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lushan Xiao
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Big Data Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Liu P, Chen YW, Liu C, Wu YT, Zhao WC, Zhu JY, An Y, Xia NX. Development and validation of a nomogram model for predicting the risk of gallstone recurrence after gallbladder-preserving surgery. Hepatobiliary Pancreat Dis Int 2024; 23:288-292. [PMID: 36443144 DOI: 10.1016/j.hbpd.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladder-preserving surgery. This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence. METHODS The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected. The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis. A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables. The C-index, receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence. RESULTS During the follow-up period, a total of 65 patients experienced gallstone recurrence, and the recurrence rate was 35.5%. Multivariate logistic regression analysis revealed that the course of gallstones > 2 years [odds ratio (OR) = 2.567, 95% confidence interval (CI): 1.270-5.187, P = 0.009], symptomatic gallstones (OR = 2.589, 95% CI: 1.059-6.329, P = 0.037), multiple gallstones (OR = 2.436, 95% CI: 1.133-5.237, P = 0.023), history of acute cholecystitis (OR = 2.778, 95% CI: 1.178-6.549, P = 0.020) and a greasy diet (OR = 2.319, 95% CI: 1.186-4.535, P = 0.014) were independent risk factors for gallstone recurrence after gallbladder-preserving surgery. A nomogram model for predicting the recurrence of gallstones was established based on the above five variables. The results showed that the C-index of the nomogram model was 0.692, suggesting it was valuable to predict gallstone recurrence. Moreover, the calibration curve showed good consistency between the predicted probability and actual probability. CONCLUSIONS The nomogram model for the prediction of gallstone recurrence might help clinicians develop a proper treatment strategy for patients with gallstones. Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks.
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Affiliation(s)
- Peng Liu
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Yong-Wei Chen
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Che Liu
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Yin-Tao Wu
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Wen-Chao Zhao
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Jian-Yong Zhu
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Yang An
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Nian-Xin Xia
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China.
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Ozturk D, Sivaslioglu A, Bulus H, Ozturk B. TyG index is positively associated with HOMA-IR in cholelithiasis patients with insulin resistance: Based on a retrospective observational study. Asian J Surg 2024; 47:2579-2583. [PMID: 38508891 DOI: 10.1016/j.asjsur.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/24/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND/OBJECTIVE Cholelithiasis is a common disease but pose significant global health and financial burdens. Mechanisms of the disease are associated with insulin resistance (IR), obesity, metabolic syndrome, and type 2 diabetes. Insulin resistance is commonly observed in cholelithiasis patients. More recently, the triglyceride-glucose (TyG) index has been proposed as an alternative marker of insulin resistance. In our study we aimed to understand whether the TyG index is correlated with HOMA-IR in cholelithiasis patients. And also we aimed the predict a cutoff value for determining insulin resistance in cholelithiasis patients. METHODS A total of 184 cholelithiasis patients were matched in terms of age, gender, and BMI. They were divided into two groups based on their Homa IR levels (IR and Non-IR group). This study was a retrospective, observational study and clinical data was obtained from electronic medical records. Cutoff value for Tyg index was established through ROC Analysis. Binary Logistic Regression was used to identify factors affecting insulin resistance. RESULTS A significant cutoff value was found for the TyG index in determining the presence of insulin resistance. Having a TyG index of ≥8.71 indicates the presence of insulin resistance. The sensitivity was 68.48%, the specificity was 58.70%. Binary Logistic Regression analyses showed that an increase in Tyg Index, waist circumference and waist-to-height ratio values increases the risk of insulin resistance by 2.705 (p = 0.001), 1.032 (p = 0.029), and 334.057 (p = 0.012) times respectively. CONCLUSION Our study indicated that TyG index is positively correlated with HOMA-IR. TyG index was found as a risk factor for insulin resistance.
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Affiliation(s)
- Dogan Ozturk
- University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Department of General Surgery, Ankara, Turkiye
| | - Aysegul Sivaslioglu
- Hacettepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkiye.
| | - Hakan Bulus
- University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Department of General Surgery, Ankara, Turkiye
| | - Bulent Ozturk
- University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Department of General Surgery, Ankara, Turkiye
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Huang W, Xu H, Guo Y, Li M, Peng G, Wu T. Efficacy of early laparoscopic cholecystectomy compared with percutaneous transhepatic gallbladder drainage in treating acute calculous cholecystitis in elderly patients. Acta Chir Belg 2024; 124:178-186. [PMID: 37578137 DOI: 10.1080/00015458.2023.2232672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 06/28/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Acute calculous cholecystitis is a common acute disease in elderly patients. This study aimed to evaluate the efficacy of early laparoscopic cholecystectomy (ELC) compared to percutaneous transhepatic gallbladder drainage (PTGD) for treating acute calculous cholecystitis in elderly patients. METHODS This retrospective study compared the clinical outcomes of two groups of elderly patients treated with ELC (group A) and PTGD (group B) from January 2018 to December 2021. Preoperative clinical characteristics and postoperative treatment outcomes were analyzed for both groups. RESULTS There were no statistically significant differences in preoperative clinical characteristics between the ELC and PTGD groups. ELC took longer to perform (69.8 ± 15.9 min vs. 29.6 ± 5.3 min, p < 0.001) but resulted in a significantly shorter duration of pain (1.9 ± 0.9 days vs. 3.9 ± 1.0 days, p < 0.001) and hospital stay (6.3 ± 2.5 days vs. 9.9 ± 3.6 days, p < 0.001), and a lower rate of sepsis (3.4% vs. 16.9%, p < 0.019). Time to soft diet was faster in the ELC group (1.5 ± 0.9 days vs. 3.0 ± 1.6 days, p < 0.001). Fewer patients in the ELC group experienced surgical reintervention than in the PTGD group (0% vs. 5.6%, p = 0.043). The incidence of postoperative complications and readmission rates in the ELC group were significantly lower than those in the PTGD group (ELC, 3.6%; PTGD, 25.4%, p = 0.001). CONCLUSIONS ELC is an effective treatment option for acute calculous cholecystitis in elderly patients, and has the added benefits of low postoperative complication rates, rapid recovery, shorter duration of pain, and excellent curative effects as compared to PTGD.
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Affiliation(s)
- Wenhao Huang
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Haisong Xu
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Yuehua Guo
- Department of Hepatobiliary and Pancreatic Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Mingyue Li
- Department of Hepatobiliary and Pancreatic Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Gongze Peng
- Department of Hepatobiliary and Pancreatic Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Tianchong Wu
- Department of Hepatobiliary and Pancreatic Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
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Du Y, Wijaya WA, Liu WH. Advancements in metabolomics research in benign gallbladder diseases: A review. Medicine (Baltimore) 2024; 103:e38126. [PMID: 38788004 PMCID: PMC11124670 DOI: 10.1097/md.0000000000038126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/12/2024] [Indexed: 05/26/2024] Open
Abstract
The burgeoning field of metabolomics has piqued the interest of researchers in the context of benign gallbladder diseases, which include conditions such as gallbladder polyps, gallstones, and cholecystitis, which are common digestive system disorders. As metabolomics continues to advance, researchers have increasingly focused their attention on its applicability in the study of benign gallbladder diseases to provide new perspectives for diagnostic, therapeutic, and prognostic evaluation. This comprehensive review primarily describes the techniques of liquid chromatography-mass spectrometry, gas chromatography-mass spectrometry, and nuclear magnetic resonance and their respective applications in the study of benign gallbladder disease. Metabolomics has made remarkable progress in various aspects of these diseases, ranging from early diagnosis, etiological research, assessment of disease progression and prognosis, and optimization of therapeutic strategies. However, challenges remain in the field of metabolomics in the study of benign gallbladder diseases. These include issues related to data processing and analysis, biomarker discovery and validation, interdisciplinary research integration, and the advancement of personalized medicine. This article attempts to summarize research findings to date, highlight future research directions, and provide a reference point for metabolomics research in benign gallbladder disease.
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Affiliation(s)
- Yanzhang Du
- Department of Gastroenterology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Wennie A. Wijaya
- West China Hospital School of Medicine, Sichuan University, Chengdu, China
| | - Wei Hui Liu
- Department of Gastroenterology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Chi X, Li X, Wang F, Huang P, Liu J. Simultaneous cholecystectomy for asymptomatic gallstones during elective colorectal cancer surgery. J Gastrointest Surg 2024; 28:656-661. [PMID: 38704202 DOI: 10.1016/j.gassur.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Asymptomatic gallstones are commonly detected using preoperative imaging in patients with colorectal cancer (CRC), but its management remains a topic of debate. METHODS Clinicopathologic characteristics of patients who had asymptomatic gallstones presenting during the colorectal procedure were retrospectively reviewed. Medical records, including postoperative morbidity, mortality, and long-term gallstone-related diseases, were assessed. RESULTS Of 134 patients with CRC having asymptomatic gallstones, 89 underwent elective colorectal surgery only (observation group), and 45 underwent elective colorectal surgery with simultaneous cholecystectomy (cholecystectomy group). After propensity score matching (PSM), the complications were similar in the 2 groups. During the follow-up period, biliary complications were noted in 11 patients (12.4%) in the observation group within 2 years after the initial CRC surgery, but no case was found in the cholecystectomy group. After PSM, the incidence of long-term biliary complications remained significantly higher in the observation group than in the cholecystectomy group (26.5% vs 0.0%; P < .01). Multivariable logistic regression analysis identified female gender, old age (≥65 years old), and small multiple gallstones as independent risk factors for the development of long-term gallstone-related diseases in patients from the observation group. CONCLUSION Simultaneous prophylactic cholecystectomy during prepared, elective CRC surgery did not increase postoperative morbidity or mortality but decreased the risk of subsequent gallstone-related complications. Hence, simultaneous cholecystectomy might be a preferred therapeutic option for patients with CRC having asymptomatic gallstones in cases of elective surgery, especially for older patients (≥65 years old), female patients, and those with small multiple calculi.
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Affiliation(s)
- Xianda Chi
- Department of Gastrointestinal Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xuejie Li
- Department of Gastrointestinal Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Fan Wang
- Department of Clinical Medicine, Sun Yat-sen University Zhongshan School of Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Pinjie Huang
- Department of Anesthesiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
| | - Jianpei Liu
- Department of Gastrointestinal Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
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Boyang H, Yanjun Y, Jing Z, Chenxin Y, Ying M, Shuwen H, Qiang Y. Investigating the influence of the gut microbiome on cholelithiasis: unveiling insights through sequencing and predictive modeling. J Appl Microbiol 2024; 135:lxae096. [PMID: 38614959 DOI: 10.1093/jambio/lxae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/26/2024] [Accepted: 04/11/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Cholelithiasis is one of the most common disorders of hepatobiliary system. Gut bacteria may be involved in the process of gallstone formation and are, therefore considered as potential targets for cholelithiasis prediction. OBJECTIVE To reveal the correlation between cholelithiasis and gut bacteria. METHODS Stool samples were collected from 100 cholelithiasis and 250 healthy individuals from Huzhou Central Hospital; The 16S rRNA of gut bacteria in the stool samples was sequenced using the third-generation Pacbio sequencing platform; Mothur v.1.21.1 was used to analyze the diversity of gut bacteria; Wilcoxon rank-sum test and linear discriminant analysis of effect sizes (LEfSe) were used to analyze differences in gut bacteria between patients suffering from cholelithiasis and healthy individuals; Chord diagram and Plot-related heat maps were used to analyze the correlation between cholelithiasis and gut bacteria; six machine algorithms were used to construct models to predict cholelithiasis. RESULTS There were differences in the abundance of gut bacteria between cholelithiasis and healthy individuals, but there were no differences in their community diversity. Increased abundance of Costridia, Escherichia flexneri, and Klebsiella pneumonae were found in cholelithiasis, while Bacteroidia, Phocaeicola, and Phocaeicola vulgatus were more abundant in healthy individuals. The top four bacteria that were most closely associated with cholelithiasis were Escherichia flexneri, Escherichia dysenteriae, Streptococcus salivarius, and Phocaeicola vulgatus. The cholelithiasis model based on CatBoost algorithm had the best prediction effect (sensitivity: 90.48%, specificity: 88.32%, and AUC: 0.962). CONCLUSION The identification of characteristic gut bacteria may provide new predictive targets for gallstone screening. As being screened by the predictive model, people at high risk of cholelithiasis can determine the need for further testing, thus enabling early warning of cholelithiasis.
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Affiliation(s)
- Hu Boyang
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Yao Yanjun
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Zhuang Jing
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Yan Chenxin
- Shulan International Medical school, Zhejiang Shuren University, No.848 Dongxin Road, Gongshu District, Hangzhou City, Zhejiang Province 310000, China
| | - Mei Ying
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Han Shuwen
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Yan Qiang
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
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Zhang D, Wu C, Liu Y, Li W, Li S, Peng L, Kang L, Ullah S, Gong Z, Li Z, Ding D, Jin Z, Huang H. Microplastics are detected in human gallstones and have the ability to form large cholesterol-microplastic heteroaggregates. JOURNAL OF HAZARDOUS MATERIALS 2024; 467:133631. [PMID: 38335610 DOI: 10.1016/j.jhazmat.2024.133631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
Ubiquitous pollution due to microplastics through the food chain is a major cause of various deleterious effects on the human health. The aim of this study was to determine the existence of microplastics and the internal mechanism of microplastics as accelerators of cholelithiasis. Gallstones were collected from 16 patients after cholecystectomy, and microplastics in the gallstones were detected through laser direct infrared and pyrolysis gas chromatographymass spectrometry examinations. Mice model of gallstone were constructed with or without different diameters of microplastic (0.5, 5 and 50 µm). The affinity between microplastic and cholesterol or bilirubin was tested by co-culturing and qualified using molecular dynamics simulations. Finally, altered gut microbiota among the groups were identified using 16 s rRNA sequencing. The presence of microplastics in the gallstones of all the patients were confirmed. Microplastic content was significantly higher in younger chololithiasis patients (age<50 years). Mice fed a high-cholesterol diet with microplastic drinks showed more severe chololithiasis. In terms of the mechanism, microplastics showed a higher affinity for cholesterol than for bilirubin. Significant alterations in the gut microbiota have also been identified after microplastic intake in mice. Our study revealed the presence of microplastics in human gallstones, showcasing their potential to aggravate chololithiasis by forming large cholesterol-microplastic heteroaggregates and altering the gut microbiota.
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Affiliation(s)
- Deyu Zhang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Chang Wu
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Yue Liu
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Wanshun Li
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Shiyu Li
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Lisi Peng
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Le Kang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Saif Ullah
- Department of Gastroenterology, First affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Zijun Gong
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhaoshen Li
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Dan Ding
- Department of General Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
| | - Zhendong Jin
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
| | - Haojie Huang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
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Yan S, Yu L, Fang S, Gu C. The association between intakes of dietary trace minerals and gallstone disease: A cross-sectional study from National Health and Nutrition Examination Survey 2017 to 2018. Medicine (Baltimore) 2024; 103:e37741. [PMID: 38579045 PMCID: PMC10994463 DOI: 10.1097/md.0000000000037741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/07/2024] [Indexed: 04/07/2024] Open
Abstract
The gallstone disease is becoming increasingly prevalent worldwide. Dietary trace minerals have been proven to be closely related to many metabolic diseases, and this study aims to explore the association between intakes of dietary trace minerals (copper, iron, selenium, and zinc) and gallstone disease (GSD). Using the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2018, intakes of dietary trace minerals and GSD data were obtained through a 24-hour recall and diagnostic questionnaire, respectively. Weighted logistic regression models were used to identify the association between intakes of dietary trace minerals and the prevalence of GSD, and the results were presented as odds ratios (OR) and 95% confidence intervals (95% CI). A total of 4077 participants were included in the final analysis, of which 456 participants had GSD and 3621 participants serving as the control group. No significant associations between GSD and intakes of dietary trace minerals (iron, selenium, and zinc) were found. However, after adjusting for all covariates, significant association was demonstrated between dietary copper (Cu) intake and GSD (OR = 0.66, 95% CI = 0.45-0.98). After conducting a weighted quantile logistic regression, a significant negative correlation was also found between dietary Cu intake and highest GSD quartile (Q4) (OR = 0.45, 95% CI = 0.26-0.80). Following the research outlined above, no association was found between intakes of dietary trace minerals (iron, selenium, and zinc) and GSD; however, a linear negative association was identified between dietary Cu intake and GSD.
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Affiliation(s)
- Shimeng Yan
- Department of Surgery, Fangta Hospital of Traditional Chinese Medicine, Songjiang District, Shanghai, China
| | - Linhai Yu
- Department of Surgery, Fangta Hospital of Traditional Chinese Medicine, Songjiang District, Shanghai, China
| | - Shengli Fang
- Department of Surgery, Fangta Hospital of Traditional Chinese Medicine, Songjiang District, Shanghai, China
| | - Chunfei Gu
- Department of Surgery, Fangta Hospital of Traditional Chinese Medicine, Songjiang District, Shanghai, China
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王 新, 白 烨, 于 文, 谢 林, 李 诗, 江 果, 李 鸿, 张 本. [New Progress in Longitudinal Research on the Risk Factors for Cholelithiasis]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:490-500. [PMID: 38645861 PMCID: PMC11026901 DOI: 10.12182/20240360508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Indexed: 04/23/2024]
Abstract
Cholelithiasis is a common disease of the digestive system. The risk factors for cholelithiasis have been reported and summarized many times in the published literature, which primarily focused on cross-sectional studies. Due to the inherent limitations of the study design, the reported findings still need to be validated in additional longitudinal studies. Moreover, a number of new risk factors for cholelithiasis have been identified in recent years, such as bariatric surgery, hepatitis B virus infection, hepatitis C virus infection, kidney stones, colectomy, osteoporosis, etc. These new findings have not yet been included in published reviews. Herein, we reviewed the 101 cholelithiasis-associated risk factors identified through research based on longitudinal investigations, including cohort studies, randomized controlled trials, and nested case control studies. The risk factors associated with the pathogenesis of cholelithiasis were categorized as unmodifiable and modifiable factors. The unmodifiable factors consist of age, sex, race, and family history, while the modifiable factors include 37 biological environmental factors, 25 socioenvironmental factors, and 35 physiochemical environmental factors. This study provides thorough and comprehensive ideas for research concerning the pathogenesis of cholelithiasis, supplying the basis for identifying high-risk groups and formulating relevant prevention strategies.
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Affiliation(s)
- 新 王
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 烨 白
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 文倩 于
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 林君 谢
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 诗懿 李
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 果恒 江
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 鸿钰 李
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 本 张
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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Esen İ, Arslan H, Aktürk Esen S, Gülşen M, Kültekin N, Özdemir O. Early prediction of gallstone disease with a machine learning-based method from bioimpedance and laboratory data. Medicine (Baltimore) 2024; 103:e37258. [PMID: 38394521 PMCID: PMC11309733 DOI: 10.1097/md.0000000000037258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
Gallstone disease (GD) is a common gastrointestinal disease. Although traditional diagnostic techniques, such as ultrasonography, CT, and MRI, detect gallstones, they have some limitations, including high cost and potential inaccuracies in certain populations. This study proposes a machine learning-based prediction model for gallstone disease using bioimpedance and laboratory data. A dataset of 319 samples, comprising161 gallstone patients and 158 healthy controls, was curated. The dataset comprised 38 attributes of the participants, including age, weight, height, blood test results, and bioimpedance data, and it contributed to the literature on gallstones as a new dataset. State-of-the-art machine learning techniques were performed on the dataset to detect gallstones. The experimental results showed that vitamin D, C-reactive protein (CRP) level, total body water, and lean mass are crucial features, and the gradient boosting technique achieved the highest accuracy (85.42%) in predicting gallstones. The proposed technique offers a viable alternative to conventional imaging techniques for early prediction of gallstone disease.
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Affiliation(s)
- İrfan Esen
- Yüksek İhtisas University, Faculty of Medicine Department of Internal Medicine, Ankara, Turkey
| | - Hilal Arslan
- Ankara Yildirim Beyazit University, Department of Software Engineering, Faculty of Engineering and Natural Sciences, Ankara, Turkey
| | | | - Mervenur Gülşen
- Keçiören VM Medicalpark Hospital, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Nimet Kültekin
- Keçiören VM Medicalpark Hospital, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Oğuzhan Özdemir
- Yüksek İhtisas University, Faculty of Medicine Department of Department of Radiology, Ankara, Turkey
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Li Y, Han H, You K, Ma C, Fan X. Investigating the association between blood cobalt and gallstones: a cross-sectional study utilizing NHANES data. Front Public Health 2024; 12:1363815. [PMID: 38384872 PMCID: PMC10879586 DOI: 10.3389/fpubh.2024.1363815] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/26/2024] [Indexed: 02/23/2024] Open
Abstract
Background With the use of cobalt alloys in medical prosthetics, the risk of cobalt exposure has increased. The objective of this study was to investigate the correlation between blood cobalt levels and the occurrence of gallstones utilizing data from the National Health and Nutrition Examination Survey (NHANES). Methods Data collected between 2017 and 2020 were analyzed, encompassing a total of 5,610 participants. Cobalt concentrations in whole blood specimens were directly measured using inductively coupled plasma mass spectrometry (ICP-MS). The presence of gallstones was ascertained through a standardized questionnaire. To assess the association between blood cobalt levels and the presence of gallstones, logistic regression analysis, restricted cubic spline analysis, and subgroup analysis were utilized. Results The results of logistic regression analysis revealed a heightened risk of developing gallstones in the Quartiles 2 and Quartiles 4 groups based on blood cobalt levels when compared to the Quartiles 1 group (OR = 1.54, 95% CI: 1.15-2.07; OR = 1.35, 95% CI: 1.03-1.77). The restricted cubic spline analysis exhibited a positive linear correlation between blood cobalt levels and the occurrence of gallstones. Subgroup analyses further demonstrated a statistically significant correlation between the Quartiles 4 category of blood cobalt levels and an elevated risk of gallstones, particularly among individuals aged 60 years or older, females, those with a body mass index (BMI) equal to or exceeding 25, serum total cholesterol levels below 200 mg/dL, as well as individuals diagnosed with hypertension or diabetes. Conclusion Our study findings indicate a notable association between elevated blood cobalt levels and an increased risk of gallstones. To establish a causal relationship between blood cobalt levels and the elevated risk of developing gallstones, further prospective cohort studies are warranted.
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Affiliation(s)
| | | | | | | | - Xin Fan
- Department of General Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Meng C, Liu K. Higher levels of systemic immune-inflammatory index are associated with the prevalence of gallstones in people under 50 years of age in the United States: a cross-sectional analysis based on NHANES. Front Med (Lausanne) 2024; 10:1320735. [PMID: 38283040 PMCID: PMC10811245 DOI: 10.3389/fmed.2023.1320735] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/30/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Inflammation plays a significant role in gallstones formation. The prognosis of various illnesses was initially predicted using the systemic immune-inflammatory index (SII). We performed an updated analysis on the impact of SII and gallstones. Methods To investigate the connection between the SII and gallstones occurrence in a sample of individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020, we employed logistic regression analysis, subgroup analysis, and smoothing curve fitting. Results In our study, an aggregate of 4,950 individuals over the age of 20 were enrolled, and 429 of them claimed to have gallstones. A fully adjusted model showed that the third and fourth quartiles of SII was parallel associated with gallstones in adults (OR = 2.43, 95% CI = 1.39-4.26; OR = 2.97, 95% CI = 1.72-5.16) under 50 years. Subgroup analysis and smoothed curve fitting provided evidence in favor of this finding. Conclusion According to our research, gallstones are more likely to occur in US adults younger than 50 years.
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Affiliation(s)
| | - Kai Liu
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
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Arumugaswamy PR, Chumber S, Rathore YS, Maitra S, Bhattacharjee HK, Bansal VK, Aggarwal S, Dhar A, Asuri K, Kataria K, Ranjan P. Low-pressure pneumoperitoneum with deep neuromuscular blockade versus standard pressure pneumoperitoneum in patients undergoing laparoscopic cholecystectomy for gallstone disease: a non-inferiority randomized control trial. Surg Endosc 2024; 38:449-459. [PMID: 38012441 DOI: 10.1007/s00464-023-10558-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/22/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Low-pressure pneumoperitoneum (LPP) is an attempt at improving laparoscopic surgery. However, it has the issue of poor working space for which deep neuromuscular blockade (NMB) may be a solution. There is a lack of literature comparing LPP with deep NMB to standard pressure pneumoperitoneum (SPP) with moderate NMB. METHODOLOGY This was a single institutional prospective non-inferiority RCT, with permuted block randomization of subjects into group A and B [Group A: LPP; 8-10 mmHg with deep NMB [ Train of Four count (TOF): 0, Post Tetanic Count (PTC): 1-2] and Group B: SPP; 12-14 mmHg with moderate NMB]. The level of NMB was monitored with neuromuscular monitor with TOF count and PTC. Cisatracurium infusion was used for continuous deep NMB in group A. Primary outcome measures were the surgeon satisfaction score and the time for completion of the procedure. Secondarily important clinical outcomes were also reported. RESULTS Of the 222 patients screened, 181 participants were enrolled [F: 138 (76.2%); M: 43 (23.8%); Group A n = 90, Group B n = 91]. Statistically similar surgeon satisfaction scores (26.1 ± 3.7 vs 26.4 ± 3.4; p = 0.52) and time for completion (55.2 ± 23.4 vs 52.5 ± 24.9 min; p = 0.46) were noted respectively in groups A and B. On both intention-to-treat and per-protocol analysis it was found that group A was non-inferior to group B in terms of total surgeon satisfaction score, however, non-inferiority was not proven for time for completion of surgery. Mean pain scores and incidence of shoulder pain were statistically similar up-to 7 days of follow-up in both groups. 4 (4.4%) patients in group B and 2 (2.2%) in group A had bradycardia (p = 0.4). Four (4.4%) cases of group A were converted to group B. One case of group B converted to open surgery. Bile spills and gallbladder perforations were comparable. CONCLUSION LPP with deep NMB is non-inferior to SPP with moderate NMB in terms of surgeon satisfaction score but not in terms of time required to complete the procedure. Clinical outcomes and safety profile are similar in both groups. However, it could be marginally costlier to use LPP with deep NMB.
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Affiliation(s)
- Prasanna Ramana Arumugaswamy
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Sunil Chumber
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Yashwant Singh Rathore
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | - Souvik Maitra
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Hemanga Kumar Bhattacharjee
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Virinder Kumar Bansal
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Sandeep Aggarwal
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Anita Dhar
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Krishna Asuri
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Kamal Kataria
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Piyush Ranjan
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
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Yuk JS, Park JY. Menopausal hormone therapy increases the risk of gallstones: Health Insurance Database in South Korea (HISK)-based cohort study. PLoS One 2023; 18:e0294356. [PMID: 38048308 PMCID: PMC10695378 DOI: 10.1371/journal.pone.0294356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/30/2023] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVE To determine whether menopausal hormone therapy (MHT) increases the risk of gallstones and gallbladder cancer. DESIGN A retrospective cohort study. PATIENTS OR OTHER PARTICIPANTS Data from the Korea National Health Insurance Corporation was obtained between January 1, 2002, and December 31, 2019. INTERVENTIONS Participants were divided into MHT and non-MHT groups; the MHT group was analyzed in detail by dividing participants into tibolone, combined estrogen plus progestin by the manufacturer (CEPM) or physician (CEPP), oral estrogen alone, and topical estrogen subgroups. MAIN OUTCOME MEASURES The incidence of gallstones and gallbladder cancer was compared between the two groups. RESULTS This study enrolled 1,004,034 and 381,711 patients in the non-MHT and the MHT groups, respectively. The incidence of gallstones was 2.6% in the non-MHT group and 3.4%, 2.6%, 3.4%, 3.2%, and 4.4% in the tibolone, CEPM, oral estrogen alone, CEPP, and topical estrogen groups, respectively. Cox proportional hazard analysis revealed that all hormones increased the risk of gallstones ([tibolone] hazard ratio [HR]: 1.347, 95% confidence interval [CI]: 1.309-1.387, [CEPM] HR: 1.146, 95% CI: 1.1-1.19, [oral estrogen alone] HR: 1.241, 95% CI: 1.18-1.305, [CEPP] HR: 1.164, 95% CI: 1.01-1.341, [topical estrogen] HR: 1.602, 95% CI: 1.295-1.983). However, the risk of gallbladder cancer did not change with any hormone therapy. CONCLUSIONS All types of MHT including tibolone, increased the risk of gallstones. This risk was the highest with topical estrogen, which may be a result of selection bias due to concerns regarding the adverse effects of CEE and MPA.
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Affiliation(s)
- Jin-Sung Yuk
- Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea
| | - Ji Young Park
- Department of Internal Medicine, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea
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Wan Z, Bai X, He C, Zhang Y, Wang Y, Shen K, Meizi L, Wang Q, Dongsheng W, Feng Y, Yang A. Distinct lipid profile in haemolytic anaemia-related gallstones compared with the general gallstone. Ann Med 2023; 55:2203514. [PMID: 37141158 PMCID: PMC10161937 DOI: 10.1080/07853890.2023.2203514] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Pigment gallstones are not uncommon among patients with chronic haemolytic anaemia. But their clinical characteristics have not been described in detail and not been directly compared with the general gallstone population. METHODS Patients at Peking Union Medical College Hospital with haemolytic anaemia and subsequent gallstones from January 2012 to December 2022 were included. Cases were matched (1:2) based on age, sex and location of stones to randomly select non-anaemia patients with gallstones (controls). RESULTS Screening 899 cases of gallstones, we finally included 76 cases and 152 controls. Total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) for cases were 3.02 ± 0.98 mmol/L, 0.89 ± 0.30 mmol/L and 1.58 ± 0.70 mmol/L, respectively, significantly lower than those in the control group (all p < 0.001). TC and HDL were both lower than the normal range, but triglyceride and LDL were within the normal range. Multiple stones were significantly more common for cases (n = 59, 78%) than for controls (n = 44, 29%, p < 0.001). The mean diameter of the maximal gallstone was 1.2 ± 0.6 cm and 1.5 ± 1.0 cm for cases and controls (p = 0.120), respectively. Stones in the elderly (p = 0.002 for univariate analysis, and 0.001 for multivariate analysis) and stones in the bile duct (p = 0.005 for univariate analysis, and 0.009 for multivariate analysis) were found to occur in a shorter period after anaemia. CONCLUSION The lipid profile of haemolytic anaemia with gallstones was distinct, low TC, low HDL, and increased-to-normal LDL, compared with the general gallstone population. Patients with haemolytic anaemia were recommended an abdominal ultrasound if aged older than 50 years, with more frequent follow-up visits.KEY MESSAGESClinical characteristics of gallstones following chronic haemolytic anaemia were described and compared with the general gallstone population.The lipid profiles were distinctly different between the patients with gallstones following chronic haemolytic anaemia and the general gallstone population.Elder patients were complicated with gallstones in a shorter period after anaemia and thus were recommended an abdominal ultrasound if aged older than 50 years, with more frequent follow-up visits.
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Affiliation(s)
- Ziqi Wan
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
- Eight-Year Program, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoyin Bai
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Chengqing He
- Eight-Year Program, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yueyi Zhang
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Wang
- Department of Ultrasound, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Kaini Shen
- Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Li Meizi
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Qiang Wang
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wu Dongsheng
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yunlu Feng
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Aiming Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Li ZZ, Guan LJ, Ouyang R, Chen ZX, Ouyang GQ, Jiang HX. Global, regional, and national burden of gallbladder and biliary diseases from 1990 to 2019. World J Gastrointest Surg 2023; 15:2564-2578. [PMID: 38111771 PMCID: PMC10725539 DOI: 10.4240/wjgs.v15.i11.2564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Gallbladder and biliary diseases (GABDs) are a major public health issue. AIM To analysis the cause-specific incidence, prevalence, and years lived with disability (YLDs) and its temporal trends of GABDs at the global, regional, and national level. Data on GABD were available from the Global Burden of Disease study 2019. METHODS The estimated annual percentage change (EAPC) was used to quantify temporal trend in GABD age-standardized incidence rates (ASIRs), age-standardized prevalence rate (ASPR), and age-standardized YLD rate (ASYR) by region, sex. We analyzed the relationship between the GABD burden and country development level using the human development index (HDI). RESULTS In 2019, the incident cases of GABD were 52003772, with an ASIR of 63432/100000 population. Globally, the number of incident cases and ASIR of GABD increased 97% and 58.9% between 1990 and 2019. Although, the ASPR and ASYR decreased from 1990 to 2019, the number of prevalent and YLDs cases increased. The highest ASIR was observed in Italy, and the highest ASPR and ASYR was observed in United Kingdom. The highest burden of GABD was found in low-SDI region, and the burden in female was significantly higher than males. A generally negative correlation (ρ = -0.24, P < 0.05) of GABD with the EAPC and human development index (HDI) (in 2021) were observed for ASIR. What's more, no correlation in ASPR (ρ = -0.06, P = 0.39) and ASYR (ρ = -0.07, P = 0.36) of GABD with the EAPC and HDI (in 2021) were observed, respectively. CONCLUSION GABD remain a major global public health challenge; however, the burden of GABD varies geographically. Globally, the number of incident cases and ASIR of GABD increased between 1990 and 2019. The results of our study provide insight into the global disease burden of GABD and may assist policymakers in formulating effective policies to mitigate modifiable risk factors.
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Affiliation(s)
- Zhong-Zhuan Li
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
- Department of Gastroenterology, Liuzhou Workers’ Hospital (The Fourth Affiliated Hospital of Guangxi Medical University), Liuzhou 545007, Guangxi Zhuang Autonomous Region, China
| | - Lin-Jing Guan
- Department of Abdomen Ultrasound, Nanning Sixth People’s Hospital, Nanning 530002, Guangxi Zhuang Autonomous Region, China
| | - Rong Ouyang
- Department of Gastroenterology, Liuzhou Workers’ Hospital (The Fourth Affiliated Hospital of Guangxi Medical University), Liuzhou 545007, Guangxi Zhuang Autonomous Region, China
| | - Zhi-Xin Chen
- Department of Gastroenterology, Liuzhou Workers’ Hospital (The Fourth Affiliated Hospital of Guangxi Medical University), Liuzhou 545007, Guangxi Zhuang Autonomous Region, China
| | - Guo-Qing Ouyang
- Department of General Surgery, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou 545006, Guangxi Zhuang Autonomous Region, China
| | - Hai-Xing Jiang
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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Li J, Zhang J, Kong B, Chen L, Yuan J, He M, Wang Y, Wei S, Chen W, Tang Y, Zhu X, Yao P. Abdominal obesity mediates the causal relationship between depression and the risk of gallstone disease: retrospective cohort study and Mendelian randomization analyses. J Psychosom Res 2023; 174:111474. [PMID: 37689051 DOI: 10.1016/j.jpsychores.2023.111474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/13/2023] [Accepted: 08/22/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVE Our study aimed to explore the causal effect of depression on the risk of gallstone disease, and the mediation effects of metabolic traits. METHODS A retrospective cohort study on Chinese elderly from the Dongfeng-Tongji cohort (including 18,141 individuals) was conducted to estimate the adverse effect of probable depression on the risk of gallstone disease. Two-sample Mendelian randomization was performed in European and East-Asian ancestries, to verify the causal relationship between major depression and gallstone disease. We further applied two-step Mendelian randomization to explore the mediation effects of metabolic traits. RESULTS In the cohort study, probable depression was associated with an increased risk of gallstone disease within 5 years, with RR (95% CI) of 1.33 (1.12, 1.58) in multivariable regression, and 1.34 (1.11, 1.61) following propensity score weighting. Bidirectional Mendelian randomization in European ancestry revealed a positive causal effect (OR: 1.21; 95% CI: 1.07 to 1.37) of genetically predicted major depression liability on gallstone disease, based on the inverse variance weighted method. Little evidence was presented from other complementary approaches, and the analysis in East-Asian ancestry (IVW estimated OR: 1.03; 95% CI: 0.92 to 1.15). The indirect effect via waist circumference and HDL-C were 1.06 (95% CI: 1.02 to 1.10) and 1.01 (95% CI: 1.00 to 1.01) respectively, which mediated 25.8% and 3.78% of the causal relationship. CONCLUSIONS Our study suggested a higher risk of gallstone disease in the population with probable depression, while the two-sample Mendelian randomization provided weak evidence for the causal relationship, which was moderately mediated by abdominal obesity.
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Affiliation(s)
- Jingxi Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jun Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Bingxuan Kong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Li Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jing Yuan
- Institute of Occupational Medicine and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Meian He
- Institute of Occupational Medicine and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Youjie Wang
- Institute of Occupational Medicine and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Weihong Chen
- Institute of Occupational Medicine and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yuhan Tang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xinhong Zhu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan 430070, China
| | - Ping Yao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Portincasa P, Di Ciaula A, Bonfrate L, Stella A, Garruti G, Lamont JT. Metabolic dysfunction-associated gallstone disease: expecting more from critical care manifestations. Intern Emerg Med 2023; 18:1897-1918. [PMID: 37455265 PMCID: PMC10543156 DOI: 10.1007/s11739-023-03355-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Abstract
About 20% of adults worldwide have gallstones which are solid conglomerates in the biliary tree made of cholesterol monohydrate crystals, mucin, calcium bilirubinate, and protein aggregates. About 20% of gallstone patients will definitively develop gallstone disease, a condition which consists of gallstone-related symptoms and/or complications requiring medical therapy, endoscopic procedures, and/or cholecystectomy. Gallstones represent one of the most prevalent digestive disorders in Western countries and patients with gallstone disease are one of the largest categories admitted to European hospitals. About 80% of gallstones in Western countries are made of cholesterol due to disturbed cholesterol homeostasis which involves the liver, the gallbladder and the intestine on a genetic background. The incidence of cholesterol gallstones is dramatically increasing in parallel with the global epidemic of insulin resistance, type 2 diabetes, expansion of visceral adiposity, obesity, and metabolic syndrome. In this context, gallstones can be largely considered a metabolic dysfunction-associated gallstone disease, a condition prone to specific and systemic preventive measures. In this review we discuss the key pathogenic and clinical aspects of gallstones, as the main clinical consequences of metabolic dysfunction-associated disease.
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Affiliation(s)
- Piero Portincasa
- Clinica Medica "A. Murri", Division of Internal Medicine, Department of Preventive and Regenerative Medicine and Ionian Area (DiMePrev-J), University of Bari Aldo Moro, p.zza Giulio Cesare 11, 70124, Bari, Italy.
| | - Agostino Di Ciaula
- Clinica Medica "A. Murri", Division of Internal Medicine, Department of Preventive and Regenerative Medicine and Ionian Area (DiMePrev-J), University of Bari Aldo Moro, p.zza Giulio Cesare 11, 70124, Bari, Italy
| | - Leonilde Bonfrate
- Clinica Medica "A. Murri", Division of Internal Medicine, Department of Preventive and Regenerative Medicine and Ionian Area (DiMePrev-J), University of Bari Aldo Moro, p.zza Giulio Cesare 11, 70124, Bari, Italy
| | - Alessandro Stella
- Laboratory of Medical Genetics, Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, Bari, Italy
| | - Gabriella Garruti
- Section of Endocrinology, Department of Preventive and Regenerative Medicine and Ionian Area (DiMePrev-J), University of Bari Aldo Moro, Bari, Italy
| | - John Thomas Lamont
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
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Hristov B, Doykov D, Stanchev D, Kraev K, Uchikov P, Kostov G, Valova S, Tilkiyan E, Doykova K, Doykov M. Hepatico-Duodenal Fistula Following Iatrogenic Strasberg Type E4 Bile Duct Injury: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1621. [PMID: 37763740 PMCID: PMC10537085 DOI: 10.3390/medicina59091621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Gallstone disease (GSD) is among the most common disorders worldwide. Gallstones are established in up to 15% of the general population. Laparoscopic cholecystectomy (LC) has become the "gold standard" for treatment of GSD but is associated with a higher rate of certain complications, namely, bile duct injury (BDI). Biliary fistulas (BF) are a common presentation of BDI (44.1% of all patients); however, they are mainly external. Post-cholecystectomy internal BF are exceedingly rare. CASE REPORT a 33-year Caucasian female was admitted with suspected BDI after LC. Strasberg type E4 BDI was established on endoscopic retrograde cholangiopancreatography (ERCP). Urgent laparotomy established biliary peritonitis. Delayed surgical reconstruction was planned and temporary external biliary drains were positioned in the right and left hepatic ducts. During follow-up, displacement of the drains occurred with subsequent evacuation of bile through the external fistula, which resolved spontaneously, without clinical and biochemical evidence of biliary obstruction or cholangitis. ERCP established bilio-duodenal fistula between the left hepatic duct (LHD) and duodenum, with a stricture at the level of the LHD. Endoscopic management was chosen with staged dilation and stenting of the fistulous tract over 18 months until fistula maturation and stricture resolution. One year after stent extraction, the patient remains symptom free. DISCUSSION Management of post-cholecystectomy BDI is challenging. The optimal approach is determined by the level and extent of ductal lesion defined according to different classifications (Strasberg, Bismuth, Hannover). Type E BDI are managed mainly surgically with a delayed surgical approach generally deemed preferable. Only three cases of choledocho-duodenal fistulas following LC BDI currently exist in the literature. Management is controversial, with expectant approach, surgical treatment (biliary reconstruction), or liver transplantation being described. Endoscopic treatment has not been described; however, in the current paper, it proved to be successful. More reports or larger case series are needed to confirm its applicability and effectiveness, especially in the long term.
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Affiliation(s)
- Bozhidar Hristov
- Section "Gastroenterology", Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Gastroenterology Clinic, University Hospital "Kaspela", 4001 Plovdiv, Bulgaria
| | - Daniel Doykov
- Section "Gastroenterology", Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Gastroenterology Clinic, University Hospital "Kaspela", 4001 Plovdiv, Bulgaria
| | - Desislav Stanchev
- Section "Gastroenterology", Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Gastroenterology Clinic, University Hospital "Kaspela", 4001 Plovdiv, Bulgaria
| | - Krasimir Kraev
- Department of Propedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Rheumatology Clinic, St. George University Hospital, 6000 Plovdiv, Bulgaria
| | - Petar Uchikov
- Department of Special Surgery, Faculty of Medicine, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Second Department of Surgery, St. George University Hospital, 4000 Plovdiv, Bulgaria
| | - Gancho Kostov
- Department of Special Surgery, Faculty of Medicine, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Department of Surgery, University Hospital "Kaspela", 4001 Plovdiv, Bulgaria
| | - Siyana Valova
- Section "Nephrology", Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Clinic of Nephrology, University Hospital "Kaspela", 4001 Plovdiv, Bulgaria
| | - Eduard Tilkiyan
- Section "Nephrology", Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Clinic of Nephrology, University Hospital "Kaspela", 4001 Plovdiv, Bulgaria
| | - Katya Doykova
- Department of Diagnostic Imaging, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Department of Diagnostic Imaging, University Hospital "Kaspela", 4001 Plovdiv, Bulgaria
| | - Mladen Doykov
- Department of Urology and General Medicine, Medical Faculty, Medical University of Plovdiv, 6000 Plovdiv, Bulgaria
- Clinic of Urology, University Hospital "Kaspela", 4001 Plovdiv, Bulgaria
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Nie C, Yang T, Wang Z, Suolang D, Wang S, Baima K, Wei L, Ling H, Liu L, Zeng Q, Qin Z, Zuo H, Hong F. Dietary Patterns and Gallstone Risks in Chinese Adults: A Cross-sectional Analysis of the China Multi-Ethnic Cohort Study. J Epidemiol 2023; 33:471-477. [PMID: 35466159 PMCID: PMC10409532 DOI: 10.2188/jea.je20220039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/05/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Little is known about the association between a plant-based diet and the risk of gallstone disease (GD), especially in developing counties. We tested the hypothesis that shifting dietary patterns would be related to the risk of GD, and that the Mediterranean diet (MED) adjusted for China would be beneficial for lowering risk of GD. METHODS Data were extracted from the baseline survey of the China Multi-Ethnic Cohort study. An alternative Mediterranean diet (aMED) score was assessed based on a food frequency questionnaire, and three posteriori dietary patterns (the modern dietary pattern, the coarse grain dietary pattern, and the rice dietary pattern) were identified using factor analysis. Multivariable logistic regression models were developed to evaluate the association between dietary patterns and GD risks. RESULTS A total of 89,544 participants were included. The prevalence of GD was 7.5%. Comparing the highest with lowest quintiles, aMED was associated with an increased risk of GD (OR 1.13; 95% CI, 1.04-1.24; Ptrend = 0.003), whereas the rice dietary pattern was inversely related to GD risk (OR 0.79; 95% CI, 0.71-0.87; Ptrend < 0.001). In stratified analysis, the rice dietary pattern had a stronger inverse association in the subgroups of females, older, urban, and overweight participants, and those with diabetes-factors associated with higher rates of GD in previous studies. CONCLUSION Higher adherence to the rice dietary pattern was associated with a lower risk of GD. For high-risk populations, making some shift to a traditional agricultural diet might help with primary prevention of GD.
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Affiliation(s)
- Chan Nie
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Tingting Yang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Ziyun Wang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Deji Suolang
- Tibet Center for Disease Control and Prevention, Lhasa, China
| | - Songmei Wang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Kangzhuo Baima
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- School of Medicine, Tibet University, Lhasa, China
| | - Li Wei
- Wuhou District Center for Disease Control and Prevention, Chengdu, China
| | - Hua Ling
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Leilei Liu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Qibing Zeng
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Zixiu Qin
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Haojiang Zuo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Food Safety Monitoring and Risk Assessment Key Laboratory of Sichuan Province, Chengdu, China
| | - Feng Hong
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
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Becker TP, Duggan B, Rao V, Deleon G, Pei K. Outcomes of Concurrent Ventral Hernia Repair and Cholecystectomy Compared to Ventral Hernia Repair Alone. Cureus 2023; 15:e45699. [PMID: 37868564 PMCID: PMC10590152 DOI: 10.7759/cureus.45699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction It has been suggested that hernia repair with concomitant cholecystectomy increases the risk of postoperative complications due to potential mesh contamination. This study compares postoperative outcomes and complications between patients who underwent ventral hernia repair (VHR) with and without concomitant cholecystectomy (CCY). Methods Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database, from 2005 to 2019, we queried patients who underwent ventral hernia repairs using the current procedural terminology (CPT) codes 49652-49657 (laparoscopic) and 49560-49566 (open), with or without cholecystectomy. The ACS NSQIP is a prospective, systematic study of patients who underwent major general surgical procedures aggregating data from over 200 hospitals. Cases involving additional concomitant procedures were excluded. Primary outcomes of interest were 30-day mortality, length of stay, readmission, return to operating room (OR), and postoperative complications. The odds ratio for primary outcomes was calculated using multivariable binomial logistic regression to control for patient risk factors. Results In total, 167586 cases were identified, 165,758 ventral hernia repairs alone, and 1,828 ventral hernia repairs with concomitant cholecystectomy. There was no difference in 30-day mortality, length of stay, readmission, return to the operating room, or postoperative complications between groups. Patients who underwent simultaneous VHR/CCY when compared to those who had VHR alone, had no differences in the rate of surgical site infections (1.86% vs. 1.97%, P = 0.57) or sepsis (0.82% vs. 0.41%, P = 0.10). Conclusion In a large national sample, there is no significant difference in postoperative outcomes, specifically infection-related complications, when comparing VHR along with concurrent VHR/CCY. Our findings suggest no increased risks for patients undergoing concurrent ventral hernia repair and cholecystectomy. Hence, surgeons might consider this combined approach to offer the best value-based care, especially when it could eliminate the need for a second operation and the risk of infection is low. Prospective studies with more procedural-specific information for hernia repairs and indications for cholecystectomy are needed however it is likely safe to perform both procedures during the same setting in cholecystectomy cases lacking signs of acute infection.
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Affiliation(s)
- Timothy P Becker
- General Surgery, Indiana University School of Medicine, Indianapolis, USA
| | - Ben Duggan
- General Surgery, Indiana University School of Medicine, Indianapolis, USA
| | - Varun Rao
- Neurological Surgery, Indiana University School of Medicine, Indianapolis, USA
| | - Genaro Deleon
- General Surgery, Indiana University School of Medicine, Indianapolis, USA
| | - Kevin Pei
- General Surgery, Parkview Health, Fort Wayne, USA
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Abstract
Diseases of the gallbladder include a spectrum of gallstone diseases (cholelithiasis, cholecystitis, choledocholithiasis, and cholangitis), cysts, polyps, and malignancy. In this review, we present the incidence, risk factors, clinical presentation, diagnosis, and treatment of these various conditions. Importantly, we report when more urgent referral is indicated, as well as red flags that warrant further intervention and/or management.
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Affiliation(s)
- Seth Anthony Politano
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA.
| | - Nida Hamiduzzaman
- Division of GHPGIM, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Dalal Alhaqqan
- Division of Gastroenterology and Hepatology, MedStar Georgetown University Hospital, Washington, DC, USA
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