The influence of cholecystectomy at young age on the course of metabolic syndrome in women

Cover Page


Cite item

Abstract

Rationale:  At present, the  metabolic  syndrome and  pathophysiology  of non-alcoholic  fatty  liver disease, as well as identification of factors that may  influence  the  rate  of development of dystrophy and fibrosis in the liver are in the focus of investigators'  attention. This study represents an attempt to  detail  metabolic  derangements and liver tissue  abnormalities  after  cholecystectomy in patients  with metabolic  syndrome  at baseline.

Aim: To study  the  influence  of cholecystectomy performed  at younger  age on the course of metabolic syndrome in women.

Materials and methods: This was a retrospective analytical study  in a sample  of 57 female  patients  with  metabolic syndrome (International Diabetes Federation criteria 2005) aged  from 18 to 44 years (young age according  to the World Health Organization definition). From those, 30 patients  with cholelithiasis were included  into the control group  and 27 patients  who  had  undergone  cholecystectomy in this age range were included into the comparison group. We analyzed  their past  history, results  of clinical examination, laboratory  tests, abdominal ultrasound  examination, esophagogastroduodenoscopy, hydrogen  respiration  test  with lactulose, as well as the results of needle  liver biopsy.

Results: Non-alcoholic steatohepatitis after cholecystectomy was associated with the excessive bacterial growth  in the small intestine  (р = 0.026), ultrasound signs of cholangitis (р = 0.041), and diarrhea syndrome (р = 0.027). Liver fibrosis was significantly more frequent in association with chronic diarrhea  (р = 0.034)  and  past  clinical signs  of post-cholecystectomy syndrome (р = 0.044). There was a strong direct correlation between the grade of fibrosis and  the  time  since  cholecystectomy (r = 0.77; р = 0.047).

Conclusion: Cholecystectomy performed  at young  age predicts  progression  of metabolic abnormalities  in women with metabolic syndrome.

About the authors

O. V. Lebedeva

M. Sechenov First Moscow State Medical University

Author for correspondence.
Email: ovgastro@mail.ru

Lebedeva Ol'ga V. – Postgraduate Student, Chair of Medical and Social Expert Assessment and Out-Patient Therapy, Postgraduate Medical Training Faculty.

2/1–41 Kustanayskaya ul., Moscow, 115580, +7 (916) 989 05 95

Russian Federation

A. O. Bueverov

M. Sechenov First Moscow State Medical University

Email: fake@neicon.ru

Bueverov Aleksey O. – MD, PhD, Professor, Chair of Medical and Social Expert Assessment and Out-Patient Therapy, Postgraduate Medical Training Faculty.

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

E. L. Bueverova

M. Sechenov First Moscow State Medical University

Email: fake@neicon.ru

Bueverova Elena L. – MD, PhD, Assistant Professor, Chair for Propaedeutics of Internal Diseases, Medical Faculty.

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

L. O. Nikitina

National Medical Research Center for Rehabilitation and Curortology

Email: fake@neicon.ru

Nikitina Liliana O. – MD, PhD, Vice-chancellor for Postgraduate and Complementary Training.

32 Novyy Arbat ul., Moscow, 121099

Russian Federation

References

  1. Shen C, Wu X, Xu C, Yu C, Chen P, Li Y. Association of cholecystectomy with metabolic syndrome in a Chinese population. PLoS One. 2014;9(2):e88189. doi: 10.1371/journal.pone.0088189.
  2. Kwak MS, Kim D, Chung GE, Kim W, Kim YJ, Yoon JH. Cholecystectomy is independently associated with nonalcoholic fatty liver disease in an Asian population. World J Gastroenterol. 2015;21(20):6287–95. doi: 10.3748/wjg.v21.i20.6287.
  3. Wang HG, Wang LZ, Fu HJ, Shen P, Huang XD, Zhang FM, Xie R, Yang XZ, Ji GZ. Cholecystectomy does not significantly increase the risk of fatty liver disease. World J Gastroenterol. 2015;21(12):3614–8. doi: 10.3748/wjg.v21.i12.3614.
  4. Ahmed F, Baloch Q, Memon ZA, Ali I. An observational study on the association of nonalcoholic fatty liver disease and metabolic syndrome with gall stone disease requiring cholecystectomy. Ann Med Surg (Lond). 2017;17:7–13. doi: 10.1016/j.amsu.2017.03.015.
  5. Cortés V, Quezada N, Uribe S, Arrese M, Nervi F. Effect of cholecystectomy on hepatic fat accumulation and insulin resistance in non-obese Hispanic patients: a pilot study. Lipids Health Dis. 2017;16(1):129. doi: 10.1186/s12944-017-0525-3.
  6. Ramos-De la Medina A, Remes-Troche JM, Roesch-Dietlen FB, Pérez-Morales AG, Martinez S, Cid-Juarez S. Routine liver biopsy to screen for nonalcoholic fatty liver disease (NAFLD) during cholecystectomy for gallstone disease: is it justified? J Gastrointest Surg. 2008;12(12):2097–102. doi: 10.1007/s11605-008-0704-7.
  7. Loria P, Lonardo A, Lombardini S, Carulli L, Verrone A, Ganazzi D, Rudilosso A, D'Amico R, Bertolotti M, Carulli N. Gallstone disease in non-alcoholic fatty liver: prevalence and associated factors. J Gastroenterol Hepatol. 2005;20(8):1176–84. doi: 10.1111/j.1440-1746.2005.03924.x.
  8. Turnbaugh PJ, Hamady M, Yatsunenko T, Cantarel BL, Duncan A, Ley RE, Sogin ML, Jones WJ, Roe BA, Affourtit JP, Egholm M, Henrissat B, Heath AC, Knight R, Gordon JI. A core gut microbiome in obese and lean twins. Nature. 2009;457(7228):480–4. doi: 10.1038/nature07540.
  9. Pattni SS, Brydon WG, Dew T, Walters JR. Fibroblast growth factor 19 and 7α-hydroxy-4-cholesten-3-one in the diagnosis of patients with possible bile acid diarrhea. Clin Transl Gastroenterol. 2012;3:e18. doi: 10.1038/ctg.2012.10.
  10. Julio-Pieper M, Bravo JA, Aliaga E, Gotteland M. Review article: intestinal barrier dysfunction and central nervous system disorders – a controversial association. Aliment Pharmacol Ther. 2014;40(10):1187–201. doi: 10.1111/apt.12950
  11. Teixeira TF, Souza NC, Chiarello PG, Franceschini SC, Bressan J, Ferreira CL, Peluzio Mdo C. Intestinal permeability parameters in obese patients are correlated with metabolic syndrome risk factors. Clin Nutr. 2012;31(5):735–40. doi: 10.1016/j.clnu.2012.02.009.
  12. Berr F, Kullak-Ublick GA, Paumgartner G, Münzing W, Hylemon PB. 7 alpha-dehydroxylating bacteria enhance deoxycholic acid input and cholesterol saturation of bile in patients with gallstones. Gastroenterology. 1996;111(6):1611–20.
  13. Guo C, Chen WD, Wang YD. TGR5, not only a metabolic regulator. Front Physiol. 2016;7:646. doi: 10.3389/fphys.2016.00646.
  14. Trabelsi MS, Daoudi M, Prawitt J, Ducastel S, Touche V, Sayin SI, Perino A, Brighton CA, Sebti Y, Kluza J, Briand O, Dehondt H, Vallez E, Dorchies E, Baud G, Spinelli V, Hennuyer N, Caron S, Bantubungi K, Caiazzo R, Reimann F, Marchetti P, Lefebvre P, Bäckhed F, Gribble FM, Schoonjans K, Pattou F, Tailleux A, Staels B, Lestavel S. Farnesoid X receptor inhibits glucagon-likepeptide-1 production by enteroendocrine L cells. Nat Commun. 2015;6:7629. doi: 10.1038/ncomms8629.
  15. Cani PD, Amar J, Iglesias MA, Poggi M, Knauf C, Bastelica D, Neyrinck AM, Fava F, Tuohy KM, Chabo C, Waget A, Delmée E, Cousin B, Sulpice T, Chamontin B, Ferrières J, Tanti JF, Gibson GR, Casteilla L, Delzenne NM, Alessi MC, Burcelin R. Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes. 2007;56(7):1761–72. doi: 10.2337/db06-1491.

Supplementary files

There are no supplementary files to display.


Copyright (c) 2017 Lebedeva O.V., Bueverov A.O., Bueverova E.L., Nikitina L.O.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies