Roesch-Dietlen F, Pérez-Morales A, Melo-Santisteban G, Díaz-Blanco F, Martínez JÁ, Cid-Juárez S

Language: Spanish
References: 22
Page: 37-42
PDF size: 106.59 Kb.

ABSTRACT

Background: In 1980, nonalcoholic fatty liver disease (NALFD) was described. It is related to the genesis of gallstones, and for this reason is considered as a manifestation of the metabolic syndrome. In order to determine the frequency, anatomoclinical characteristics and biochemical and histological alterations in NAFLD, patients underwent cholecystectomy and, for this reason, we considered carrying out this study.
Methods: This was a prospective and observational study. The study population was comprised of patients with gallstone disease who were treated at the “Hospital Español” in Veracruz, Mexico from January 1, 2005 to November 30, 2006 and underwent cholecystectomy and liver biopsy. Analyzed variables were anthropometric characteristics and risk factors, and in each patient biochemical tests, abdominal ultrasound and histological liver study were performed.
Results: In 95 patients, according to liver biopsy diagnoses, we found a frequency of 54.74 % of NAFLD associated with gallstones. Females were more affected (71.15 %) and the average age was 55.6 ± 17.87 years. Risk factors were obesity (67.3 %), diabetes mellitus (17.3 %), and dyslipidemia (76.92 %). Patients with NAFLD had elevated levels of glucose, glycosylated hemoglobin, cholesterol, triglycerides and HDL-cholesterol, and aminotransferases. Abdominal ultrasound did not show sufficient specificity and sensitivity to detect NAFLD. Histological findings showed stage I steatosis in 51.93 %, stage II in 28.84 % and stage III in 19.23%. Cirrhosis was found in 3.15 %.
Discussion: Results of our study confirm the high frequency of NAFLD in association with gallstone disease. We consider this the first work to analyze and describe the primary clinical, biochemical and morphological characteristics.

REFERENCES

1. Stone BG, Ericksion SK, Craig WY. Regulation of rat biliary cholesterol secretion in the intrahepatic metabolism. J Clin Invest 1985;76:1773.

2. 2. Jungst D, Lang T, Von Ritter C. The role of high total proteins in gallbladder bile in the formation of cholesterol gallstone. Gastroenterology 2002;111:843.

3. 3. Dile AK. Epidemiology and natural history of gallstone disease. Gastroenterol Clin North Am 2001;30:3.

4. 4. Tanaer B, Nagorney DM, Donohue JH. Surgical treatment of gallblader disease. J. Gastrointest Surg 2004;8:82.

5. 5. Schwesinger WH, Dile AK. Indicaciones cambiantes de la colecistectomía. Surg Clin North Am 1996;76:485.

6. 6. Admirand WH, Small DM. The physico-chemical basis of cholesterol gallstone formation in man. J Clin Invest 1968;47:104.

7. 7. Azzout-Marniche D, Bicard D, Guichard C, Foretz M, Ferre P, Foufelle F. Insulin effects on sterol regulatory-element-binding protein-1c (SREBP-1C) transcriptional activity in rat hepatocytes. Biochem J 2000;350:389-393.

8. 8. Goldblatt MI, Swartz BD, Al-Azzawi HH, Trahn KQ, Nakeeb A, Pitt HA. Nonalcoholic fatty gallblader disease. The influence of diet in lean and obese mice. J. Gastrointest Surg 2006;10:193.

9. 9. Goldblatt MI, Swartz BD, Svatek CL, Nakeeb A, Pitt HA. Decreased gallbladder response in leptin deficiency in obese mice. J Gastrointest Surg 2002;6:438.

10. 10. Chen Q, Amara J, Biancani P, Behar J. Excess membrane cholesterol alters human gallblader muscule contractility and membrane fluidity. Gastroenterology 1999;116:678.

11. 11. Torgerson JL, Lindroos AK, Naslund I, Peltonen M. Gallstones, gallbladder disease and pancreatitis: cross-sectional and 2-year data from the Swedish Obese Subjects and SOS reference studies. Am J Gastroenterol 2003;98:1032.

12. 12. Duarte RA, Herrera MF, Robles DG. Obesidad y su implicación en las enfermedades gastroenterológicas. Rev Gastroenterol Mex 2006;71:Suppl 2.

13. 13. Marchesini G, Bugianesi E, Forlani G, Cerrelli F, Lenzi M, Manini R, et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology 2003;37:917-923.

14. 14. Clark J.M. The epidemiology of nonalcoholic fatty liver disease in adults. J Clin Gastroenterol 2006;40(Suppl 1):10.

15. 15. Roesch DF, Dorantes CA, Carrillo TM, Martinez SC, Rojas CS, Bonilla RS, et al. Frecuencia del hígado graso no alcohólico en un grupo de pacientes con síndrome metabólico estudiado en la ciudad de Veracruz. Rev Gastroenterol Mex 2006;71:446.

16. 16. Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G, Bellentani S. Prevalence of and risk factors for nonalcoholic fatty liver disease: The Dionisos nutrition and liver study. Hepatology 2005;42:44-52.

17. 17. Bernal RR, Bernal SD. Utilidad de las pruebas de funcionamiento hepático y del ultrasonido (US) en el diagnóstico de la esteatohepatitis no alcohólica (EHNA). Rev Gastroenterol Mex 2006;71:6-10.

18. 18. Farrell G. Mechanisms of fatty liver disease. Liver disease in the 21st century: clinico-pathologic correlates. AASLD Posgraduate Course 2003:75-80.

19. 19. Aguilar-Salinas CA, Rojas R, Gómez-Pérez FJ, Valles V, Ríos-Torres JM, Franco A, et al. High prevalence of metabolic syndrome in Mexico. Arch Med Res 2004;35:75-81.

20. 20. Torre DA. Hepatopatía grasa y esteatohepatitis no alcohólica. Rev Gastroenterol Mex 2005;71:104.

21. 21. Méndez SA, Villa AR, Chávez TN. Trends in liver disease prevalence in Mexico from 2005 to 2050 through mortality data. Am J Hepatol 2005;4:52.

22. 22. Neuschwander BA, Caldwell S. Nonalcoholic steatohepatitis: summary of an AASLD single topic conference. Hepatology 2003;37:1202-1219.