Email this article The influence of cholecystectomy at young age on the course of metabolic syndrome in women
- Authors: Lebedeva O.V.1, Bueverov A.O.1, Bueverova E.L.1, Nikitina L.O.2
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Affiliations:
- M. Sechenov First Moscow State Medical University
- National Medical Research Center for Rehabilitation and Curortology
- Issue: Vol 45, No 5 (2017)
- Pages: 384-391
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/615
- DOI: https://doi.org/10.18786/2072-0505-2017-45-5-384-391
- ID: 615
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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
РоссияA. 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
РоссияE. 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
РоссияL. 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
РоссияReferences
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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
- 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.
- 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.
- Guo C, Chen WD, Wang YD. TGR5, not only a metabolic regulator. Front Physiol. 2016;7:646. doi: 10.3389/fphys.2016.00646.
- 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.
- 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.
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