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Insulin resistance causes human gallbladder dysmotility.

Attila Nakeeb1, Anthony G Comuzzie, Hayder Al-Azzawi

  • 1Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. anakeeb@iupui.edu

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|July 18, 2006
PubMed
Summary

Insulin resistance and elevated fasting glucose are linked to abnormal gallbladder emptying in lean individuals. This suggests insulin resistance may cause gallbladder dysfunction and gallstone formation.

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Area of Science:

  • Gastroenterology and Metabolism

Background:

  • Obesity, diabetes, and hyperlipidemia are established risk factors for gallstone development.
  • Insulin resistance is increasingly correlated with organ dysfunction, but its link to gallbladder motility is unclear.

Purpose of the Study:

  • To investigate the association between obesity, insulin resistance, hyperlipidemia, and abnormal gallbladder motility in nondiabetic volunteers.

Main Methods:

  • 192 healthy, nondiabetic adults underwent gallbladder ultrasound before and after a fatty meal to calculate ejection fraction (EF).
  • Serum analysis included glucose, insulin, cholesterol, triglycerides, cholecystokinin, and leptin.
  • Insulin resistance was assessed using the Homeostasis Model Assessment (HOMA) index.

Main Results:

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  • 15% of participants had gallstones and were excluded; 19% exhibited abnormal gallbladder motility (EF < 25%).
  • In lean subjects, gallbladder dysmotility (EF < 25%) was significantly associated with higher fasting glucose and HOMA index.
  • No significant association was found between gallbladder dysmotility and fasting glucose, insulin, or insulin resistance in obese subjects.

    • Conclusions:

    • In lean, nondiabetic individuals without gallstones, gallbladder dysmotility is linked to elevated fasting glucose and insulin resistance.
    • Insulin resistance may be a primary cause of gallbladder dysmotility, potentially leading to acalculous cholecystitis or gallstone formation.