[Metabolic profile of patients with cholesterol gallstone disease]

Metabolic syndrome is a clustering of cardiovascular risk factors as well as associated co morbidities, including cholesterol gallstones disease.The aim of our study is to prove the association between metabolic syndrome and cholesterol gallstones, to identify the main risk factors for this association and to trace the particularities of the metabolic syndrome in such patients.

Our cohort study enrolled 449 subjects, 312 patients diagnosed with metabolic syndrome and gallstones or cholecystectomy (group 1) and 137 patients diagnosed only with metabolic syndrome (group 2), hospitalized in the Respiratory Rehabilitation Medical Clinic between 2007-2009.

85.25% of the patients with metabolic syndrome and cholesterol gallstones and 79.92% of the patients with metabolic syndrome alone had a body mass index (BMI) > or = 25 Kg/m2. Univariate and multivariate logistic regression were used to calculate the risk of gallstone disease associated with different metabolic syndrome variables. Waist circumference, BMI, fasting glycemia, insulinemia and insulin resistance index (HOMA-IR) registered statistical significant differences between the two study groups and were significantly associated with a higher risk of cholesterol gallstone as well as were blood pressure values > or = 130/85 mmHg. The presence of 4 or 5 components of the metabolic syndrome increased the risk of gallstone disease by 3 times (OR = 3.3, p < 0.001) compared to a 2 times higher risk (OR = 2.1, p = 0.02) in case of increased insulin resistance; there was no statistical significance for any of the lipid parameters.

In our study, cholesterol gallstones appeared strongly associated with anthropometric measurements, fasting glycemia and insulin resistance index, as well as with the presence of metabolic syndrome as defined by the new clinical definition, despite the negative results for the lipidic components. These findings are consistent with the hypothesis that insulin resistance plays an important role in the pathogenesis and that cholesterol gallstone disease belong to metabolic syndrome.