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王 新, 白 烨, 于 文, 谢 林, 李 诗, 江 果, 李 鸿, 张 本. [New Progress in Longitudinal Research on the Risk Factors for Cholelithiasis]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:490-500. [PMID: 38645861 PMCID: PMC11026901 DOI: 10.12182/20240360508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Indexed: 04/23/2024]
Abstract
Cholelithiasis is a common disease of the digestive system. The risk factors for cholelithiasis have been reported and summarized many times in the published literature, which primarily focused on cross-sectional studies. Due to the inherent limitations of the study design, the reported findings still need to be validated in additional longitudinal studies. Moreover, a number of new risk factors for cholelithiasis have been identified in recent years, such as bariatric surgery, hepatitis B virus infection, hepatitis C virus infection, kidney stones, colectomy, osteoporosis, etc. These new findings have not yet been included in published reviews. Herein, we reviewed the 101 cholelithiasis-associated risk factors identified through research based on longitudinal investigations, including cohort studies, randomized controlled trials, and nested case control studies. The risk factors associated with the pathogenesis of cholelithiasis were categorized as unmodifiable and modifiable factors. The unmodifiable factors consist of age, sex, race, and family history, while the modifiable factors include 37 biological environmental factors, 25 socioenvironmental factors, and 35 physiochemical environmental factors. This study provides thorough and comprehensive ideas for research concerning the pathogenesis of cholelithiasis, supplying the basis for identifying high-risk groups and formulating relevant prevention strategies.
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Affiliation(s)
- 新 王
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 烨 白
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 文倩 于
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 林君 谢
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 诗懿 李
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 果恒 江
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 鸿钰 李
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 本 张
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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Guman MSS, Hoozemans JB, Haal S, de Jonge PA, Aydin Ö, Lappa D, Meijnikman AS, Westerink F, Acherman Y, Bäckhed F, de Brauw M, Nielsen J, Nieuwdorp M, Groen AK, Gerdes VEA. Adipose tissue, bile acids, and gut microbiome species associated with gallstones after bariatric surgery. J Lipid Res 2022; 63:100280. [PMID: 36115596 DOI: 10.1016/j.jlr.2022.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/09/2022] [Accepted: 08/27/2022] [Indexed: 11/29/2022] Open
Abstract
Several risk factors are associated with gallstone disease after bariatric surgery, but the underlying pathophysiological mechanisms of gallstone formation are unclear. We hypothesize that gallstone formation after bariatric surgery is induced by different pathways compared to gallstone formation in the general population, since postoperative formation occurs rapidly in patients who did not develop gallstones in preceding years. To identify both pathophysiological and potentially protective mechanisms against postoperative gallstone formation, we compared the preoperative fasting metabolome, fecal microbiome, and liver and adipose tissue transcriptome obtained before or during bariatric surgery of obese patients with and without postoperative gallstones. In total, 88 patients were selected from the BARIA longitudinal cohort study. Within this group, 32 patients had postoperative gallstones within two years. Gut microbiota metagenomic analyses showed group differences in abundance of 41 bacterial species, particularly abundance of Lactobacillaceae and Enterobacteriaceae in patients without gallstones. Subcutaneous adipose tissue transcriptomic analyses revealed four genes that were suppressed in gallstone patients compared to patients without gallstones. These baseline gene expression and gut microbiota composition differences might relate to protective mechanisms against gallstone formation after bariatric surgery. Moreover, baseline fasting blood samples of patients with postoperative gallstones showed increased levels of several bile acids. Overall, we revealed different genes and bacteria associated with gallstones than those previously reported in the general population, supporting the hypothesis that gallstone formation after bariatric surgery follows a different trajectory. Further research is necessary to confirm the involvement of the bile acids, adipose tissue activity, and microbial species observed here.
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Affiliation(s)
- M S S Guman
- Departments of Internal and Experimental Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands; Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, the Netherlands.
| | - J B Hoozemans
- Departments of Internal and Experimental Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands; Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, the Netherlands
| | - S Haal
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, the Netherlands; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Location AMC, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
| | - P A de Jonge
- Departments of Internal and Experimental Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Ö Aydin
- Departments of Internal and Experimental Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - D Lappa
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - A S Meijnikman
- Departments of Internal and Experimental Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - F Westerink
- Departments of Internal and Experimental Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Y Acherman
- Department of Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands
| | - F Bäckhed
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Goteborg, Sweden; Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Kobenhavn, Denmark; Department of Clinical Physiology, Region Västtra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M de Brauw
- Department of Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands
| | - J Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - M Nieuwdorp
- Departments of Internal and Experimental Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - A K Groen
- Departments of Internal and Experimental Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - V E A Gerdes
- Departments of Internal and Experimental Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands; Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, the Netherlands
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Zhang X, Guan L, Tian H, Li Y. Prevalence and Risk Factors of Gallbladder Stones and Polyps in Liaoning, China. Front Med (Lausanne) 2022; 9:865458. [PMID: 35547207 PMCID: PMC9082677 DOI: 10.3389/fmed.2022.865458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To investigate the incidence and risk factors of gallbladder stones and polyps in individuals undergoing physical examinations in Liaoning province, China. Methods This is a retrospective study of adults who underwent routine health examinations at Xikang Medical Center in Liaoning Province (Shenyang, Dandong, and Dalian) from 01/2016 to 12/2020. The routine health examination included anthropometry, blood tests, and liver ultrasound. Based on liver ultrasound results, patients were grouped into those with gallbladder stones, those with gallbladder polyps, those with both stones and polyps, and those with neither. Results Of the 284,129 included subjects, 6,537 (2.30%) were diagnosed with gallbladder stones, and 18,873 (6.64%) were diagnosed with gallbladder polyps. The overall prevalence in Liaoning province increased each year, peaking in 2020. The prevalence of gallbladder stones was higher among females than males (2.39% vs. 2.23%, respectively), while the prevalence of gallbladder polyps was higher among males. The gallbladder polyp group had higher BMI, FBG, SBP, DBP, TG, TC, LDL-C, HDL-C, AST, ALP, GGT, BUN, Scr, SUA. Except for HDL-C, all factors were also higher in the gallbladder stone group. Patients with fatty liver had a higher prevalence of gallbladder stones and polyps than participants without fatty liver. Conclusion The prevalence of gallbladder stones and polyps in Liaoning varies by sex, economic status of the city of residence, BMI, and metabolic indicators.
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Affiliation(s)
- Xinhe Zhang
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Lin Guan
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haoyu Tian
- The Third Clinical Department, China Medical University, Shenyang, China
| | - Yiling Li
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
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Hu H, Shao W, Liu Q, Liu N, Wang Q, Xu J, Zhang X, Weng Z, Lu Q, Jiao L, Chen C, Sun H, Jiang Z, Zhang X, Gu A. Gut microbiota promotes cholesterol gallstone formation by modulating bile acid composition and biliary cholesterol secretion. Nat Commun 2022; 13:252. [PMID: 35017486 PMCID: PMC8752841 DOI: 10.1038/s41467-021-27758-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 12/03/2021] [Indexed: 12/11/2022] Open
Abstract
Cholesterol gallstone disease is a worldwide common disease. Cholesterol supersaturation in gallbladder bile is the prerequisite for its pathogenesis, while the mechanism is not completely understood. In this study, we find enrichment of gut microbiota (especially Desulfovibrionales) in patients with gallstone disease. Fecal transplantation of gut microbiota from gallstone patients to gallstone-resistant strain of mice can induce gallstone formation. Carrying Desulfovibrionales is associated with enhanced cecal secondary bile acids production and increase of bile acid hydrophobicity facilitating intestinal cholesterol absorption. Meanwhile, the metabolic product of Desulfovibrionales, H2S increase and is shown to induce hepatic FXR and inhibit CYP7A1 expression. Mice carrying Desulfovibrionales present induction of hepatic expression of cholesterol transporters Abcg5/g8 to promote biliary secretion of cholesterol as well. Our study demonstrates the role of gut microbiota, Desulfovibrionales, as an environmental regulator contributing to gallstone formation through its influence on bile acid and cholesterol metabolism. Metabolic conditions associated with alterations of the gut microbiome, such as obesity and diabetes, predispose to gallstone disease. Here the authors demonstrate that the gut microbiome, in particular the genus Desulfovibrionale, contribute to gallstone formation in mice.
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Affiliation(s)
- Hai Hu
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Wentao Shao
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China.,State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.,Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu, China.,School of Instrument Science and Engineering, Southeast University, Nanjing, Jiangsu, China
| | - Qian Liu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.,Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu, China.,State Key Laboratory of Reproductive Medicine (Suzhou Center), Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Ning Liu
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qihan Wang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Jin Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.,Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Zhang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.,Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhenkun Weng
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.,Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qifan Lu
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Long Jiao
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Chaobo Chen
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Haidong Sun
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Zhaoyan Jiang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China.
| | - Xiaoping Zhang
- Department of Institution of Interventional and Vascular Surgery, Tongji University School of Medicine, Shanghai, China.
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China. .,Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu, China.
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Lyu J, Lin Q, Fang Z, Xu Z, Liu Z. Complex impacts of gallstone disease on metabolic syndrome and nonalcoholic fatty liver disease. Front Endocrinol (Lausanne) 2022; 13:1032557. [PMID: 36506064 PMCID: PMC9727379 DOI: 10.3389/fendo.2022.1032557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Patients with gallstone disease (GSD) often have highly co-occurrence with metabolic syndrome (MetS) and Nonalcoholic fatty liver disease (NAFLD) both associated with insulin resistance (IR). Meanwhile, highly prevalence of NAFLD was found in patients who received cholecystectomy. However, the associations of GSD with MetS, NAFLD is inconsistent in the published literature. And risk of cholecystectomy on NAFLD is unclear. METHODS We searched the Medline EMBASE and WOS databases for literature that met our study topic. To be specific, studies with focus on associations between GSD and MetS/NAFLD, and risk evaluation on cholecystectomy and NAFLD incidence were enrolled for further analysis. The random effect model was used to calculate the combined relative ratio (RR) and odds ratio (OR)and 95% confidence interval (CI). RESULTS Seven and six papers with focus on connections between GSD and NAFLD/MetS prevalence. Correspondingly, seven papers with focus on risk of cholecystectomy on NAFLD occurrence were also enrolled into meta-analysis. After pooling the results from individual study, patients with GSD had higher risk of MetS (OR:1.45, 95%CI: 1.23-1.67, I2 = 41.1%, P=0.165). Risk of GSD was increased by 52% in NAFLD patients (pooled OR:1.52, 95%CI:1.24-1.80). And about 32% of increment on NAFLD prevalence was observed in patients with GSD (pooled OR: 1.32, 95%CI:1.14-1.50). With regard to individual MetS components, patients with higher systolic blood pressure were more prone to develop GSD, with combined SMD of 0.29 (96%CI: 0.24-0.34, P<0.05). Dose-response analysis found the GSD incidence was significantly associated with increased body mass index (BMI) (pooled OR: 1.02, 95%CI:1.01-1.03) in linear trends. Patients who received cholecystectomy had a higher risk of post-operative NAFLD (OR:2.14, 95%CI: 1.43-2.85), P<0.05). And this impact was amplified in obese patients (OR: 2.51, 95%CI: 1.95-3.06, P<0.05). CONCLUSION Our results confirmed that controls on weight and blood pressure might be candidate therapeutic strategy for GSD prevention. And concerns should be raised on de-novo NAFLD after cholecystectomy.
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Affiliation(s)
- Jingting Lyu
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Qinghong Lin
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Zhongbiao Fang
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Zeling Xu
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Zhengtao Liu
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
- NHC Key Laboratory of Combined Multi-Organ Transplantation, Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, CAMS, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Organ Transplantation, Zhejiang Province, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Shulan (Hangzhou) Hospital, Hangzhou, China
- *Correspondence: Zhengtao Liu, ;
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Parra-Landazury NM, Cordova-Gallardo J, Méndez-Sánchez N. Obesity and Gallstones. Visc Med 2021; 37:394-402. [PMID: 34722722 PMCID: PMC8543292 DOI: 10.1159/000515545] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The prevalence of obesity has been increasing globally and represents the main risk factor for the development of gallstone disease (GD). SUMMARY Excess body weight represents the main cause for the development of GD; nevertheless, there have been described multiple risk factors for its development, among them modifiable risk factors as diet, lifestyle, physical inactivity, and non-modifiable risk factors as ethnicity, female sex, advanced age, parity, and genetic mutations. Body mass index, abdominal perimeter, and waist-hip index have been used to determine the degree of adiposity of a person. Hence, central abdominal fat has been mostly associated with insulin resistance with the consequent increase in the hepatic cholesterol secretion; contributing as one of the multiple mechanisms associated with the development of gallstones. This disease has a low mortality; however, it has been associated with multiple diseases such as cardiovascular diseases, carotid atherosclerosis, metabolic associated fatty liver disease, and gallbladder cancer, probably because they share many of the risk factors. KEY MESSAGES GD continues to be considered a disease with a high medical burden, in which it is sought to intervene in modifiable risk factors to reduce its development.
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Affiliation(s)
| | - Jacqueline Cordova-Gallardo
- Department of Hepatology, Service of Surgery and Obesity Clinic, General Hospital “Dr. Manuel Gea González”, Mexico City, Mexico
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Nahum Méndez-Sánchez
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
- Liver Research Unit, Medica Sur Clinic and Foundation, Mexico City, Mexico
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Sun M, Wang W, Liu X, Wang Y, Cui H, Liu S, Cao L. Total cholesterol, alanine aminotransferase and the risk of primary liver cancer: A population-based prospective study. Medicine (Baltimore) 2021; 100:e25746. [PMID: 33950959 PMCID: PMC8104288 DOI: 10.1097/md.0000000000025746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 04/07/2021] [Indexed: 01/04/2023] Open
Abstract
Previous studies have shown that serum total cholesterol (TC) and serum alanine aminotransferase (ALT) are associated with liver cancer risk. However, the common contribution of TC and normal-high ALT to primary liver cancer (PLC) has not been reported. We aim to assess the separate and joint effect of low TC level and normal-high ALT level on the risk of PLC, a large prospective cohort was conducted in our study.The participants were divided into 4 groups via the cross-matching method according to TC [low level (-)/non-low level (+)] and ALT [normal level (-)/normal-high level(+)] status, and using the lower quartile value of TC and the upper quartile value of ALT as a threshold, respectively. Incident PLC was confirmed by review of medical records. Cox proportional hazards regression models and interactive additive models were used to evaluate whether the joint effect of low TC level and normal-high ALT level is associated with the risk of PLC.During 1,248,895 person-years follow-up, 298 participants were diagnosed with PLC among 114,972 subjects. In male population, TC < 4.24 mmol/L was group "TC (-)"; TC ≥ 4.24 mmol/L was group "TC (+)"; ALT < 23 U/L was group "ALT (-)": 33 U/L ≥ ALT ≥ 23 U/L was group "ALT (+)". Compared with the group "TC (+)", group "ALT (-)", respectively, the adjusted hazard ratio (HR) and 95% confidence interval (95%CI) for PLC risk was 1.74 (1.36-2.25) in group "TC (-)" and 1.49 (1.15-1.94) in group "ALT (+)". In combinatorial analysis, compared with group "TC (+) and ALT (-)", the significant increased risk of PLC were observed in group "TC (+) and ALT (+)" (HR = 1.41; 95% confidence intervals [CI]: 1.02-1.95), group "TC (-) and ALT (-)" (HR = 1.67; 95%CI: 1.24-2.27) and group "TC (-) and ALT (+)" (HR = 2.72; 95%CI: 1.81-4.09), respectively. However, no statistical significance was found among female.The separate and joint effect of low TC level and normal-high ALT level was observed for PLC risk in males. When combined, individuals with coexistence of low TC level and normal-high ALT level significantly increase the risk of PLC.
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Affiliation(s)
- Miaomiao Sun
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
- Department of Graduate School, North China University of Science and Technology, Tangshan, Hebei, China
| | - Wanchao Wang
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
| | - Xining Liu
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
| | - Yiming Wang
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
| | - Haozhe Cui
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
- Department of Graduate School, North China University of Science and Technology, Tangshan, Hebei, China
| | - Siqing Liu
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
| | - Liying Cao
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
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8
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Gallstone Disease, Obesity and the Firmicutes/Bacteroidetes Ratio as a Possible Biomarker of Gut Dysbiosis. J Pers Med 2020; 11:jpm11010013. [PMID: 33375615 PMCID: PMC7823692 DOI: 10.3390/jpm11010013] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022] Open
Abstract
Obesity is a major risk factor for developing gallstone disease (GSD). Previous studies have shown that obesity is associated with an elevated Firmicutes/Bacteroidetes ratio in the gut microbiota. These findings suggest that the development of GSD may be related to gut dysbiosis. This review presents and summarizes the recent findings of studies on the gut microbiota in patients with GSD. Most of the studies on the gut microbiota in patients with GSD have shown a significant increase in the phyla Firmicutes (Lactobacillaceae family, genera Clostridium, Ruminococcus, Veillonella, Blautia, Dorea, Anaerostipes, and Oscillospira), Actinobacteria (Bifidobacterium genus), Proteobacteria, Bacteroidetes (genera Bacteroides, Prevotella, and Fusobacterium) and a significant decrease in the phyla Bacteroidetes (family Muribaculaceae, and genera Bacteroides, Prevotella, Alistipes, Paludibacter, Barnesiella), Firmicutes (genera Faecalibacterium, Eubacterium, Lachnospira, and Roseburia), Actinobacteria (Bifidobacterium genus), and Proteobacteria (Desulfovibrio genus). The influence of GSD on microbial diversity is not clear. Some studies report that GSD reduces microbial diversity in the bile, whereas others suggest the increase in microbial diversity in the bile of patients with GSD. The phyla Proteobacteria (especially family Enterobacteriaceae) and Firmicutes (Enterococcus genus) are most commonly detected in the bile of patients with GSD. On the other hand, the composition of bile microbiota in patients with GSD shows considerable inter-individual variability. The impact of GSD on the Firmicutes/Bacteroidetes ratio is unclear and reports are contradictory. For this reason, it should be stated that the results of reviewed studies do not allow for drawing unequivocal conclusions regarding the relationship between GSD and the Firmicutes/Bacteroidetes ratio in the microbiota.
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Liu T, Siyin ST, Yao N, Duan N, Xu G, Li W, Qu J, Liu S. Relationship between high-sensitivity C reactive protein and the risk of gallstone disease: results from the Kailuan cohort study. BMJ Open 2020; 10:e035880. [PMID: 32963062 PMCID: PMC7509952 DOI: 10.1136/bmjopen-2019-035880] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Gallstone disease (GSD) can be caused by various health and clinical factors such as obesity, dyslipidaemia and an unhealthy diet, all of which are associated with higher high-sensitivity C reactive protein (hs-CRP) concentrations. Whether hs-CRP represents an independent risk factor for GSD is still unclear. We prospectively investigated hs-CRP in relation to the occurrence of GSD based on the Kailuan study. STUDY DESIGN Prospective cohort study. SETTING The Kailuan cohort study was conducted in Tangshan City in northern China. PARTICIPANTS 95 319 participants who were free from GSD were recruited in this study. Epidemiological data, anthropometric parameters and biochemical data of participants were collected. PRIMARY AND SECONDARY OUTCOME MEASURES Cox proportional hazards regression models were used to evaluate the association between hs-CRP concentrations and the risk of GSD after adjustments for potential confounders. RESULTS During the mean 7.58 years of follow-up among 95 319 participants, 4205 participants were identified as newly diagnosed with GSD or having undergone cholecystectomy for cholelithiasis. Compared with the hs-CRP<1 mg/L group, elevated hs-CRP concentrations were significantly associated with higher risk of GSD with the corresponding HR of 1.11 (95% CI 1.03 to 1.19), 1.12 (95% CI 1.04 to 1.22) in the 1≤hs-CRP≤3 mg/L and hs-CRP>3 mg/L group, respectively. The multivariate model which included hs-CRP not only had a better line of fitness but also had better predictive values to help identify new cases of GSD during follow-up. CONCLUSION Elevated hs-CRP concentration is an independent risk factor for new-onset GSD among the Chinese population. TRIAL REGISTRATION NUMBER ChiCTR-TNC-11001489.
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Affiliation(s)
- Tong Liu
- Department of General Surgery, Aerospace Central Hospital, Beijing, China
| | - Sarah Tan Siyin
- Department of General Surgery, Beijing Children's Hospital, National Center for Children's Health, Beijing, China
| | - Nan Yao
- Department of General Surgery, Aerospace Central Hospital, Beijing, China
| | - Ning Duan
- Department of General Surgery, Aerospace Central Hospital, Beijing, China
| | - Guoshuai Xu
- Department of General Surgery, Aerospace Central Hospital, Beijing, China
| | - Wenqiang Li
- Department of General Surgery, Aerospace Central Hospital, Beijing, China
| | - Jun Qu
- Department of General Surgery, Aerospace Central Hospital, Beijing, China
| | - Siqing Liu
- Department of Hepatological Surgery, Kailuan General Hospital, Tangshan, China
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10
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Sun M, Cui H, Liang M, Wang W, Wang Y, Liu X, Liu S, Cao L. Perceived dietary salt intake and the risk of primary liver cancer: a population-based prospective study. J Hum Nutr Diet 2020; 33:833-840. [PMID: 32548912 DOI: 10.1111/jhn.12761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Although a high-salt diet is associated with high risk of chronic diseases such as hypertension, stroke and cardiovascular disease, little is known about the relationship between a high-salt diet and the risk of primary liver cancer (PLC). Consequently, we prospectively assessed the association of high perceived salt intake with the risk of PLC in the Kailuan Study. METHODS In total, 97 006 participants who were healthy adults or free living adults at the baseline (2006) were included in the present study. The data of perceived salt intake were collected via questionnaire and classified into three categories: <6 g day-1 for low salt intake, 6-10 g day-1 for intermediate salt intake, >10 g day-1 for high-salt intake. PLC including hepatocellular carcinoma and intrahepatic cholangiocarcinoma (excluding liver metastasis), and was confirmed by review of medical records. We used a Cox proportional hazards model to analyse the association between high perceived salt diet and the risk of PLC after adjusting for possible confounders, including age, gender, body mass index, high sensitivity-C-reactive protein, low-density lipoprotein-cholesterol, total cholesterol, triglycerides, alanine aminotransferase, HbsAg positive, cirrhosis, fatty liver, hypertension, diabetes, drinking status, smoking status and physical exercise. RESULTS During the follow-up period of 1 113 816 person-years, 397 PLC events were diagnosed. After adjusting for most potential confounders, subjects in intermediate salt intake and high salt intake had a multivariable hazard ratio and 95% confidence interval of 1.49 (0.97-2.29) and 1.98 (1.22-3.22) (P for trend = 0.0042), respectively, compared to low salt intake. CONCLUSIONS A higher perceived salt intake was associated with a higher risk of PLC.
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Affiliation(s)
- M Sun
- Department of Graduate School, North China University of Science and Technology, Tangshan, Hebei, China.,Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - H Cui
- Department of Graduate School, North China University of Science and Technology, Tangshan, Hebei, China.,Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - M Liang
- Department of Graduate School, North China University of Science and Technology, Tangshan, Hebei, China.,Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - W Wang
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - Y Wang
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - X Liu
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - S Liu
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - L Cao
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
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Mosli HH, Kutbi HA, Alhasan AH, Mosli RH. Understanding the Interrelationship between Education, Income, and Obesity among Adults in Saudi Arabia. Obes Facts 2020; 13:77-85. [PMID: 31955158 PMCID: PMC7098293 DOI: 10.1159/000505246] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 12/02/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To examine the association of sociodemographic variables with the odds of being obese among adults in Saudi Arabia, and to examine whether or not the association between the educational level and the odds of being obese among adults in Saudi Arabia is modified by the income level. METHODS A total of 3,925 participants were recruited for this cross--sectional study. Sociodemographic and anthropometric data were collected using standardized procedures. Unadjusted and adjusted logistic regression models were examined, with a dichotomous obesity status variable as the outcome. Furthermore, an interaction term for income level with educational level was tested and appeared significant. Thus, additional regression models were run in order to examine the association between educational level and obesity status separately among the low- and higher-income groups. RESULTS Compared to participants with a college degree or higher, illiterate participants and those with an elementary education had higher odds of obesity (OR: 2.76, 95% CI: 1.81-4.22, and OR: 2.68, 95% CI: 1.89-3.82, respectively). However, participants with a low income had lower odds than participants who had a higher income (OR: 0.84, 95% CI: 0.70-0.99). Examining the association between educational level and obesity while stratifying by income revealed that a negative association between education and obesity exists among both income groups. However, the magnitude of the ORs was higher among participants with higher income, suggesting a stronger association between education and obesity among wealthier individuals. CONCLUSION Individuals in the highest income bracket with lower levels of education may have greater odds of obesity. Targeting them in intervention programs is warranted.
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Affiliation(s)
- Hala H Mosli
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,
| | - Hebah A Kutbi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed H Alhasan
- College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Rana H Mosli
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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12
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Liu T, Wang W, Cui H, Sun M, Wang Y, Liu X, Cao L, Liu H, Liu S. Elevated fasting serum glucose levels increase the risk of hepatocellular carcinoma: A prospective cohort study. Medicine (Baltimore) 2019; 98:e16369. [PMID: 31348238 PMCID: PMC6709261 DOI: 10.1097/md.0000000000016369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Previous studies have demonstrated a positive relationship between liver cancer and diabetes mellitus. However, elevated fasting blood glucose (FBG) itself may be a risk factor for the development of hepatocellular carcinoma (HCC) rather than diabetes, and during the follow-up period, death is an event that may occur before the occurrence of HCC, which should be dealt with competing risk models. Our study aims to investigate the relationship between FBG and new-onset HCC by using competing risk regression models.We prospectively studied the relationship between FBG concentrations and risk of HCC in a cohort of 93,447 participants who were free of prior HCC, and whose demographic characteristics and biochemical parameters were recorded. Cox proportional hazards regression models and competing risk regression models were used to evaluate the association between FBG concentrations and risk of incident HCC.A total of 302 participants were diagnosed with HCC among 93,447 subjects during 810,499 person-years of follow-up. The multivariable hazard ratios (HRs) [95% confidence interval (95% CI)] for the association of FBG and log(FBG) with HCC were 1.07 (1.01∼1.12), 1.84 (1.23∼2.74) in an analysis adjusted for other potential variables. In the multivariable adjusted analysis, participants who were in 4.82 mmol/L≤FBG≤5.49 mmol/L group and FBG >5.49 mmol/L group would have increased the risk of HCC by 47% and 69%, respectively. In a cause-specific hazard model (CS model), the multivariable HRs (95% CI) for the association of FBG with HCC were 1.46 (1.09∼1.98), 1.69 (1.27∼2.27) in the multivariable adjusted analysis. Similar results were also observed in sub-distribution hazard function model (SD model) with corresponding multivariate HRs (95% CI) of 1.46 (1.09∼2.00), 1.69 (1.25∼2.27) in 4.82 mmol/L≤FBG≤5.49 mmol/L group and FBG >5.49 mmol/L group, respectively.Higher FBG concentrations itself were positively associated with new-onset HCC in the Cox proportional hazards regression models and competing risk models. FBG concentrations can be used as a scientific and important way to identify individuals with a higher risk of HCC and control of FBG concentrations might serve as a possible way to decrease the risk of HCC among Chinese population.Trial registration: ChiCTR-TNRC-11001489. Registered August 24, 2011 (retrospectively registered).
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Affiliation(s)
- Tong Liu
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
| | - Wanchao Wang
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
| | - Haozhe Cui
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
- Department of Graduate School, North China University of Science and Technology
| | - Miaomiao Sun
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
- Department of Graduate School, North China University of Science and Technology
| | - Yiming Wang
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
| | - Xining Liu
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
| | - Liying Cao
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
| | - Hai Liu
- Department of Anesthesiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - Siqing Liu
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology
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