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Boyang H, Yanjun Y, Jing Z, Chenxin Y, Ying M, Shuwen H, Qiang Y. Investigating the influence of the gut microbiome on cholelithiasis: unveiling insights through sequencing and predictive modeling. J Appl Microbiol 2024; 135:lxae096. [PMID: 38614959 DOI: 10.1093/jambio/lxae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/26/2024] [Accepted: 04/11/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Cholelithiasis is one of the most common disorders of hepatobiliary system. Gut bacteria may be involved in the process of gallstone formation and are, therefore considered as potential targets for cholelithiasis prediction. OBJECTIVE To reveal the correlation between cholelithiasis and gut bacteria. METHODS Stool samples were collected from 100 cholelithiasis and 250 healthy individuals from Huzhou Central Hospital; The 16S rRNA of gut bacteria in the stool samples was sequenced using the third-generation Pacbio sequencing platform; Mothur v.1.21.1 was used to analyze the diversity of gut bacteria; Wilcoxon rank-sum test and linear discriminant analysis of effect sizes (LEfSe) were used to analyze differences in gut bacteria between patients suffering from cholelithiasis and healthy individuals; Chord diagram and Plot-related heat maps were used to analyze the correlation between cholelithiasis and gut bacteria; six machine algorithms were used to construct models to predict cholelithiasis. RESULTS There were differences in the abundance of gut bacteria between cholelithiasis and healthy individuals, but there were no differences in their community diversity. Increased abundance of Costridia, Escherichia flexneri, and Klebsiella pneumonae were found in cholelithiasis, while Bacteroidia, Phocaeicola, and Phocaeicola vulgatus were more abundant in healthy individuals. The top four bacteria that were most closely associated with cholelithiasis were Escherichia flexneri, Escherichia dysenteriae, Streptococcus salivarius, and Phocaeicola vulgatus. The cholelithiasis model based on CatBoost algorithm had the best prediction effect (sensitivity: 90.48%, specificity: 88.32%, and AUC: 0.962). CONCLUSION The identification of characteristic gut bacteria may provide new predictive targets for gallstone screening. As being screened by the predictive model, people at high risk of cholelithiasis can determine the need for further testing, thus enabling early warning of cholelithiasis.
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Affiliation(s)
- Hu Boyang
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Yao Yanjun
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Zhuang Jing
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Yan Chenxin
- Shulan International Medical school, Zhejiang Shuren University, No.848 Dongxin Road, Gongshu District, Hangzhou City, Zhejiang Province 310000, China
| | - Mei Ying
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Han Shuwen
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
| | - Yan Qiang
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Department of General Surgery, Huzhou Central Hospital, Affiliated Huzhou Central Hospital, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
- Huzhou Key Laboratory of Intelligent and Digital Precision Surgery, No.1558, Sanhuan North Road, Wuxing District, Huzhou, Zhejiang Province 313000, China
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Chen L, Qiu W, Sun X, Gao M, Zhao Y, Li M, Fan Z, Lv G. Novel insights into causal effects of serum lipids and lipid-modifying targets on cholelithiasis. Gut 2024; 73:521-532. [PMID: 37945330 DOI: 10.1136/gutjnl-2023-330784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE Different serum lipids and lipid-modifying targets should affect the risk of cholelithiasis differently, however, whether such effects are causal is still controversial and we aimed to answer this question. DESIGN We prospectively estimated the associations of four serum lipids with cholelithiasis in UK Biobank using the Cox proportional hazard model, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Furthermore, we estimated the causal associations of the genetically predicted serum lipids with cholelithiasis in Europeans using the Mendelian randomisation (MR) design. Finally, both drug-target MR and colocalisation analyses were performed to estimate the lipid-modifying targets' effects on cholelithiasis, including HMGCR, NPC1L1, PCSK9, APOB, LDLR, ACLY, ANGPTL3, MTTP, PPARA, PPARD and PPARG. RESULTS We found that serum levels of LDL-C and HDL-C were inversely associated with cholelithiasis risk and such associations were linear. However, the serum level of TC was non-linearly associated with cholelithiasis risk where lower TC was associated with higher risk of cholelithiasis, and the serum TG should be in an inverted 'U-shaped' relationship with it. The MR analyses supported that lower TC and higher TG levels were two independent causal risk factors. The drug-target MR analysis suggested that HMGCR inhibition should reduce the risk of cholelithiasis, which was corroborated by colocalisation analysis. CONCLUSION Lower serum TC can causally increase the risk of cholelithiasis. The cholelithiasis risk would increase with the elevation of serum TG but would decrease when exceeding 2.57 mmol/L. The use of HMGCR inhibitors should prevent its risk.
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Affiliation(s)
- Lanlan Chen
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Qiu
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiaodong Sun
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Menghan Gao
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yuexuan Zhao
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Mingyue Li
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Zhongqi Fan
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Guoyue Lv
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
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Dong H, Chen R, Xu F, Cheng F. Can Lipid-Lowering Drugs Reduce the Risk of Cholelithiasis? A Mendelian Randomization Study. Clin Epidemiol 2024; 16:131-141. [PMID: 38410417 PMCID: PMC10896097 DOI: 10.2147/clep.s439642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/09/2024] [Indexed: 02/28/2024] Open
Abstract
Background and Aims Cholelithiasis etiology intricately involves lipid metabolism. We sought to investigate the plausible causal link between genetically proxied lipid-lowering medications-specifically HMGCR inhibitors, PCSK9 inhibitors, and NPC1L1 inhibitors-and cholelithiasis risk. Methods Our study utilized two genetic instruments for exposure to lipid-lowering drugs. These instruments encompassed genetic variants linked to low-density lipoprotein (LDL) cholesterol within or in proximity to drug target genes, along with loci governing gene expression traits of these targets. Effect estimates were derived through Inverse-variance-weighted MR (IVW-MR) and summary-data-based MR (SMR) methods. Results Higher HMGCR-mediated LDL cholesterol levels (IVW-MR, OR = 2.15, 95% CI = 1.58-2.94; P = 0.000) and increased HMGCR expression (SMR, OR = 1.19, 95% CI = 1.04-1.37; P = 0.014) are linked to elevated cholelithiasis risk, suggesting potential benefits of HMGCR inhibition. In contrast, higher PCSK9-mediated LDL cholesterol levels (IVW-MR, OR = 0.72, 95% CI = 0.56-0.94; P = 0.015) and increased PCSK9 expression (SMR, OR = 0.90, 95% CI = 0.82-0.99; P = 0.035) both correlate with lower cholelithiasis risk, indicating that PCSK9 inhibition may elevate this risk. Nevertheless, no substantial link emerged between NPC1L1-mediated LDL cholesterol or NPC1L1 expression and cholelithiasis in both IVW-MR and SMR analyses. Conclusion This MR investigation affirms the causal link between the utilization of HMGCR inhibitors and a diminished risk of cholelithiasis. Additionally, it indicates a causal link between PCSK9 inhibitors use and increased cholelithiasis risk. However, no significant correlation was found between NPC1L1 inhibitors use and cholelithiasis risk.
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Affiliation(s)
- Hao Dong
- Department of Gastroenterology and Hepatology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Rong Chen
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China
| | - Fang Xu
- Clinical Medical Laboratory Center, Taizhou People’s Hospital, Taizhou, Jiangsu, 225300, People’s Republic of China
| | - Fang Cheng
- Department of Gastroenterology, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430023, People’s Republic of China
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Li Y, Han H, You K, Ma C, Fan X. Investigating the association between blood cobalt and gallstones: a cross-sectional study utilizing NHANES data. Front Public Health 2024; 12:1363815. [PMID: 38384872 PMCID: PMC10879586 DOI: 10.3389/fpubh.2024.1363815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/26/2024] [Indexed: 02/23/2024] Open
Abstract
Background With the use of cobalt alloys in medical prosthetics, the risk of cobalt exposure has increased. The objective of this study was to investigate the correlation between blood cobalt levels and the occurrence of gallstones utilizing data from the National Health and Nutrition Examination Survey (NHANES). Methods Data collected between 2017 and 2020 were analyzed, encompassing a total of 5,610 participants. Cobalt concentrations in whole blood specimens were directly measured using inductively coupled plasma mass spectrometry (ICP-MS). The presence of gallstones was ascertained through a standardized questionnaire. To assess the association between blood cobalt levels and the presence of gallstones, logistic regression analysis, restricted cubic spline analysis, and subgroup analysis were utilized. Results The results of logistic regression analysis revealed a heightened risk of developing gallstones in the Quartiles 2 and Quartiles 4 groups based on blood cobalt levels when compared to the Quartiles 1 group (OR = 1.54, 95% CI: 1.15-2.07; OR = 1.35, 95% CI: 1.03-1.77). The restricted cubic spline analysis exhibited a positive linear correlation between blood cobalt levels and the occurrence of gallstones. Subgroup analyses further demonstrated a statistically significant correlation between the Quartiles 4 category of blood cobalt levels and an elevated risk of gallstones, particularly among individuals aged 60 years or older, females, those with a body mass index (BMI) equal to or exceeding 25, serum total cholesterol levels below 200 mg/dL, as well as individuals diagnosed with hypertension or diabetes. Conclusion Our study findings indicate a notable association between elevated blood cobalt levels and an increased risk of gallstones. To establish a causal relationship between blood cobalt levels and the elevated risk of developing gallstones, further prospective cohort studies are warranted.
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Affiliation(s)
| | | | | | | | - Xin Fan
- Department of General Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Tatoli R, Bonfiglio C, Cuccaro F, Campanella A, Coletta S, Pesole PL, Giannelli G, Donghia R. Effects of Egg Consumption on Subjects with SLD or Hypertension: A MICOL Study. Nutrients 2024; 16:430. [PMID: 38337714 PMCID: PMC10856908 DOI: 10.3390/nu16030430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Steatotic liver disease (SLD) is defined as a fat accumulation in more than 5% of hepatocytes; it can progress to non-alcoholic steatohepatitis (NASH), associated with an increased state of inflammation. The aim of this study was to explore the protective effects of eating eggs and any association with SLD and hypertension (HTN). METHODS The study cohort included 908 participants assessed in the fourth recall of the MICOL study, grouped into four groups, based on NALFD and/or HTN. RESULTS The prevalence of HTN and SLD among participants was 31.61%. Overall, the results indicated a statistical significance of egg consumption, showing a protective role against the two disease conditions, in both the raw and adjusted models (RRR = 0.34, p = 0.009, 0.15 to 0.76 95% C.I.). CONCLUSIONS Many differences were found among the groups, and the protective role of eating eggs was amply demonstrated. We can conclude that it is unwise to demonize the intake of this food and its nutritional properties, in contrast with previous reports in the literature.
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Affiliation(s)
- Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | | | - Angelo Campanella
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Sergio Coletta
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Pasqua Letizia Pesole
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
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Donghia R, Pesole PL, Castellaneta A, Coletta S, Squeo F, Bonfiglio C, De Pergola G, Rinaldi R, De Nucci S, Giannelli G, Di Leo A, Tatoli R. Age-Related Dietary Habits and Blood Biochemical Parameters in Patients with and without Steatosis-MICOL Cohort. Nutrients 2023; 15:4058. [PMID: 37764841 PMCID: PMC10534690 DOI: 10.3390/nu15184058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Steatosis is now the most common liver disease in the world, present in approximately 25% of the global population. The aim of this study was to study the association between food intake and liver disease and evaluate the differences in blood parameters in age classes and steatosic condition. METHODS The present study included 1483 participants assessed in the fourth recall of the MICOL study. Patients were subdivided by age (>65 years) and administered a validated food frequency questionnaire (FFQ) with 28 food groups. RESULTS The prevalence of steatosis was 55.92% in the adult group and 55.88% in the elderly group. Overall, the results indicated many statistically significant blood parameters and dietary habits. Analysis of food choices with a machine learning algorithm revealed that in the adult group, olive oil, grains, processed meat, and sweets were associated with steatosis, while the elderly group preferred red meat, dairy, seafood, and fruiting vegetables. Furthermore, the latter ate less as compared with the adult group. CONCLUSIONS Many differences were found between the two age groups, both in blood parameters and food intake. The random forest also revealed different foods predicted steatosis in the two groups. Future analysis will be useful to understand the molecular basis of these differences and how different food intake causes steatosis in people of different ages.
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Affiliation(s)
- Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Pasqua Letizia Pesole
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Antonino Castellaneta
- Gastroenterology and Digestive Endoscopy, University Hospital, 70124 Bari, Italy; (A.C.); (F.S.); (A.D.L.)
| | - Sergio Coletta
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Francesco Squeo
- Gastroenterology and Digestive Endoscopy, University Hospital, 70124 Bari, Italy; (A.C.); (F.S.); (A.D.L.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Giovanni De Pergola
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Roberta Rinaldi
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Sara De Nucci
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Alfredo Di Leo
- Gastroenterology and Digestive Endoscopy, University Hospital, 70124 Bari, Italy; (A.C.); (F.S.); (A.D.L.)
| | - Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
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Donghia R, Pesole PL, Coletta S, Bonfiglio C, De Pergola G, De Nucci S, Rinaldi R, Giannelli G. Food Network Analysis in Non-Obese Patients with or without Steatosis. Nutrients 2023; 15:2713. [PMID: 37375618 DOI: 10.3390/nu15122713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Steatosis is the most common liver disease worldwide and the leading cause of liver-associated morbidity and mortality. The aim of this study was to explore the differences in blood parameters and dietary habits in non-obese patients with and without steatosis. METHODS The present study included 987 participants with BMI < 30, assessed in the fourth recall of the MICOL study. Patients were divided by steatosis grade, and a validated food frequency questionnaire (FFQ) with 28 food groups was administered. RESULTS The prevalence of non-obese participants with steatosis was 42.86%. Overall, the results indicated many statistically significant blood parameters and dietary habits. Analysis of dietary habits revealed that non-obese people with or without steatosis had similar dietary habits, although higher daily amounts of red meat, processed meat, ready meals, and alcohol were recorded in participants with liver disease (p < 0.05). CONCLUSIONS Many differences were found in non-obese people with and without steatosis, but in light of a network analysis, the two groups demonstrated similar dietary habits, proving that pathophysiological, genetic, and hormonal patterns are probably the basis of their liver status, regardless of weight. Future genetic analyses will be performed to analyze the expression of genes involved in the development of steatosis in our cohort.
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Affiliation(s)
- Rossella Donghia
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Pasqua Letizia Pesole
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Sergio Coletta
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Caterina Bonfiglio
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Giovanni De Pergola
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Sara De Nucci
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Roberta Rinaldi
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
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8
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Srivastava S, Kumar R. Is hyperleptinemia associated with gallstone disease? A systematic review and meta-analysis. Indian J Gastroenterol 2023; 42:324-331. [PMID: 37247176 DOI: 10.1007/s12664-022-01332-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 12/18/2022] [Indexed: 05/30/2023]
Abstract
BACKGROUND Obesity is one of the risk factors for gallstone disease (GD). Leptin hormone is known to regulate central obesity. Thus, hyperleptinemia may also be involved in gallstone disease pathogenesis. In the present study, a meta-analysis was performed to compare the leptin levels in GD and controls. METHODS The authors reviewed studies till April 12, 2021, which reported the serum leptin levels in gallstone patients and healthy controls. The online search involved ScienceDirect and PubMed databases. The data obtained from the research articles was scrutinized for selection criteria. Only those articles which fulfilled the inclusion criteria were subjected to meta-analysis. RESULTS Of 2047 articles, a total of eight studies met the inclusion and exclusion criteria and were considered for the meta-analysis. After meta-analysis, it was observed that the patients with GD had high leptin levels as compared to healthy controls. A significant level of heterogeneity was observed in the included studies (I2 = 89%, p < 0.01). There was no publication bias. CONCLUSION High leptin levels might be involved in GD pathogenesis.
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Affiliation(s)
| | - Ravindra Kumar
- ICMR-National Institute of Research in Tribal Health, Nagpur Road, P.O. Garha, Jabalpur, 482 003, India.
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9
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Li S, Guizzetti L, Ma C, Shaheen AA, Dixon E, Ball C, Wani S, Forbes N. Epidemiology and Outcomes of Symptomatic Cholelithiasis and Cholecystitis in the USA: Trends and Urban-Rural Variations. J Gastrointest Surg 2023; 27:932-944. [PMID: 36720756 DOI: 10.1007/s11605-023-05604-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/29/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gallstone disease remains a major health issue. There have been significant changes in the management and demographics of patients with these conditions. We aimed to evaluate trends in hospitalization, management, and post-procedural adverse events for patients with gallstone disease. METHODS The National Inpatient Sample was used to identify discharges for symptomatic cholelithiasis and cholecystitis between 2005 and 2014. Temporal trends were evaluated by calculating annual percent changes (APCs). Joinpoint regression was used to assess inflection points. Multivariable regression models were used to evaluate associations between urban and rural divisions and mortality, use of interventional procedures, and post-procedural adverse events. RESULTS From 77,394,755 unweighted discharges, there was a decline in discharges for cholelithiasis (APC - 5.5%, 95% confidence intervals, CI, - 7.6 to - 3.4%) and cholecystitis from 2012 to 2014 (APC - 4.5%, 95% CI - 7.2 to - 1.7%). Interventions were more likely at urban hospitals for symptomatic cholelithiasis (odds ratio, OR, 1.49, 95% CI 1.24 to 1.66) and cholecystitis (OR 1.96, 95% CI 1.86 to 2.05). In-hospital mortality significantly decreased annually for patients with cholecystitis (OR 0.92, 95% CI 0.91 to 0.93). In-hospital mortality between rural and urban centers was comparable for symptomatic cholelithiasis (OR 1.27, 95% CI 0.79 to 2.03) and cholecystitis (OR 0.93, 95% CI 0.84 to 1.04). CONCLUSIONS Hospitalizations for gallstone disease have decreased since the 2010s. In-hospital mortality between urban and rural centers is similar, but urban hospitals utilize a higher rate of procedural interventions. Future studies should evaluate practice trends and costs across inpatient and ambulatory settings between rural and urban divisions.
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Affiliation(s)
- Suqing Li
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, AB, Calgary, Canada.
| | | | - Christopher Ma
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, AB, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Abdel Aziz Shaheen
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, AB, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Elijah Dixon
- Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Chad Ball
- Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Sachin Wani
- Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nauzer Forbes
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, AB, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
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10
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Portincasa P, Bonfrate L, Wang DQH, Frühbeck G, Garruti G, Di Ciaula A. Novel insights into the pathogenic impact of diabetes on the gastrointestinal tract. Eur J Clin Invest 2022; 52:e13846. [PMID: 35904418 DOI: 10.1111/eci.13846] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/20/2022] [Accepted: 06/26/2022] [Indexed: 11/09/2022]
Abstract
Type 2 and type 1 diabetes are common endocrine disorders with a progressively increasing incidence worldwide. These chronic, systemic diseases have multiorgan implications, and the whole gastrointestinal (GI) tract represents a frequent target in terms of symptom appearance and interdependent pathophysiological mechanisms. Metabolic alterations linked with diabetic complications, neuropathy and disrupted hormone homeostasis can lead to upper and/or lower GI symptoms in up to 75% of diabetic patients, with multifactorial involvement of the oesophagus, stomach, upper and lower intestine, and of the gallbladder. On the other hand, altered gastrointestinal motility and/or secretions are able to affect glucose and lipid homeostasis in the short and long term. Finally, diabetes has been linked with increased cancer risk at different levels of the GI tract. The presence of GI symptoms and a comprehensive assessment of GI function should be carefully considered in the management of diabetic patients to avoid further complications and to ameliorate the quality of life. Additionally, the presence of gastrointestinal dysfunction should be adequately managed to improve metabolic homeostasis, the efficacy of antidiabetic treatments and secondary prevention strategies.
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Affiliation(s)
- Piero Portincasa
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Leonilde Bonfrate
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - David Q-H Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Gema Frühbeck
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Pamplona, Spain.,Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Gabriella Garruti
- Department of Emergency and Organ Transplants, Unit of Endocrinology, University of Bari Medical School, Bari, Italy
| | - Agostino Di Ciaula
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
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11
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Chen L, Yang H, Li H, He C, Yang L, Lv G. Insights into modifiable risk factors of cholelithiasis: A Mendelian randomization study. Hepatology 2022; 75:785-796. [PMID: 34624136 PMCID: PMC9300195 DOI: 10.1002/hep.32183] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS The risk factors of cholelithiasis have not been clearly identified, especially for total cholesterol. Here, we try to identify these causal risk factors. APPROACH AND RESULTS We obtained genetic variants associated with the exposures at the genome-wide significance (p < 5 × 10-8 ) level from corresponding genome-wide association studies. Summary-level statistical data for cholelithiasis were obtained from FinnGen and UK Biobank (UKB) consortia. Both univariable and multivariable Mendelian randomization (MR) analyses were conducted to identify causal risk factors of cholelithiasis. Results from FinnGen and UKB were combined using the fixed-effect model. In FinnGen, the odds of cholelithiasis increased per 1-SD increase of body mass index (BMI) (OR = 1.631, p = 2.16 × 10-7 ), together with body fat percentage (OR = 2.108, p = 4.56 × 10-3 ) and fasting insulin (OR = 2.340, p = 9.09 × 10-3 ). The odds of cholelithiasis would also increase with lowering of total cholesterol (OR = 0.789, p = 8.34 × 10-5 ) and low-density lipoprotein-cholesterol (LDL-C) (OR = 0.792, p = 2.45 × 10-4 ). However, LDL-C was not significant in multivariable MR. In UKB, the results of BMI, body fat percentage, total cholesterol, and LDL-C were replicated. In meta-analysis, the liability to type 2 diabetes mellitus and smoking could also increase the risk of cholelithiasis. Moreover, there were no associations with other predominant risk factors. CONCLUSIONS Our MR study corroborated the risk factors of cholelithiasis from previous MR studies. Furthermore, lower total cholesterol level could be an independent risk factor.
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Affiliation(s)
- Lanlan Chen
- Department of Hepatobiliary and Pancreatic SurgeryThe First Hospital of Jilin UniversityChangchunJilinChina
| | - Hongqun Yang
- Department of Hepatobiliary and Pancreatic SurgeryThe First Hospital of Jilin UniversityChangchunJilinChina
| | - Haitao Li
- Department of OrthopedicsThe China-Japan Union Hospital of Jilin UniversityChangchunJilinChina
| | - Chang He
- Department of Molecular BiologyCollege of Basic Medical SciencesJilin UniversityChangchunJilinChina
| | - Liu Yang
- Department of Neurology and Institute of NeurologyHuashan HospitalShanghai Medical CollegeFudan UniversityShanghaiChina
| | - Guoyue Lv
- Department of Hepatobiliary and Pancreatic SurgeryThe First Hospital of Jilin UniversityChangchunJilinChina
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12
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Kharazmi E, Sundquist K, Sundquist J, Fallah M, Bermejo JL. Risk of Gynecological Cancers in Cholecystectomized Women: A Large Nationwide Cohort Study. Cancers (Basel) 2022; 14:cancers14061484. [PMID: 35326635 PMCID: PMC8946708 DOI: 10.3390/cancers14061484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Gallstones affect women more frequently than men, and symptomatic gallstones are increasingly treated with surgical removal of the gallbladder (cholecystectomy). Breast, endometrial, and ovarian cancer share several risk factors with gallstones, including overweight, obesity, and exposure to female sex hormones. We intended to assess the association between cholecystectomy and female cancer risk, which has not been comprehensively investigated. Methods: We investigated the risk of female cancers after cholecystectomy leveraging the Swedish Cancer, Population, Patient, and Death registries. Standardized incidence ratios (SIRs) adjusted for age, calendar period, socioeconomic status, and residential area were used to compare cancer risk in cholecystectomized and non-cholecystectomized women. Results: During a median follow-up of 11 years, 325,106 cholecystectomized women developed 10,431 primary breast, 2888 endometrial, 1577 ovarian, and 705 cervical cancers. The risk of ovarian cancer was increased by 35% (95% confidence interval (CI) 2% to 77%) in the first 6 months after cholecystectomy. The exclusion of cancers diagnosed in the first 6 months still resulted in an increased risk of endometrial (19%, 95%CI 14% to 23%) and breast (5%, 95%CI 3% to 7%) cancer, especially in women cholecystectomized after age 50 years. By contrast, cholecystectomized women showed decreased risks of cervical (-13%, 95%CI -20% to -7%) and ovarian (-6%, 95%CI -10% to -1%) cancer. Conclusions: The risk of ovarian cancer increased by 35% in a just short period of time (6 months) following the surgery. Therefore, it is worth ruling out ovarian cancer before cholecystectomy. Women undergoing cholecystectomy showed an increased risk of breast and endometrial cancer up to 30 years after surgery. Further evaluation of the association between gallstones or gallbladder removal on female cancer risk would allow for the assessment of the need to intensify cancer screening in cholecystectomized women.
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Affiliation(s)
- Elham Kharazmi
- Institute of Medical Biometry, University of Heidelberg, 69120 Heidelberg, Germany;
- Risk Adapted Prevention Group, Division of Preventive Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany;
- Center for Primary Health Care Research, Lund University, 202 13 Malmö, Sweden; (K.S.); (J.S.)
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, 202 13 Malmö, Sweden; (K.S.); (J.S.)
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Center for Community-Based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, 202 13 Malmö, Sweden; (K.S.); (J.S.)
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Center for Community-Based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Mahdi Fallah
- Risk Adapted Prevention Group, Division of Preventive Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany;
- Center for Primary Health Care Research, Lund University, 202 13 Malmö, Sweden; (K.S.); (J.S.)
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Justo Lorenzo Bermejo
- Institute of Medical Biometry, University of Heidelberg, 69120 Heidelberg, Germany;
- Correspondence: ; Tel.: +49-6221-56-4195
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13
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Sun Q, Gao N, Xia W. Association between omega-3/6 fatty acids and cholelithiasis: A mendelian randomization study. Front Nutr 2022; 9:964805. [PMID: 36211516 PMCID: PMC9537577 DOI: 10.3389/fnut.2022.964805] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background Omega-3 and omega-6 may be protective factors for cholelithiasis. However, this relationship has not yet been demonstrated clearly. Therefore, we attempted to identify these causal relationships. Materials and methods The omega-3/6 fatty acid discovery dataset was obtained from UK Biobank and contained 114,999 individuals. The validation set was derived from an independent genome-wide association study (GWAS) and contained 13,544 individuals. The cholelithiasis dataset was derived from FinnGen and contained 19,023 cases and 195,144 controls. The inverse variance weighting (IVW) method was used as the main method of analysis in this study. Multiple methods of analysis were also used in the repeated methods, including the MR-Egger, weighted median, MR-pleiotropic residual sum (MR-PRESSO), outliers, and maximum likelihood methods. In addition, we used multiple sensitivity analyses to identify the potential pleiotropy. Result In the discovery stage, the results of the random effect IVW analysis showed that higher omega-3 levels were correlated inversely with the risk of cholelithiasis (β = -0.22, 95% CI [-0.32 to -0.12], P = 1.49 × 10-5). When the replication analysis was performed using another set of instrumental variables (IVs), the causal relationship between omega-3 fatty acids and cholelithiasis remained stable (β = -0.42, 95% CI [-0.66 to -0.18], P = 5.49 × 10-4), except for the results obtained using the MR-Egger method, which were not significant. The results of the IVW approach showed that each SD increase in omega-6 levels was associated negatively with the risk of cholelithiasis, both in the discovery (β = -0.21, 95% CI [-0.35 to -0.06], P = 4.37 × 10-3) and the validation phases (β = -0.21, 95% CI [-0.40 to -0.02], P = 3.44 × 10-2). Conclusion The results of our MR study suggest that omega-3/6 is associated with cholelithiasis risk. Attention to the risk of cholelithiasis in individuals with low serum omega-3/6 levels is necessary.
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Affiliation(s)
- Qi Sun
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ning Gao
- Department of Cardiovascular Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Weiliang Xia
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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14
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Li W, Liang J, Shao W, Xu C, Xu J, Jiang Z, Gu A. Maternal smoking during pregnancy is risk factor for gallbladder disease in offspring during adulthood: a prospective study from UK Biobank. Ann Hepatol 2021; 26:100558. [PMID: 34653688 DOI: 10.1016/j.aohep.2021.100558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/11/2021] [Accepted: 04/20/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Gallbladder disease is a common disease with high prevalence. Majority of gallbladder disease is due to gallstone. Though genetics are believed to play a role in its pathogenesis, the contribution of environmental pressures in early life to the development of this disease in adulthood has not been ever investigated. This study aimed to clarify the risk of maternal smoking exposure in association with gallbladder disease in adulthood. The interaction of maternal smoking and own smoking during adulthood on this association was studied as well. PATIENTS AND METHODS A total of 286,731 eligible participants from the UK Biobank population-based cohort were included. Multivariable Cox regression analysis were used to examine the HR and 95% CI with adjustment for covariates. RESULT During a median of 8.8 years follow-up, 7110 incident cases of gallbladder disease including 6800 (95.6%) gallstone were identified. Maternal smoking was associated with increased risk of incident total gallbladder disease (HR = 1.13; 95%CI: 1.06 - 1.21; P = 0.0002) as well as gallstones (HR = 1.13; 95%CI: 1.06 -1.21; P = 0.0003) in adulthood. Compared with those who were neither exposed to maternal smoking nor own smoking, subjects adherence to no smoking during adulthood but having maternal smoking exposure still had increased risk of total gallbladder disease (HR = 1.21; 95%CI: 1.1-1.34, P=0.0001) and gallstones (HR = 1.21; 95%CI: 1.1-1.35, P=0.0001). CONCLUSION The present study using large prospective cohort data from UK Biobank, for the first time, demonstrated maternal smoking exposure bringing elevated risk of incident total gallbladder disease/gallstone in adulthood.
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Affiliation(s)
- Wenxiang Li
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jingjia Liang
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wentao Shao
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Cheng Xu
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China; Department of Maternal, Child, and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jin Xu
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhaoyan Jiang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China.
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
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15
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Mirizzi A, Aballay LR, Misciagna G, Caruso MG, Bonfiglio C, Sorino P, Bianco A, Campanella A, Franco I, Curci R, Procino F, Cisternino AM, Notarnicola M, D’Aprile PF, Osella AR. Modified WCRF/AICR Score and All-Cause, Digestive System, Cardiovascular, Cancer and Other-Cause-Related Mortality: A Competing Risk Analysis of Two Cohort Studies Conducted in Southern Italy. Nutrients 2021; 13:nu13114002. [PMID: 34836259 PMCID: PMC8620807 DOI: 10.3390/nu13114002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 01/19/2023] Open
Abstract
Background: In real life, nutrition goes beyond purely biological domains. Primary prevention is the most efficient approach for reducing the risk of mortality. We aimed to study the association of lifestyle, as measured by a modified World Cancer Research Fund/American Institute for Cancer Research (mWCRF/AICR) scoring system with all-cause, digestive system disease-related (DSD-related), cardiovascular disease-related (CVD-related), cancer–related and other cause-related mortality using data from two population-based cohort studies conducted in Southern Italy. Methods: A random sample of 5271 subjects aged 18 years or older was enrolled in 2005–2006 and followed up until 2020. Usual food intakes were estimated using a validated dietary questionnaire. Competing risks survival models were applied. Results: High adherence to the mWCRF/AICR score was found to be statistically significant and negatively associated with all-cause mortality (HR 0.56, 95%CI 0.39; 0.82), DSD-related mortality (SHR 0.38, 95%CI 0.15; 0.97) and cancer-related mortality (SHR 0.43, 95%CI 0.19; 0.97) in the male sub-cohort and other-cause mortality (SHR 0.43, 95%CI 0.21; 0.88) only in the female group. Conclusions: This mWCRF/AICR score can be seen as a simple, easy tool for use in clinical practice to evaluate both qualitative and quantitative aspects of the diet.
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Affiliation(s)
- Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Laura R. Aballay
- Human Nutrition Research Center (CenINH), School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba X5000, Argentina;
| | - Giovanni Misciagna
- Scientific and Ethical Committee Polyclinic Hospital, University of Bari, 70124 Bari, Puglia, Italy; (G.M.); (M.G.C.)
| | - Maria G. Caruso
- Scientific and Ethical Committee Polyclinic Hospital, University of Bari, 70124 Bari, Puglia, Italy; (G.M.); (M.G.C.)
- Clinical Nutrition Outpatients Clinic, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy;
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Ritanna Curci
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Filippo Procino
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Anna M. Cisternino
- Clinical Nutrition Outpatients Clinic, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy;
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry (MN), National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy;
| | - Pierina F. D’Aprile
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Alberto R. Osella
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
- Correspondence: ; Tel.: +39-0804994655; Fax: +39-0804994650
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Dowais R, Al Sharie S, Araydah M, Al Khasawneh S, Haddad F, AlJaiuossi A. Pearl-white gallstones: A report of a case and a chemical analysis by FTIR and XRD. Int J Surg Case Rep 2021; 87:106449. [PMID: 34571346 PMCID: PMC8476646 DOI: 10.1016/j.ijscr.2021.106449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction Gallstones' color is usually yellow, brown, black or more commonly a mixture of two or more of these colors in different proportions, depending on their composition, with yellow being the most commonly encountered color. Pearl-white gallstones are a very rare entity that has not been studied and reported sufficiently. Case presentation Our patient is a 44-year-old lady who was suffering from recurrent attacks of epigastric and right hypochondrial abdominal pain that was aggravated by consumption of fatty meals. Ultrasound Imaging revealed multiple gallbladder stones. After an elective cholecystectomy unusual pearl-white gallstones were found inside a distended gallbladder filled with transparent thick fluid. Chemical analysis To evaluate the chemical composition of these stones Fourier-transform infrared (FTIR) spectroscopy and X-Ray Diffraction (XRD) tests were performed and revealed that these stones are composed of cholesterol (99.6%) and calcium carbonate (0.4%). Discussion Gallstones are bile depositions of a solid consistency formed inside the gallbladder. Cholesterol, bilirubin, and other substances are involved in the composition of different kinds of gallstones. The presence of gallstones alone inside the gallbladder is usually presented as colicky abdominal pain. Cholecystectomy is a simple surgical removal of the gallbladder from it bed and is the definitive treatment of gallstone disease. Conclusion Pearl-white gallstones are rarely encountered and lack information about their pathogenesis, thus prompting further evaluation and studying. Pearl-white coloration of gallstones in extremely rare. FTIR and XRD are useful tools to analyze the chemical composition of gallstones. Cholesterol is the major component of pearl-white gallstones.
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Affiliation(s)
- Raad Dowais
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | | | | | | | - Fadi Haddad
- Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Anas AlJaiuossi
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
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17
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Bonfiglio C, Leone CM, Silveira LVA, Guerra R, Misciagna G, Caruso MG, Bruno I, Buongiorno C, Campanella A, Guerra VMB, Notarnicola M, Deflorio V, Franco I, Bianco A, Mirizzi A, Aballay LR, Cisternino AM, Sorino P, Pesole PL, Osella AR. Remnant cholesterol as a risk factor for cardiovascular, cancer or other causes mortality: A competing risks analysis. Nutr Metab Cardiovasc Dis 2020; 30:2093-2102. [PMID: 32819783 DOI: 10.1016/j.numecd.2020.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/08/2020] [Accepted: 07/01/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Cardiovascular diseases (CVDis) are leading causes of morbidity and mortality. Even after the introduction of pharmacological therapy to lower Cholesterol, there is still a residual risk that may be ascribed to remnant cholesterol (RC). We aimed, by analyzing two prospective cohort studies, to estimate the effect of RC on risk and hazard of cardiovascular deaths (CVDs), while accounting for competing risks such as cancer (CDs) and other-causes deaths (OCDs). METHODS AND RESULTS Cohorts were enrolled in 1992 and 2005. Personal data history was recorded. A fasting venous blood sample was obtained, and RC was calculated at baseline. Cause of Death was coded by using ICD-10th version. Follow-up ended on December 31, 2017. Flexible parametric competing-risks models were applied, with age at death as time-axis. In total, 5729 subjects were enrolled. There were 861 (15.1%) deaths: 234 CVDs (27.2%), 245 CDs (28.5%), 271 OCDs (31.5%) and 111 unknown causes of death (12.8%). RC exposure was a strong risk factor only for CVDs (Risk 2.54, 95% Confidence Interval 1.21; 5.34; Trend 1.26 (1.00; 1.58) for ≥1.29 mmol/L). CONCLUSIONS RC is a strong independent risk factor for cardiovascular mortality. Competing risk analysis is demonstrably a useful tool to disentangle associations among different competing events with a common risk factor.
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Affiliation(s)
- Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Carla M Leone
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Liciana V A Silveira
- Department of Biostatistics, Biosciences Institute, São Paulo State University, Av Rubião Jr.-Centro, Botucatu-SP, 18618-970 Botucatu, São Paulo, Brazil (Liciana V.A. Silveira)
| | - Rocco Guerra
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Giovanni Misciagna
- Scientific and Ethical Committee, Policlinic Hospital, University of Bari, Piazza Giulio Cesare, 11, 70124 Bari, BA, Italy (Giovanni Misciagna)
| | - Maria G Caruso
- Laboratory of Nutritional Biochemistry National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Maria Gabriella Caruso, Maria Notarnicola); Clinical Nutrition Outpatient Clinic National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Anna Maria Cisternino)
| | - Irene Bruno
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Claudia Buongiorno
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Vito M B Guerra
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Maria Gabriella Caruso, Maria Notarnicola)
| | - Valentina Deflorio
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Laura R Aballay
- Human Nutrition Research Center (CenINH), School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba, Argentina; Enrique Barros Pabellón Biología Celular, Ciudad Universitaria, X5000 Córdoba, Argentina
| | - Anna M Cisternino
- Clinical Nutrition Outpatient Clinic National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Anna Maria Cisternino)
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Pasqua L Pesole
- Laboratory of Clinical Pathology, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Pasqua Letizia Pesole)
| | - Alberto R Osella
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino).
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18
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Castellana F, Zupo R, Bortone I, Giannelli G, Donghia R, Lampignano L, Griseta C, De Pergola G, Boeing H, Cisternino AM, Logroscino G, Sardone R, Guerra V. Traditional Old Dietary Pattern of Castellana Grotte (Apulia) Is Associated with Healthy Outcomes. Nutrients 2020; 12:E3097. [PMID: 33053620 PMCID: PMC7600964 DOI: 10.3390/nu12103097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND There is still room for further studies aimed at investigating the most widespread diets in the Mediterranean area. The objective of the study is to analyze the relation of food group intake to clinical chemical indicators of health, and also to compare the food group intake with healthy well-known diet indices. METHODS Lifestyle, dietary, and clinical data collected in 2005/2006 and 2012/2018 from Castellana Grotte, located in the rural area of Apulia, were analyzed. The study populations included newly recruited subjects at each time period (n = 1870) as well as subjects examined twice and compared over time regarding health indicators (n = 734). Diet was assessed through a validated food frequency questionnaire. Three healthy diet indices were calculated and related to 29 food groups. We also performed prospective regression of food group consumption with health indicators. RESULTS The diet over the time period of observation was very stable and consisted of a high proportion of vegetables, fruit and grains. No major changes in body mass index (BMI) and blood pressure were observed. Consumption of low-fat dairy, juices, olive oil, and water were related to reductions in weight gain, systolic blood pressure, high-density lipoprotein (HDL)-cholesterol and cholesterol (total and HDL) levels, in that order. Over the time periods we observed only a slight decrease of adherence to the Meddietscore. The correlations of the healthy diet indices with food groups revealed some differences among the indices, mostly regarding the intake of fruit and vegetables. CONCLUSIONS The dietary pattern of Apulia is in line with many principles of a healthy diet and the cohort population seems to be less liable to undergo a transition to a westernized diet.
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Affiliation(s)
- Fabio Castellana
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Roberta Zupo
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Ilaria Bortone
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Rossella Donghia
- Unit of Epidemiology and Biostatistics, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.D.); (V.G.)
| | - Luisa Lampignano
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Chiara Griseta
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Giovanni De Pergola
- Clinical Nutrition Unit, Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari, Policlinico, 70124 Bari, Italy;
| | - Heiner Boeing
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
- German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany
| | - Anna Maria Cisternino
- Clinical Nutrition Unit, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Rodolfo Sardone
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Vito Guerra
- Unit of Epidemiology and Biostatistics, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.D.); (V.G.)
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19
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Riveras E, Azocar L, Moyano TC, Ocares M, Molina H, Romero D, Roa JC, Valbuena JR, Gutiérrez RA, Miquel JF. Transcriptomic profiles reveal differences in zinc metabolism, inflammation, and tight junction proteins in duodenum from cholesterol gallstone subjects. Sci Rep 2020; 10:7448. [PMID: 32366946 DOI: 10.1038/s41598-020-64137-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/13/2020] [Indexed: 02/08/2023] Open
Abstract
Cholesterol Gallstone Disease (GSD) is a common multifactorial disorder characterized by crystallization and aggregation of biliary cholesterol in the gallbladder. The global prevalence of GSD is ~10–20% in the adult population but rises to 28% in Chile (17% among men and 30% among women). The small intestine may play a role in GSD pathogenesis, but the molecular mechanisms have not been clarified. Our aim was to identify the role of the small intestine in GSD pathogenesis. Duodenal biopsy samples were obtained from patients with GSD and healthy volunteers. GSD status was defined by abdominal ultrasonography. We performed a transcriptome study in a discovery cohort using Illumina HiSeq. 2500, and qPCR, immunohistochemistry and immunofluorescence were used to validate differentially expressed genes among additional case-control cohorts. 548 differentially expressed genes between GSD and control subjects were identified. Enriched biological processes related to cellular response to zinc, and immune and antimicrobial responses were observed in GSD patients. We validated lower transcript levels of metallothionein, NPC1L1 and tight junction genes and higher transcript levels of genes involved in immune and antimicrobial pathways in GSD patients. Interestingly, serum zinc and phytosterol to cholesterol precursor ratios were lower in GSD patients. A significant association was observed between serum zinc and phytosterol levels. Our results support a model where proximal small intestine plays a key role in GSD pathogenesis. Zinc supplementation, modulation of proximal microbiota and/or intestinal barrier may be novel targets for strategies to prevent GSD.
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20
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Alsaif FA, Alqahtani SH, Alsadoon AM, Alswat KA, Abdo AA, Hassanain MM, Alsharabi AB, Aljuhani GR, Alkhalidi HM, Elsharkawy MS, Alotaibi MA, Sanai FM, Al-hamoudi WK. Prevalence of biopsy-proven nonalcoholic fatty liver among patients with gallstone disease. Saudi J Gastroenterol 2020; 26:282502. [PMID: 32341228 PMCID: PMC7580734 DOI: 10.4103/sjg.sjg_29_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/AIM Gallstone disease (GD) and nonalcoholic fatty liver disease (NAFLD) are associated with metabolic syndrome. Despite the benign nature of NAFLD, 10% of patients may develop advanced fibrosis and cirrhosis. We aimed to identify the prevalence and factors associated with NAFLD among GD patients in the Saudi population. PATIENTS AND METHODS This is a single-center, observational cohort study that included patients seen in general surgery clinics at our institution from 2011 to 2017. All liver biopsies were taken at the same time as the cholecystectomy. Demographical and clinical data were prospectively collected from the study population. RESULTS Of the 301 GD patients in the study, 15% had a normal body mass index (BMI), 29% were overweight, and 56% were obese. There were 143 (47.8%) patients with NAFLD, of which 125 (41.8%) showed steatosis and 18 (6%) had nonalcoholic steatohepatitis. There was a significant positive correlation between NAFLD and age (r = 0.243; P < 0.0001), and BMI (r = 0.242; P < 0.0001). Obese patients with BMI 30-40 kg/m[2] were 2.403 (P = 0.039) more likely to have NAFLD compared with normal BMI patients, and this value increased to 6.145 (P = 0.002) in patients with BMI >40 kg/m[2]. Additionally, patients with T2DM were 2.839 times (P = 0.015) more likely to have NAFLD compared with those who did not. CONCLUSIONS The prevalence of NAFLD among GD patients is high. High BMI and diabetes are independent factors associated with NAFLD in GD patients. The results suggest that there may be a need for routine liver biopsy in selected patients during cholecystectomy.
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Affiliation(s)
- Faisal A. Alsaif
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sara H. Alqahtani
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Amani M. Alsadoon
- Liver Disease Research Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Khalid A. Alswat
- Liver Disease Research Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ayman A. Abdo
- Liver Disease Research Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mazen M. Hassanain
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Abdulsalam B. Alsharabi
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ghadeer R. Aljuhani
- Department of Surgery, King Salman Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Hisham M. Alkhalidi
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammad S. Elsharkawy
- Department of Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Maram A. Alotaibi
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Faisal M. Sanai
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Kingdom of Saudi Arabia
| | - Waleed K. Al-hamoudi
- Liver Disease Research Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Liver Transplant, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
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21
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Song ST, Shi J, Wang XH, Guo YB, Hu PF, Zhu F, Zeng X, Xie WF. Prevalence and risk factors for gallstone disease: A population-based cross-sectional study. J Dig Dis 2020; 21:237-245. [PMID: 32166900 DOI: 10.1111/1751-2980.12857] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To explore the prevalence of and risk factors for gallstone disease in Shanghai, China. METHODS A population-based cross-sectional study was conducted in Shanghai between 2016 and 2017. Using a three-stage stratified sampling strategy, 4009 participants (1753 men and 2256 women) from 10 districts were enrolled. RESULTS The overall prevalence of gallstones was 6.83% (6.22% for men vs 7.31% for women, P = 0.173). According to the multivariate analysis, individuals aged ≥40 years (odds ratio [OR] 3.058, 95% confidence interval [CI] 2.110-4.433, P < 0.001), hypertension (OR 1.479, 95% CI 1.076-2.034, P = 0.016), thyroid disease (OR 1.409, 95% CI 1.029-1.928, P = 0.032), a family history of gallstones (OR 2.234, 95% CI 1.362-3.662, P = 0.001) and a waist-to-height ratio ≥0.5 (OR 1.656, 95% CI 1.197-2.292, P = 0.002) had an increased risk of developing gallstones. The risk of gallstone disease was 2.232 (95% CI 1.167-4.268, P = 0.015) times higher in individuals with elevated C4 levels than in those with normal C4 levels. Diabetes (OR 4.144, 95% CI 1.171-14.671, P = 0.028) was a risk factor for the formation of gallstones with diameters ≥1 cm, and men were more susceptible to develop multiple stones (OR 2.356, 95% CI 1.321-4.200, P = 0.004). CONCLUSION Individuals aged ≥40 years, with a history of hypertension and familial gallstones, a high waist-to-height ratio, thyroid disease and high C4 levels were related to an increased risk of gallstone disease.
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Affiliation(s)
- Sen Tao Song
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jian Shi
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xiao Hang Wang
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yi Bin Guo
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Ping Fang Hu
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Feng Zhu
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xin Zeng
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wei Fen Xie
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Wang J, Shen S, Wang B, Ni X, Liu H, Ni X, Yu R, Suo T, Liu H. Serum lipid levels are the risk factors of gallbladder stones: a population-based study in China. Lipids Health Dis 2020; 19:50. [PMID: 32192520 PMCID: PMC7083041 DOI: 10.1186/s12944-019-1184-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/30/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Gallstones are the cause of a majority of biliary tract discomfort. Although many community-based studies have addressed the risk factors for gallstone disease (GSD), little is known about GSD prevalence and risk factors in Chinese populations. METHODS From January 2014 to January 2015, participants (N = 2,068,523) were recruited by Meinian Onehealth Healthcare Co., Ltd. They received a physical examination, and GSD was determined by ultrasound. RESULTS The prevalence of GSD was 8.1%. Risks of GSD were similar between males and females in all age groups. Risk factors for gallstones include body mass index, waist circumference, waist-to-hip ratio, and physical activity, as well as biological factors such as age, sex, and elevated blood lipid levels. Serum lipid levels of GSD were statistically different from controls in total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (H-DL), low-density lipoprotein cholesterol (LDL), and apolipoprotein B (APOB). Furthermore, TC > 5.00 mmol/L, TG > 1.39 mmol/L, HDL < 1.19 mmol/L, LDL > 3.04 mmol/L, and APOB > 0.97 mmol/L were risk factors for gallstones. CONCLUSIONS Serum lipid levels are associated with GSD. TC, TG, LDL, and APOB are risk factors, while HDL is a protective factor.
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Affiliation(s)
- Jiwen Wang
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Sheng Shen
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Bo Wang
- Biliary Tract Disease Institute, Fudan University, Shanghai, 200032, China
| | - Xiaojian Ni
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Han Liu
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Xiaoling Ni
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Rong Yu
- Biliary Tract Disease Institute, Fudan University, Shanghai, 200032, China
| | - Tao Suo
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China. .,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China.
| | - Houbao Liu
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China. .,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China.
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Shanmugam H, Molina Molina E, Di Palo DM, Faienza MF, Di Ciaula A, Garruti G, Wang DQH, Portincasa P. Physical Activity Modulating Lipid Metabolism in Gallbladder Diseases. J Gastrointestin Liver Dis 2020; 29:99-110. [PMID: 32176752 PMCID: PMC8114792 DOI: 10.15403/jgld-544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 01/28/2020] [Indexed: 02/05/2023]
Abstract
Physical activity encompasses a series of overall benefits on cardiovascular health and metabolic disorders. Research has recently focused on the hepatobiliary tract, as an additional target of the health-related outcomes of different types of physical exercise. Here, we focus on the global features of physical activity with respect to exercise modality and intensity, and on studies linking physical activity to lipid metabolism, gallbladder diseases (gallstones, symptoms, complications and health-related quality of life), gallbladder motor-function, enterohepatic circulation of bile acids, and systemic metabolic inflammation. Additional studies need to unravel the pathophysiological mechanisms involved in both beneficial and harmful effects of physical activity in populations with different metabolic conditions.
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Affiliation(s)
- Harshitha Shanmugam
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy. .
| | - Emilio Molina Molina
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.
| | - Domenica Maria Di Palo
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.
| | - Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, Paediatric Section, University of Bari "A. Moro", Bari, Italy.
| | - Agostino Di Ciaula
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.
| | - Gabriella Garruti
- Section of Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplants, University of Bari Medical School, Bari, Italy.
| | - David Q H Wang
- Department of Medicine, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
| | - Piero Portincasa
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.
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Alsaif FA, Alabdullatif FS, Aldegaither MK, Alnaeem KA, Alzamil AF, Alabdulkarim NH, Aldohayan AD. Incidence of symptomatic cholelithiasis after laparoscopic sleeve gastrectomy and its association with rapid weight loss. Saudi J Gastroenterol 2020; 26:94-98. [PMID: 32031160 PMCID: PMC7279075 DOI: 10.4103/sjg.sjg_472_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIM The worldwide prevalence of obesity has increased dramatically over the past years. In the Arab region, 66%-75% of adults and 25%-40% of children are either overweight or obese. Bariatric surgery has become the most effective approach for managing obesity and its co-morbidities. An expected outcome of bariatric surgery is cholelithiasis, which is one of the established risk factors of rapid weight loss. The aim of this study is to detect the incidence of symptomatic cholelithiasis among bariatric patients. PATIENTS AND METHODS A retrospective cohort study on 711 patients aged between 18 and 60 who underwent laparoscopic sleeve gastrectomy (LSG) was conducted at King Saud University Medical City from January 2016 to January 2018. RESULTS The postoperative incidence of symptomatic cholelithiasis was 3.5%. The mean duration of symptom development was 12.4 months. The rates of weight loss at 6 and 12 months for patients with symptomatic cholelithiasis were 28.94 ± 4.89% and 38.51 ± 6.84%, respectively (P = 0.002), which were significantly higher than in patients without symptomatic cholelithiasis during the same follow-up period (24.41 ± 6.6% and 32.29 ± 10.28%), respectively; (P = 0.012). CONCLUSION We found a 3.5% incidence of symptomatic cholelithiasis among post-LSG patients in a period of 2 years. Rapid weight loss was the only risk factor that contributed to the development of post-LSG gallbladder disease. STATISTICAL ANALYSIS USED Results were expressed as absolute numbers and percentages for categorical variables and as mean and standard deviation for continuous variables. A paired sample t-test was performed to determine significant differences between means at different time stamps. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 23.0.
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Affiliation(s)
- Faisal A. Alsaif
- Department of Surgery, King Saud University, Riyadh, Kingdom of Saudi Arabia,Address for correspondence: Dr. Faisal A. Alsaif, Department of Surgery, HPB and Transplant Surgery, College of Medicine, King Saud University, P.O. Box 7805 Riyadh - 11472, Kingdom of Saudi Arabia. E-mail:
| | - Fahad S. Alabdullatif
- Department College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Khalid A. Alnaeem
- Department College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Nouf H. Alabdulkarim
- Department College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Rahmani B, Gandhi J, Joshi G, Smith NL, Reid I, Khan SA. The Role of Diabetes Mellitus in Diseases of the Gallbladder and Biliary Tract. Curr Diabetes Rev 2020; 16:931-948. [PMID: 32133965 DOI: 10.2174/1573399816666200305094727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The increasing prevalence of diabetes mellitus worldwide continues to pose a heavy burden. Though its gastrointestinal impact is appropriately recognized, the lesser known associations may be overlooked. OBJECTIVE We aim to review the negative implications of diabetes on the gallbladder and the biliary tract. METHODS A MEDLINE® database search of literature was conducted with emphasis on the previous five years, combining keywords such as "diabetes," "gallbladder," and "biliary". RESULTS The association of diabetes to the formation of gallstones, gallbladder cancer, and cancer of the biliary tract are discussed along with diagnosis and treatment. CONCLUSION Though we uncover the role of diabetic neuropathy in gallbladder and biliary complications, the specific individual diabetic risk factors behind these developments is unclear. Also, in addition to diabetes control and surgical gallbladder management, the treatment approach also requires further focus.
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Affiliation(s)
- Benjamin Rahmani
- Department of Physiology and Biophysics, Renaissance School of Medicine at Stony Brook University, Stony Brook,
NY, USA
| | - Jason Gandhi
- Department of Physiology and Biophysics, Renaissance School of Medicine at Stony Brook University, Stony Brook,
NY, USA
- Medical Student Research Institute, St. George’s University School of Medicine, Grenada, West Indies
| | - Gunjan Joshi
- Department of Internal Medicine, Stony Brook Southampton Hospital, Southampton, NY, USA
| | | | - Inefta Reid
- Department of Physiology and Biophysics, Renaissance School of Medicine at Stony Brook University, Stony Brook,
NY, USA
| | - Sardar Ali Khan
- Department of Physiology and Biophysics, Renaissance School of Medicine at Stony Brook University, Stony Brook,
NY, USA
- Department of Urology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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26
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Zhao J, Kim H, Han Y, Choi YJ, Byun Y, Kwon W, Jang JY. Chronological changes in epidemiologic features of patients with gallstones over the last 20 years in a single large-volume Korean center. Ann Surg Treat Res 2019; 97:136-141. [PMID: 31508394 PMCID: PMC6722291 DOI: 10.4174/astr.2019.97.3.136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/11/2019] [Accepted: 07/19/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose South Korea has a high prevalence of gallstones, the type of which could be influenced by changes in diet and socioeconomic status. Here we aimed to investigate the epidemiological characteristics and changing patterns of gallstones over the past 20 years in Korea. Methods A total of 5,808 patients who underwent cholecystectomy due to gallstones at Seoul National University Hospital between 1996 and 2015 were analyzed. Patients were divided into 4 subgroups: period 1 (1996-2000, n = 792), period 2 (2001-2005, n = 1,215), period 3 (2006-2010, n = 1,525), period 4 (2011-2015, n = 2,276). Gallstones were classified by type: pure cholesterol (PC), mixed cholesterol (MC), calcium bilirubinate (CB), black pigment (BP), and combination (COM). Results The female to male ratio was 1.16 with mean ages of 53.6 and 55.3 years old, respectively. The ratio of cholesterol stones to pigment stones was 0.96:1. The mean age and male to female ratio of the patients increased over time. The proportion of cholesterol vs pigment stone did not differ significantly. Proportions of PC and MC stone subtypes did not change notably, whereas proportion of BP stones increased (34.0% to 45.5%), and CB stones decreased (20.7% to 5.3%). Conclusion Gallstone types and occurrences were affected by environmental changes, and pigment stones remained common in Korea. Although no distinct increase in cholesterol stones was noted, the proportion of CB stones decreased. As the mean age at gallstone presentation increases, BP stones could become more prevalent.
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Affiliation(s)
- Jiyong Zhao
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hongbeom Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngmin Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Jin Choi
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonhyeong Byun
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Young Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Abstract
We investigated possible associations between fatty liver and gallstone disease (GD) in a Chinese population.This cross-sectional study included 897 people who visited the clinical center and underwent ultrasonography at The First Hospital of Jilin University between January 2018 and June 2018.The overall prevalence of GD was 8.8%; the between-sex difference (9.3% in men, 8.4% in women) was not statistically significant. The risk of GD was similar for men and women across all age groups. GD prevalence increased steadily with increasing age, from 2.1% in patients ≤30 years of age to 15.4% in those >70 years of age. Older age (≥50 years) and fatty liver were associated with GD development. Diabetes mellitus (adjusted odds ratio [AOR]: 3.066; 95% confidence interval [CI]: 1.563-6.013) was associated with GD in female but not in male subjects. In younger patients (<50 years), fatty liver (AOR: 5.268; 95% CI: 1.832-15.147) was associated with GD development.The factors older age and fatty liver predicted GD risk in Chinese individuals. Further studies are required to explore differences in lithogenesis according to sex.
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28
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Di Ciaula A, Molina-Molina E, Bonfrate L, Wang DQH, Dumitrascu DL, Portincasa P. Gastrointestinal defects in gallstone and cholecystectomized patients. Eur J Clin Invest 2019; 49:e13066. [PMID: 30592298 PMCID: PMC8118136 DOI: 10.1111/eci.13066] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 12/25/2018] [Accepted: 12/27/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM Several gallstone patients complain of dyspeptic symptoms, irrespective of the presence of typical colicky pain. Symptoms often persist after a cholecystectomy. Systematic studies on dyspepsia and dynamic gastrointestinal motor function are missing in gallstone patients with preserved gallbladder or after a cholecystectomy. MATERIALS AND METHODS Forty-six gallstone patients (age 55 ± 2 years; 15M, 31F) and 24 cholecystectomized patients (age 57 ± 2 years; 6M, 18F) (no difference in type and volume of gallstones between the two groups) were compared against a group of 65 healthy controls (age 51 ± 2 years; 30M, 35F). Dyspepsia occurring in the prior months was assessed by a questionnaire, gastric and gallbladder emptying by functional ultrasonography and orocecal transit time by a hydrogen breath test using a lactulose-enriched standard liquid meal. RESULTS Gallstone patients had significantly greater dyspepsia, fasting and residual gallbladder volumes, and slower gallbladder emptying, gastric emptying and small intestinal transit time than controls. In cholecystectomized patients, gastric emptying further delayed, compared to gallstone patients and controls. CONCLUSION Gallstone patients with the gallbladder "in situ" or after a cholecystectomy display dyspeptic symptoms. Symptoms are associated with multiple gastrointestinal motility defects involving the gallbladder, stomach and small intestine. After cholecystectomy, gastric emptying worsens.
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Affiliation(s)
- Agostino Di Ciaula
- Division of Internal Medicine, Hospital of Bisceglie, ASL BAT, Bisceglie, Italy
| | - Emilio Molina-Molina
- Department of Biomedical Sciences and Human Oncology, Clinica Medica “A. Murri”, University of Bari Medical School, Bari, Italy
| | - Leonilde Bonfrate
- Department of Biomedical Sciences and Human Oncology, Clinica Medica “A. Murri”, University of Bari Medical School, Bari, Italy
- Division of Geriatrics and Gerontology, Hospital “Miulli”, Acquaviva delle Fonti, Italy
| | - David Q.-H. Wang
- Department of Medicine, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Albert Einstein College of Medicine, Bronx, New York
| | - Dan L. Dumitrascu
- 2nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica “A. Murri”, University of Bari Medical School, Bari, Italy
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Abstract
Cholesterol gallstone disease have relationships with various conditions linked with insulin resistance, but also with heart disease, atherosclerosis, and cancer. These associations derive from mechanisms active at a local (i.e. gallbladder, bile) and a systemic level and are involved in inflammation, hormones, nuclear receptors, signaling molecules, epigenetic modulation of gene expression, and gut microbiota. Despite advanced knowledge of these pathways, the available therapeutic options for symptomatic gallstone patients remain limited. Therapy includes oral litholysis by the bile acid ursodeoxycholic acid (UDCA) in a small subgroup of patients at high risk of postdissolution recurrence, or laparoscopic cholecystectomy, which is the therapeutic radical gold standard treatment. Cholecystectomy, however, may not be a neutral event, and potentially generates health problems, including the metabolic syndrome. Areas covered: Several studies on risk factors and pathogenesis of cholesterol gallstone disease, acting at a systemic level have been reviewed through a PubMed search. Authors have focused on primary prevention and novel potential therapeutic strategies. Expert commentary: The ultimate goal appears to target the manageable systemic mechanisms responsible for gallstone occurrence, pointing to primary prevention measures. Changes must target lifestyles, as well as experimenting innovative pharmacological tools in subgroups of patients at high risk of developing gallstones.
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Affiliation(s)
- Agostino Di Ciaula
- a Division of Internal Medicine , Hospital of Bisceglie , Bisceglie , Italy
| | - David Q-H Wang
- b Department of Medicine, Division of Gastroenterology and Liver Diseases , Marion Bessin Liver Research Center, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Piero Portincasa
- c Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri" , University of Bari Medical School , Bari , Italy
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30
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Di Ciaula A, Garruti G, Frühbeck G, De Angelis M, de Bari O, Wang DQH, Lammert F, Portincasa P. The Role of Diet in the Pathogenesis of Cholesterol Gallstones. Curr Med Chem 2019; 26:3620-3638. [PMID: 28554328 PMCID: PMC8118138 DOI: 10.2174/0929867324666170530080636] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/03/2017] [Accepted: 03/16/2017] [Indexed: 02/06/2023]
Abstract
Cholesterol gallstone disease is a major health problem in Westernized countries and depends on a complex interplay between genetic factors, lifestyle and diet, acting on specific pathogenic mechanisms. Overweigh, obesity, dyslipidemia, insulin resistance and altered cholesterol homeostasis have been linked to increased gallstone occurrence, and several studies point to a number of specific nutrients as risk- or protective factors with respect to gallstone formation in humans. There is a rising interest in the identification of common and modifiable dietetic factors that put the patients at risk of gallstones or that are able to prevent gallstone formation and growth. In particular, dietary models characterized by increased energy intake with highly refined sugars and sweet foods, high fructose intake, low fiber contents, high fat, consumption of fast food and low vitamin C intake increase the risk of gallstone formation. On the other hand, high intake of monounsaturated fats and fiber, olive oil and fish (ω-3 fatty acids) consumption, vegetable protein intake, fruit, coffee, moderate alcohol consumption and vitamin C supplementation exert a protective role. The effect of some confounding factors (e.g., physical activity) cannot be ruled out, but general recommendations about the multiple beneficial effects of diet on cholesterol gallstones must be kept in mind, in particular in groups at high risk of gallstone formation.
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Affiliation(s)
| | - Gabriella Garruti
- Department of Emergency and Organ Transplants, Section of Endocrinology, Andrology and Metabolic Diseases, University of Bari Medical School, Bari, Italy
| | - Gema Frühbeck
- Dept Endocrinology and Nutrition, University of Navarra Medical School, Pamplona, Spain
| | - Maria De Angelis
- Department of Soil, Plant and Food Science, Department of Biomedical Sciences and Human Oncology
| | - Ornella de Bari
- Clinica Medica “A. Murri”, Department of Biomedical Sciences and Human Oncology
| | - David Q.-H. Wang
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
| | - Frank Lammert
- Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Biomedical Sciences and Human Oncology
- Address correspondence to this author at the University of Bari Medical School, Clinica Medica “A. Murri”; Department of Biosciences and Human Oncology (DIMO), Policlinico Hospital - 70124 Bari, Italy; Tel: +39-080-5478227; Fax: +39-080-5478232;
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Shukla M, Kumar A, Srivastava RK, Jahan S. Anatomical and molecular studies of cytochrome P450 family CYP7A1 gene polymorphism and its association with gallstone in north Indian population. J ANAT SOC INDIA 2018; 67:6-11. [DOI: 10.1016/j.jasi.2018.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Liu T, Wang W, Ji Y, Wang Y, Liu X, Cao L, Liu S. Association between different combination of measures for obesity and new-onset gallstone disease. PLoS One 2018; 13:e0196457. [PMID: 29772027 DOI: 10.1371/journal.pone.0196457] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 04/15/2018] [Indexed: 12/17/2022] Open
Abstract
Background Body mass index(BMI) is a calculation index of general obesity. Waist circumference(WC) is a measure of body-fat distribution and always used to estimate abdominal obesity. An important trait of general obesity and abdominal obesity is their propensity to coexist. Using one single measure of obesity could not estimate persons at risk for GSD precisely. Objectives This study aimed to compare the predictive values of various combination of measures for obesity(BMI, WC, waist to hip ratio) for new-onset GSD. Methods We prospectively studied the predictive values of various combination of measures for obesity for new-onset GSD in a cohort of 88,947 participants who were free of prior gallstone disease, demographic characteristics and biochemical parameters were recorded. Results 4,329 participants were identified to have GSD among 88,947 participants during 713 345 person-years of follow-up. Higher BMI, WC and waist to hip ratio (WHtR) were significantly associated with higher risks of GSD in both genders even after adjustment for potential confounders. In males, the hazard ratio for the highest versus lowest BMI, WC, WHtR were 1.63(1.47~1.79), 1.53(1.40~1.68), 1.44(1.31~1.58), respectively. In females, the hazard ratio for the highest versus lowest BMI, WC, WHtR were 2.11(1.79~2.49), 1.85(1.55~2.22), 1.84(1.55~2.19), respectively. In male group, the combination of BMI+WC improved the predictive ability of the model more clearly than other combinations after adding them to the multivariate model in turn, while for females the best predictive combination was BMI+WHtR. Conclusions Elevated BMI, WC and WHtR were independent risk factors for new-onset GSD in both sex groups after additional adjustment was made for potential confounders. In males, the combination of BMI+WC seemed to be the most predictable model to evaluate the effect of obesity on new-onset GSD, while the best combination in females was BMI+WHtR.
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Chang LY, Lee CH, Chang CH, Lee MC, Lee MR, Wang JY, Lee LN. Acute biliary events during anti-tuberculosis treatment: hospital case series and a nationwide cohort study. BMC Infect Dis 2018; 18:64. [PMID: 29390977 PMCID: PMC5796404 DOI: 10.1186/s12879-018-2966-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 01/17/2018] [Indexed: 01/07/2023] Open
Abstract
Background Tuberculosis (TB) remains one of the major infectious diseases worldwide. Adverse reactions are common during TB treatment. Few reports, however, are available on treatment-related acute biliary events (ABEs), such as cholelithiasis, biliary obstruction, acute cholecystitis, and cholangitis. Methods We first report four pulmonary TB patients who developed ABEs during anti-TB treatment. Abdominal sonography revealed multiple gall stones with dilated intrahepatic ducts in three patients and cholecystitis in one patient. To investigate the incidence of and risk factors for ABEs during anti-TB treatment, we subsequently conducted a nationwide cohort study using the National Health Insurance Research Database of Taiwan. Results A total of 159,566 pulmonary TB patients were identified from the database between 1996 and 2010, and among them, 195 (0.12%) developed ABEs within 180 days after beginning anti-TB treatment. Logistic regression analysis revealed that the risk factors associated with ABEs are older age (relative risk [RR]: 1.32 [1.21–1.44] per 10-year increment) and diabetes mellitus (RR: 1.59 [1.19–2.13]). Conclusions Although infrequently encountered, ABEs should be considered among patients with TB who experience abdominal discomfort with hyperbilirubinemia, especially patients who have older age or diabetes.
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Affiliation(s)
- Lih-Yu Chang
- Department of Internal Medicine, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Chih-Hsin Lee
- Division of Pulmonary Medicine, Wanfang Hospital, Taipei Medical University, Taipei, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Hao Chang
- Department of Internal Medicine, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Ming-Chia Lee
- Department of Pharmacy, New Taipei City Hospital, New Taipei City, Taiwan.,School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Meng-Rui Lee
- Department of Internal Medicine, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, #7, Chung-Shan South Road, Zhongzheng District, Taipei, 10002, Taiwan.
| | - Li-Na Lee
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
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34
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Abstract
PURPOSE OF REVIEW The emphasis of this review article is to bring to the forefront the spectrum of pancreatobiliary disorders and their association with diabetes. We hope to systematically discuss the link between diabetes and disorders of the pancreas including acute and chronic pancreatitis, as well as pancreatic cancer. We also hope to review and highlight the literature with respect to other cancers of the biliary tree including gallbladder and cholangiocarcinoma. Lastly, we discuss diabetes and biliary dyskinesia. RECENT FINDINGS Newer cohort studies suggest the presence of diabetes to increase the severity and worsen outcomes in acute pancreatitis. Post pancreatitis diabetes is a novel disease entity being increasingly recognized. The use of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis may attenuate the risk of endocrine dysfunction. Pancreatic cancer may either be the consequence of diabetes or a presenting manifestation. The use of anti-diabetic medications may confer protection against development of pancreatic cancer. Gallbladder adenocarcinoma and cholangiocarcinoma risks are elevated in those with underlying diabetes. Diabetes can directly impact or deteriorate outcome of acute and chronic pancreatitis and well as pancreatobiliary malignancies. It could also occur as a result of loss of endocrine function after pancreatitis. Like many areas of the digestive tract, biliary motility could be impacted by diabetes.
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Affiliation(s)
- Muhammad Shafqet
- Gastroenterology and Hepatology, Temple University Hospital, Philadelphia, PA, USA
| | - Kaveh Sharzehi
- Division of Gastroenterology and Hepatology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, L461, Portland, OR, 97239, USA.
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Abstract
Gallstone disease is one of the most common public health problems in the United States. Approximately 10%-20% of the national adult populations currently carry gallstones, and gallstone prevalence is rising. In addition, nearly 750,000 cholecystectomies are performed annually in the United States; direct and indirect costs of gallbladder surgery are estimated to be $6.5 billion. Cholelithiasis is also strongly associated with gallbladder, pancreatic, and colorectal cancer occurrence. Moreover, the National Institutes of Health estimates that almost 3,000 deaths (0.12% of all deaths) per year are attributed to complications of cholelithiasis and gallbladder disease. Although extensive research has tried to identify risk factors for cholelithiasis, several studies indicate that definitive findings still remain elusive. In this review, predisposing factors for cholelithiasis are identified, the pathophysiology of gallstone disease is described, and nonsurgical preventive options are discussed. Understanding the risk factors for cholelithiasis may not only be useful in assisting nurses to provide resources and education for patients who are diagnosed with gallstones, but also in developing novel preventive measures for the disease.
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Wang Y, Yu X, Zhao QZ, Zheng S, Qing WJ, Miao CD, Sanjay J. Thyroid dysfunction, either hyper or hypothyroidism, promotes gallstone formation by different mechanisms. J Zhejiang Univ Sci B 2017; 17:515-25. [PMID: 27381728 DOI: 10.1631/jzus.b1500210] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We have investigated comprehensively the effects of thyroid function on gallstone formation in a mouse model. Gonadectomized gallstone-susceptible male C57BL/6 mice were randomly distributed into three groups each of which received an intervention to induce hyperthyroidism, hypothyroidism, or euthyroidism. After 5 weeks of feeding a lithogenic diet of 15% (w/w) butter fat, 1% (w/w) cholesterol, and 0.5% (w/w) cholic acid, mice were killed for further experiments. The incidence of cholesterol monohydrate crystal formation was 100% in mice with hyperthyroidism, 83% in hypothyroidism, and 33% in euthyroidism, the differences being statistically significant. Among the hepatic lithogenic genes, Trβ was found to be up-regulated and Rxr down-regulated in the mice with hypothyroidism. In contrast, Lxrα, Rxr, and Cyp7α1 were up-regulated and Fxr down-regulated in the mice with hyperthyroidism. In conclusion, thyroid dysfunction, either hyperthyroidism or hypothyroidism, promotes the formation of cholesterol gallstones in C57BL/6 mice. Gene expression differences suggest that thyroid hormone disturbance leads to gallstone formation in different ways. Hyperthyroidism induces cholesterol gallstone formation by regulating expression of the hepatic nuclear receptor genes such as Lxrα and Rxr, which are significant in cholesterol metabolism pathways. However, hypothyroidism induces cholesterol gallstone formation by promoting cholesterol biosynthesis.
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Affiliation(s)
- Yong Wang
- Department of Thyroid Surgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Xing Yu
- Cancer Institute, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Qun-Zi Zhao
- Department of Thyroid Surgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Shu Zheng
- Cancer Institute, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Wen-Jie Qing
- Department of Clinical Medicine, School of Medicine, Zhejiang University, Hangzhou 310029, China
| | - Chun-di Miao
- Department of Clinical Medicine, School of Medicine, Zhejiang University, Hangzhou 310029, China
| | - Jaiswal Sanjay
- Department of Clinical Medicine, School of Medicine, Zhejiang University, Hangzhou 310029, China
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Zhang FM, Chen LH, Chen HT, Shan GD, Hu FL, Yang M, Chen WG, Xu GQ. Hepatitis C Virus Infection Is Positively Associated with Gallstones in Liver Cirrhosis. Digestion 2017; 93:221-8. [PMID: 27093174 DOI: 10.1159/000444252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 01/26/2016] [Indexed: 02/04/2023]
Abstract
AIM To elucidate the prevalence and risk factors of gallstone disease (GD) among patients with liver disease and explore their association with the aetiology and severity of hepatic injury. METHODS We analysed 4,832 subjects of hepatic injury induced by one of the following aetiologies: hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, excessive alcohol consumption. The risk factors significantly associated with GD were analysed using stepwise logistic regression analysis, the influence of aetiology and severity of liver disease on the prevalence of GD were assessed by multiple logistic regression analysis adjusting for confounding factors. RESULTS Three thousand forty eight patients were of positive HBV surface antigen alone with a prevalence of GD of 18.6%, 526 were tested as positive Anti-HCV alone with a prevalence of GD of 22.4%, and 1,258 were identified with excessive alcohol consumption patterns with a prevalence of GD of 13.5%. In each aetiological category, the prevalence of GD increased by age. Stepwise logistic regression analysis showed that age, female, low-density lipoprotein-cholesterol (LDL-Cho), family history of GD, HBV infection, HCV infection, chronic hepatitis and cirrhosis were independent factors associated with GD. After adjusting for age, LDL-Cho and family history of GD, the prevalence of gallstone disease was significantly associated with HCV-related cirrhosis in both genders, HBV-related cirrhosis in males and alcohol-related cirrhosis in females compared with patients with less severe liver disease [corrected]. After adjusting for gender, age, LDL-Cho and family history of GD, patients with HCV-related cirrhosis (OR 2.66, 95% CI 1.49-3.84) but not HBV-related cirrhosis (OR 1.52, 95% CI 0.73-1.82) were more likely to have GD compared with alcohol-related cirrhosis. CONCLUSION HCV infection is positively associated with gallstone formation especially in those with cirrhosis patients.
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Affiliation(s)
- Fen-Ming Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
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Mark-Christensen A, Brandsborg S, Laurberg S, Johansen N, Pachler JH, Thorlacius-Ussing O, Kjær MD, Qvist N, Preisler L, Hillingsø J, Rosenberg J, Jepsen P. Increased Risk of Gallstone Disease Following Colectomy for Ulcerative Colitis. Am J Gastroenterol 2017; 112:473-478. [PMID: 28117363 DOI: 10.1038/ajg.2016.564] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/10/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Biochemical studies suggest that patients who have had a colectomy or restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) are at an increased risk of developing gallstone disease, but epidemiological studies are lacking. We evaluated the risk of gallstone disease following colectomy and IPAA. METHODS Individuals who had a colectomy were identified from a national cohort of patients with ulcerative colitis (UC), and controls without colectomy were sampled from within the same cohort, matching on gender, calendar year, and year of birth. We used Cox regression to examine the effect of colectomy on the hazard rates of gallstone disease and cholecystectomy, adjusting for alcoholism, stroke, chronic obstructive pulmonary disease, cancer, cardiac disease, diabetes mellitus, hypothyroidism, hyperlipidemia, cirrhosis, obesity, renal failure, and transient ischemic attacks. The effect of an IPAA was determined for patients who had colectomy by including the procedure as a time-dependent variable. RESULTS We identified 4548 patients and matched these to 44 372 controls without colectomy. During a median follow-up of 11.9 years, 1963 patients were hospitalized for gallstone disease. Patients who had a colectomy were at an increased risk (adjusted hazard ratio (HR)=1.63 (1.39-1.91)), and sensitivity analyses of the risk of undergoing cholecystectomy revealed a similar association (adjusted HR=1.55 (1.22-1.98)). An IPAA did not affect the risk of developing gallstones among patients who had a colectomy (adjusted HR=1.03 (0.77-1.37)). CONCLUSION The risk of gallstone disease increases following colectomy for UC.
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Affiliation(s)
- Anders Mark-Christensen
- Department of Surgery, Section of Coloproctology, Aarhus University Hospital, Aarhus C, Denmark
| | - Søren Brandsborg
- Department of Surgery, Section of Coloproctology, Aarhus University Hospital, Aarhus C, Denmark
| | - Søren Laurberg
- Department of Surgery, Section of Coloproctology, Aarhus University Hospital, Aarhus C, Denmark
| | - Niels Johansen
- Department of Surgery, Lillebaelt Hospital, Kolding, Denmark
| | | | - Ole Thorlacius-Ussing
- Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Mie Dilling Kjær
- Department of Surgery A, Odense University Hospital, Odense, Denmark
| | - Niels Qvist
- Department of Surgery A, Odense University Hospital, Odense, Denmark
| | - Louise Preisler
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jens Hillingsø
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Peter Jepsen
- Department of Gastroenterology and Hepatology, Aarhus University Hospital, Aarhus C, Denmark.,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
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Abstract
Aim: To determine the prevalence of cholelithiasis in a Nigerian population. Subjects and Methods: A cross-sectional study of Igbo adult subjects in Nnewi, Nigeria, was conducted from June 2011 to April 2014. A sample of 3501 adult subjects’ gallbladders and associated biliary systems was evaluated by sonography, and the presence or absence of cholelithiasis was documented. The age and anthropometric variables of the subjects were recorded. Results: The subjects (18-92 years) comprised 1731 men (49.4%) and 1770 women (50.6%). Only 4.4% (n = 154) had cholelithiasis. It is more common in women than men, at a ratio of 2.8:1. It is also more common in subjects with a high body mass index. Conclusion: The prevalence of cholelithiasis among the Igbo people in Nnewi is 4.40%, and it is about three times more common in women than men.
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Affiliation(s)
- Charles Ugwoke Eze
- Department of Medical Radiography and Radiological Sciences, Faculty of Health Science and Technology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Emmanuel Emeka Ezugwu
- Department of Radiography and Radiological Sciences, Faculty of Health Science and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Christopher Chukwuemeka Ohagwu
- Department of Radiography and Radiological Sciences, Faculty of Health Science and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
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Łubowska-Pająk E, Kołomecki K. Assessment of Pharmacological Prophylaxis for Acute Pancreatitis Following ERCP in Patients with Choledoholithiasis. Pol Przegl Chir 2017; 87:620-5. [PMID: 26963056 DOI: 10.1515/pjs-2016-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Indexed: 11/15/2022]
Abstract
UNLABELLED Endoscopic retrograde cholangiopancreatography (ERCP) is an effective tool in the diagnostics and treatment of bile duct diseases. Although minimally invasive, the procedure is associated with a risk of complications, with acute pancreatitis being the most serious. In recent years, high hopes have been placed on pharmacological prevention of acute pancreatitis after ERCP. The aim of the study was assessment of the efficacy of low-molecular-weight heparin and somatostatin in combination with diclofenac in the prevention of acute pancreatitis after ERCP. MATERIAL AND METHODS The study enrolled three groups of 30 patients diagnosed with cholelithiasis; group I: patients who received low-molecular-weight heparin prior to ERCP, group II: patients who received somatostatin and diclofenac, group III: control group. The study assessed the incidence of acute pancreatitis, hyperamylasemia and increased CRP levels. RESULTS Acute pancreatitis was observed in 13.3% of group I patients, 10% of group II patients and 16.7% of group III patients (no statistical significance). Hyperamylasemia was observed in 16.7% of group I patients, 16.7% of group II patients and 43.3% of group III patients. These differences were statistically significant. No significant differences were found in the occurrence of increased CRP levels among the study groups. CONCLUSIONS No significant reduction in the occurrence of acute pancreatitis after ERCP was observed in patients who received pharmacological prophylaxis. A significant reduction in the occurrence of hyperamylasemia was found in drug-treated patients.
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European Association for the Study of the Liver (EASL). Electronic address: easloffice@easloffice.eu. EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol 2016; 65:146-81. [PMID: 27085810 DOI: 10.1016/j.jhep.2016.03.005] [Citation(s) in RCA: 255] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 03/09/2016] [Indexed: 02/06/2023]
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Portincasa P, Di Ciaula A, Grattagliano I. Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians. Korean J Fam Med 2016; 37:205-13. [PMID: 27468338 PMCID: PMC4961852 DOI: 10.4082/kjfm.2016.37.4.205] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 02/05/2023] Open
Abstract
Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographical databases were searched. Prospective and retrospective cohort studies and case-controlled studies were analyzed and graded for evidence quality. The epidemiological data confirmed that genetic factors are estimated to account for only approximately 25% of the overall risk of gallstones, while metabolic/environmental factors are at least partially modifiable in stone-free risk groups, and are thus modifiable by primary prevention measures related to diet, lifestyle, and environmental factors (i.e., rapid weight loss, bariatric surgery, somatostatin or analogues therapy, transient gallbladder stasis, and hormone therapy). There is no specific recommendation for the secondary prevention of recurrent gallstones. Family physicians can contribute to preventing gallstones due to their capability to identify and effectively manage several risk factors discussed in this study. Although further studies are needed to better elucidate the involvement of epigenetic factors that may regulate the effect of environment and lifestyle on gene expression in the primary prevention of gallstone formation, preventive interventions are feasible and advisable in the general practice setting.
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Affiliation(s)
- Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari Medical School, Bari, Italy
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Alves KR, Goulart AC, Ladeira RM, Oliveira IRSD, Benseñor IM. Frequency of cholecystectomy and associated sociodemographic and clinical risk factors in the ELSA-Brasil study. SAO PAULO MED J 2016; 134:240-50. [PMID: 27355799 PMCID: PMC10496596 DOI: 10.1590/1516-3180.2015.0250130216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 02/13/2016] [Indexed: 01/01/2023] Open
Abstract
CONTEXT AND OBJECTIVE There are few data in the literature on the frequency of cholecystectomy in Brazil. The frequency of cholecystectomy and associated risk factors were evaluated in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). DESIGN AND SETTING Cross-sectional study using baseline data on 5061 participants in São Paulo. METHODS The frequency of cholecystectomy and associated risk factors were evaluated over the first two years of follow-up of the study and over the course of life. A multivariate regression analysis was presented: odds ratio (OR) and 95% confidence interval (95% CI). RESULTS A total of 4716 individuals (93.2%) with information about cholecystectomy were included. After two years of follow-up, 56 had undergone surgery (1.2%: 1.7% of the women; 0.6% of the men). A total of 188 participants underwent cholecystectomy during their lifetime. The risk factors associated with surgery after the two-year follow-up period were female sex (OR, 2.85; 95% CI, 1.53-5.32), indigenous ethnicity (OR, 2.1; 95% CI, 2.28-15.85) and body mass index (BMI) (OR, 1.10; 95% CI, 1.01-1.19 per 1 kg/m2 increase). The risk factors associated over the lifetime were age (OR, 1.03; 95% CI, 1.02-1.05 per one year increase), diabetes (OR, 1.92; 95% CI, 1.34-2.76) and previous bariatric surgery (OR, 5.37; 95% CI, 1.53-18.82). No association was found with parity or fertile age. CONCLUSION Female sex and high BMI remained as associated risk factors while parity and fertile age lost significance. New factors such as bariatric surgery and indigenous ethnicity have gained importance in this country.
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Affiliation(s)
- Kamila Rafaela Alves
- BSc. Postgraduate Student, Department of Medicine, Education and Health, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Alessandra Carvalho Goulart
- MD, PhD. Clinical Epidemiologist and Researcher, Center for Clinical and Epidemiological Research, University Hospital, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Roberto Marini Ladeira
- MD, PhD. Attending Physician at Hospital Foundation of the State of Minas Gerais, Epidemiologist in the Municipal Health Department of Belo Horizonte, MG, Brazil and Director of the Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil), Belo Horizonte, MG, Brazil
| | - Ilka Regina Souza de Oliveira
- MD, PhD. Professor, Department of Radiology, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Isabela Martins Benseñor
- MD, PhD. Professor, Department of Internal Medicine, and Director of Center for Clinical and Epidemiological Research, University Hospital, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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Espinoza JA, Bizama C, García P, Ferreccio C, Javle M, Miquel JF, Koshiol J, Roa JC. The inflammatory inception of gallbladder cancer. Biochim Biophys Acta Rev Cancer 2016; 1865:245-54. [PMID: 26980625 DOI: 10.1016/j.bbcan.2016.03.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 02/06/2023]
Abstract
Gallbladder cancer is a lethal disease with notable geographical variations worldwide and a predilection towards women. Its main risk factor is prolonged exposure to gallstones, although bacterial infections and other inflammatory conditions are also associated. The recurrent cycles of gallbladder epithelium damage and repair enable a chronic inflammatory environment that promotes progressive morphological impairment through a metaplasia-dysplasia-carcinoma, along with cumulative genome instability. Inactivation of TP53, which is mutated in over 50% of GBC cases, seems to be the earliest and one of the most important carcinogenic pathways involved. Increased cell turnover and oxidative stress promote early alteration of TP53, cell cycle deregulation, apoptosis and replicative senescence. In this review, we will discuss evidence for the role of inflammation in gallbladder carcinogenesis obtained through epidemiological studies, genome-wide association studies, experimental carcinogenesis, morphogenetic studies and comparative studies with other inflammation-driven malignancies. The evidence strongly supports chronic, unresolved inflammation as the main carcinogenic mechanism of gallbladder cancer, regardless of the initial etiologic trigger. Given this central role of inflammation, evaluation of the potential for GBC prevention removing causes of inflammation or using anti-inflammatory drugs in high-risk populations may be warranted.
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Affiliation(s)
- Jaime A Espinoza
- SciLifeLab, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Solna, Stockholm SE171 76, Sweden
| | - Carolina Bizama
- Department of Pathology, Advanced Center for Chronic Diseases (ACCDiS), UC-Center for Investigational Oncology (CITO), School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Patricia García
- Department of Pathology, Advanced Center for Chronic Diseases (ACCDiS), UC-Center for Investigational Oncology (CITO), School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Catterina Ferreccio
- Department of Public Health, Advanced Center for Chronic Diseases (ACCDiS), School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Milind Javle
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Juan F Miquel
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda 20850, MD, USA
| | - Juan C Roa
- Department of Pathology, Advanced Center for Chronic Diseases (ACCDiS), UC-Center for Investigational Oncology (CITO), School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
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Gyedu A, Adae-Aboagye K, Badu-Peprah A. Prevalence of cholelithiasis among persons undergoing abdominal ultrasound at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Afr Health Sci 2015; 15:246-52. [PMID: 25834555 DOI: 10.4314/ahs.v15i1.32] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The prevalence of gallstones among Ghanaians is unknown. We aimed to determine the prevalence of gallstones among persons undergoing abdominal ultrasound at the Komfo Anokye Teaching Hospital (KATH). METHODS We performed a cross-sectional study of patients aged ≥14years presenting to KATH for abdominal ultrasound between 2009 and 2012. Patient demographics were recorded. The gallbladder was assessed by ultrasonography. Cholelithiasis was defined as presence of gallstones or absence of gallbladder. Data was expressed as descriptive and inferential statistics. RESULTS There were 2824 participants. 55% were females. Mean age was 47±18 years. Mean body mass index (BMI) was 24.0±5.5. Mean parity among females was 3±3. Prevalence of cholelithiasis was 5.9 (95%C.I:5.0,6.8). Females had a high prevalence compared to males (6.8 vs 4.7). Prevalence increased steadily by age. Prevalence was 6.6, 5.1 and 8.8 for patients with BMI <18.5, 18.5-24.9 and ≥30 respectively. Prevalence among women with parity of 0,1-5 and >5 was 3.1, 6.7 and 6.4 respectively.On multivariate regression analysis, female sex (AOR=1.55;p<0.05), age≥40 years (AOR=2.05;p<0.01), BMI<18.5 (AOR=1.25;p>0.05) or BMI≥30 (AOR=1.39;p>0.05) and family history of gallstones (AOR=11.9;p<0.01) increased the odds of cholelithiasis. CONCLUSIONS Prevalence of cholelithiasis among patients undergoing ultrasonography at KATH was 5.9. Patient age, sex and family history significantly influenced the prevalence.
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Affiliation(s)
- Adam Gyedu
- Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ; Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
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Klahan S, Kuo CN, Chien SC, Lin YW, Lin CY, Lin CH, Chang WC, Lin CI, Hung KS, Chang WP. Osteoporosis increases subsequent risk of gallstone: a nationwide population-based cohort study in Taiwan. BMC Gastroenterol 2014; 14:192. [PMID: 25404001 PMCID: PMC4247648 DOI: 10.1186/s12876-014-0192-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 10/27/2014] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Osteopontin (OPN) is a pro-inflammatory cytokine which is expressed in various tissues. It participates in the bone remodeling process and stimulates bone resorption by osteoclasts. It is also a core protein of cholesterol gallstones. We hypothesized osteoporotic patients might have higher risk in developing gallstones and conducted a population-based study to examine the risk of developing gallstone in osteoporotic patients in Taiwan. METHODS A total of 1,638 patients diagnosed with osteoporosis between 2003 and 2005 were identified in the National Health Insurance Research Database. A comparison cohort without osteoporosis (n =6,552) was randomly matched to each osteoporosis patient at a ratio of 4: 1 based on age and sex. A Cox proportional-hazards regression analysis was performed to evaluate the 5-year gallstone-free survival rates for the 2 cohorts. RESULTS During the 5-year follow-up period, 114 and 311 cases of gallstone occurred in the osteoporosis and comparison cohorts, respectively. After adjusting for the confounders, the Cox regression analysis of the risk of gallstone in the osteoporosis and comparison cohorts yielded a hazard ratio of 1.35 (95% confidence interval: 1.07 - 1.69; p < 0 .01). CONCLUSION Patients with osteoporosis in Taiwan have a higher risk of developing gallstone than the general population.
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Affiliation(s)
- Sukhontip Klahan
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.
| | - Chun-Nan Kuo
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan. .,Department of Pharmacy, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
| | - Shu-Chen Chien
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan. .,Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan.
| | - Yea-Wen Lin
- Department of Healthcare Management, Yuanpei University of Medical Technology, HsinChu, Taiwan.
| | - Chun-Yi Lin
- Department of Healthcare Management, Yuanpei University of Medical Technology, HsinChu, Taiwan.
| | - Chia-Hsien Lin
- Department of Health Industry Management, Kainan University, Taoyuan, Taiwan.
| | - Wei-Chiao Chang
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan. .,Department of Pharmacy, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan. .,Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan. .,Graduate Institute of Pharmacognosy, Taipei Medical University, Taipei, Taiwan.
| | - Ching-I Lin
- Department of Nutrition and Health Sciences, Kainan University, Taoyuan, Taiwan.
| | - Kuo-Sheng Hung
- Department of Neurosurgery, Clinical Research Center, Graduate Institute of Injury Prevention and Control, Taipei Medical University, Wan Fang Hospital, Taipei, Taiwan. .,Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan. .,Comprehensive Cancer Center of Taipei Medical University, Taipei, Taiwan.
| | - Wei-Pin Chang
- Department of Healthcare Management, Yuanpei University of Medical Technology, HsinChu, Taiwan.
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Abstract
Epidemiological and clinical studies have found that gallstone prevalence is twice as high in women as in men at all ages in every population studied. Hormonal changes occurring during pregnancy put women at higher risk. The incidence rates of biliary sludge (a precursor to gallstones) and gallstones are up to 30 and 12%, respectively, during pregnancy and postpartum, and 1-3% of pregnant women undergo cholecystectomy due to clinical symptoms or complications within the first year postpartum. Increased estrogen levels during pregnancy induce significant metabolic changes in the hepatobiliary system, including the formation of cholesterol-supersaturated bile and sluggish gallbladder motility, two factors enhancing cholelithogenesis. The therapeutic approaches are conservative during pregnancy because of the controversial frequency of biliary disorders. In the majority of pregnant women, biliary sludge and gallstones tend to dissolve spontaneously after parturition. In some situations, however, the conditions persist and require costly therapeutic interventions. When necessary, invasive procedures such as laparoscopic cholecystectomy are relatively well tolerated, preferably during the second trimester of pregnancy or postpartum. Although laparoscopic operation is recommended for its safety, the use of drugs such as ursodeoxycholic acid (UDCA) and the novel lipid-lowering compound, ezetimibe would also be considered. In this paper, we systematically review the incidence and natural history of pregnancy-related biliary sludge and gallstone formation and carefully discuss the molecular mechanisms underlying the lithogenic effect of estrogen on gallstone formation during pregnancy. We also summarize recent progress in the necessary strategies recommended for the prevention and the treatment of gallstones in pregnant women.
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Affiliation(s)
- Ornella de Bari
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, USA
| | - Tony Y Wang
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, USA; Department of Biomedical Engineering, Washington University, St. Louis, USA
| | - Min Liu
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Chang-Nyol Paik
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, USA
| | - Piero Portincasa
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
| | - David Q-H Wang
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, USA
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Simonsen MH, Erichsen R, Frøslev T, Rungby J, Sørensen HT. Postmenopausal estrogen therapy and risk of gallstone disease: a population-based case-control study. Drug Saf 2014; 36:1189-97. [PMID: 24174288 DOI: 10.1007/s40264-013-0118-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Female gender and increasing age are key risk factors for gallstone disease; therefore, postmenopausal women are at high risk. Estrogen increases cholesterol saturation of bile and may further increase gallstone risk, but population-based evidence is sparse. OBJECTIVE Our objective was to examine the association between postmenopausal estrogen therapy and risk of gallstone disease and the impact of duration of treatment and use of opposing progestin. STUDY DESIGN We conducted a population-based case-control study. Cases were postmenopausal women (defined as aged ≥45 years) with gallstone disease identified in the period 1996-2010. For each case, we selected ten population controls matched to cases by age and sex. We defined exposure as any use of estrogen (opposed and unopposed by progestin). Cases/controls were categorized as current estrogen users if their last prescription was redeemed <90 days before gallstone diagnosis (or corresponding date for controls); all other users were categorized as former users. The reference group consisted of cases/controls with no/rare estrogen use. SETTING Medical databases covering the population of Northern Denmark (2.4 million inhabitants through the period 1996-2010). MAIN OUTCOME MEASURE We used conditional logistic regression to compute adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) of gallstone disease in women treated with estrogen. The ORs were adjusted for relevant comorbidity, other drugs known to influence gallstone risk, and parity. RESULTS We identified 16,386 cases with gallstone disease and 163,860 controls. A total of 1,425 cases (8.7 %) and 8,930 controls (5.4 %) were current estrogen users, yielding an adjusted OR for gallstone disease of 1.74 (95 % CI 1.64-1.85) compared with non-users. The corresponding adjusted OR for former users was 1.35 (95 % CI 1.28-1.42). The results suggested a duration response for current users. Use of unopposed estrogen was associated with higher adjusted ORs than estrogen opposed by progestin. CONCLUSION Postmenopausal estrogen therapy was associated with increased risk of gallstone disease in current and former estrogen users. Use of unopposed estrogen was associated with higher risk than use of estrogen opposed by progestin; this finding needs to be confirmed and explored further in future studies.
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Affiliation(s)
- Maja Hellfritzsch Simonsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Oluf Palmes Allé 43-45, 8200, Aarhus N, Denmark,
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Takahashi Y, Yamamichi N, Shimamoto T, Mochizuki S, Fujishiro M, Takeuchi C, Sakaguchi Y, Niimi K, Ono S, Kodashima S, Mitsushima T, Koike K. Helicobacter pylori infection is positively associated with gallstones: a large-scale cross-sectional study in Japan. J Gastroenterol 2014; 49:882-9. [PMID: 23736795 DOI: 10.1007/s00535-013-0832-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 05/01/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND Our aim is to elucidate causative factors for gallstones, especially focusing on Helicobacter pylori (HP) infection. METHODS We analyzed 15,551 Japanese adults who had no history of gastrectomy, cholecystectomy, HP eradication, and didn't use proton pump inhibitors, anti-diabetic drugs, or anti-cholesterol drugs. 1,057 subjects who previously had HP eradication were analyzed separately. RESULTS Gallstones were detected in 409 of 8,625 men (4.74%) and 285 of 6,926 women (4.11%) by ultrasonography. Among the 25 factors univariately analyzed, age, HP infection, alcohol intake, weight, body mass index (BMI), and 14 blood test values (AST, ALT, ALP, γ-GTP, T-Chol, HDL-Chol, LDL-Chol, TG, TP, Hb, HbA1c, pepsinogen I, pepsinogen II, and pepsinogen I/II ratio) displayed significant association with gallstones (p < 0.05), whereas gender, smoking, height, and three blood test values (Alb, T-Bil, MCV) did not. Multivariate analysis showed that age, gender, alcohol intake, BMI, γ-GTP, LDL-Chol, TP, and HP infection had significant association (p < 0.05). Successive multiple logistic regression analysis calculating odds ratio (OR) and standardized coefficients (β) showed that age (OR/β = 1.57/0.450), BMI (OR/β = 1.30/0.264), HP infection (OR/β = 1.51/0.206), lower alcohol intake (OR/β = 1.33/0.144), γ-GTP (OR/β = 1.15/0.139), and pepsinogen I/II ratio (OR/β = 1.08/0.038) have significant positive association with gallstones, whereas gender does not. The gallstone prevalence among HP-negative, HP-eradicated, and HP-positive subjects was 3.81, 4.73 and 6.08%, respectively. The matched analysis controlling age, BMI, γ-GTP, alcohol intake, pepsinogen I/II ratio and gender also demonstrated that gallstone prevalence among HP-eradicated subjects was significantly lower compared with HP-positive subjects (p < 0.05). CONCLUSIONS HP infection is positively associated with gallstones. HP eradication may lead to prevention of gallstones.
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Bertolotti M, Mussi C, Pellegrini E, Magni A, Del Puppo M, Ognibene S, Carulli L, Anzivino C, Baldelli E, Loria P, Carulli N. Age-associated alterations in cholesterol homeostasis: evidence from a cross-sectional study in a Northern Italy population. Clin Interv Aging 2014; 9:425-32. [PMID: 24669190 PMCID: PMC3962317 DOI: 10.2147/cia.s57714] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background The modifications of cholesterol metabolism associated with aging are ill-defined. The objective of this study was to define age-associated alterations of the different metabolic pathways controlling cholesterol homeostasis by analyzing circulating sterols. Methods We analyzed serum samples collected from 201 adult (75 male, 126 female) subjects within the epidemiological MICOL study (Multicentrica Italiana Colelitiasi). The age range was 38–79 years; 103 had evidence of gallstones. The concentrations of the different sterols, recognized as markers of the main pathways of cholesterol homeostasis, were analyzed by gas chromatography-mass spectrometry, including lathosterol (synthesis), campesterol and sitosterol (absorption), and 7α-hydroxy-4-cholesten-3-one (degradation to bile acids). Results A significant direct correlation was detected between age and cholesterol levels (r =0.34, P<0.01). The lathosterol/cholesterol ratio was lower in older age quartiles (P<0.05 by analysis of variance), with an inverse correlation between the lathosterol/cholesterol ratio and age (r=−0.32, P<0.01). Such correlation was particularly evident in females. The campesterol/cholesterol and sitosterol/cholesterol ratios were inversely correlated with aging in control, but not in gallstone patients. The levels of 7α-hydroxy-4-cholesten-3-one were not correlated with age. Conclusion These data show a reduction of cholesterol synthesis with aging which is associated with increased circulating cholesterol levels. The finding might be related to a reduced metabolic need for cholesterol in advancing age, leading to a downregulation of the main mechanisms of cholesterol intake in the liver. A different age-related behavior was observed in gallstone-free versus gallstone patients regarding cholesterol absorption. The possible implications in terms of the pharmacological management of hypercholesterolemia in the elderly remain to be defined.
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Affiliation(s)
- Marco Bertolotti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Mussi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisa Pellegrini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Magni
- Department of Health Sciences, University of Milano Bicocca, Monza, Italy
| | - Marina Del Puppo
- Department of Health Sciences, University of Milano Bicocca, Monza, Italy
| | - Silvia Ognibene
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lucia Carulli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Anzivino
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrica Baldelli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Paola Loria
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Carulli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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