The Correlation Between Nonalcoholic Fatty Liver Disease And Gallstone Disease And Their Risk Factors

Background and aimsWith the development of people’s living standards,the accelerated pace of life and the proliferation of Western-style fast food,problems such as overnutrition,irregular diet and lack of exercise are becoming more and more common.At the same time,the incidence of obesity increases.The incidence of nonalcoholic fatty liver disease(NAFLD)and gallstone which are closely related to obesity are also increasing,imposing a huge burden on national health and national finance.Gallstone and NAFLD share common risk factors such as age,obesity,insulin resistance,hypertension,hyperlipidemia,and sedentary lifestyles.There has been some relevant epidemiological investigations about the relationship between NAFLD and gallstone,but the results are still controversial.Therefore,in order to explore the relationship between NAFLD and gallstone and the of their risk factors,we designed this case-control study.Patients and methodsPatients who were hospitalized in our hospital at 2018.12-2019.03 and who underwent the liver and gallbladder ultrasound during hospitalization are our target population.Patients who have viral hepatitis,autoimmune hepatitis,hypothyroidism,major heart and kidney disease(uremia,heart function level 3 or higher),hemolysis,long-term application of drugs(hormone,amiodarone,methotrexate),total parenteral nutrition,tumor,mental disorders are excluded.Patients who are pregnant or drinking a lot(male>140g/week,female>70g/week)are excluded,too.Measure the patient’s fasting height,weight,waist circumference,hip circumference,blood pressure,and ask the patient about the history of diabetes,medication history,smoking history,drinking history,physical activity,family history of fatty liver disease.The following indicators from laboratory examination after admission were recorded:total cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,very low-density lipoprotein,APOA,APOB,APOE,uric acid,fasting blood glucose,glycosylated hemoglobin,C-reaction protein,etc.The relationship between NAFLD/gallstone and continuous variables was analyzed by independent sample T test.The relationship between NAFLD/gallstone and categorical variables was analyzed by chi-square test.Binary logistic regression analysis was performed on valuable factors to obtain the independent risk factors of NAFLD/gallstone.Results1.A total of 343 patients were enrolled in the study,including 190 in the NAFLD group and 146 in the non-NAFLD group.There were 55 patients with gallstone and 283 patients with non-gallstone.2.There was no significant difference in the incidence of gallstone between the NAFLD group and the non-NAFLD group(16.8%VS 15.6%,P>0.05).There was no significant difference in the incidence of NAFLD between the gallstone group and the non-gallstone group(58.2%VS 56.2%,P>0.05).There was no correlation between NAFLD and gallstone.3.The prevalence of diabetes mellitus,long duration of diabetes,glycosylated hemoglobin,body weight,BMI,waist circumference,hip circumference,waist-to-hip ratio,systolic blood pressure,low-density lipoprotein,APOB,and APOE of the NAFLD group were higher than the non-NAFLD group.The difference was statistically significant.(P<0.05).High-density lipoprotein in the NAFLD group was lower than that in the non-NAFLD group,and the difference was statistically significant(P<0.05).Binary logistic regression analysis showed:very low density lipoprotein(OR=4.164,CI=1.727-10.004,P=0.01),family history(OR=5.630,CI=1.176-26.956,P=0.031),diabetes(OR=2.850,1.139-6.065,P=0.007),uric acid(OR=1.007,CI=1.002-1.012,P=0.005),waist circumference(OR=1.072,CI=1.016=1.131.,P=0.011),body weight(OR=1.083,CI=1.031-1.037,P=0.001)were risk factors of NAFLD,and female(OR=0.380,CI=0.165-0.876,P=0.023)was a independent protective factor of NAFLD.4.Draw a ROC curve using VLDL as the test variable and NAFLD as the state variable.The area under the curve is 0.683.5.The age,waist-to-hip ratio,triglyceride,very low density lipoprotein,male and C-reactive protein in gallstone group were higher than those in non-gallstone group(P<0.05).APOA in gallstone group was lower than non-gallstone group.The difference was statistically significant(P<0.05).Binary logistic regression analysis showed that age(P=0.043,CI=1.001-1.065,OR=1.033)was a risk factor for gallstone,and APOA(P=0.004,CI=0.023-0.480,OR=0.105)was a protective factor for gallstone(P=0.006,OR=0.130).Conclusions1.There is no significant correlation between NAFLD and gallstone.2.Diabetes history,family history of fatty liver,high LDL,abdominal obesity,high uric acid,high body weight,and male were the risk factors of NAFLD.3.VLDL can be used as a predictor of NAFLD in the population.4.Age is an independent risk factor of gallstone.5.Inpatients should routinely measure the waist circumference to assess visceral fat,and give advice on a reasonably lifestyle.