A Risk Factor Analysis Of The Relationship Between Gallstone Disease And Non-alcoholic Fatty Liver Disease

Objective:This investigation seeks to explore the link between gallstone disease(GD)and non-alcoholic fatty liver disease(NAFLD)and the elements that can lead to the emergence of gallstone disease,with the aim of furnishing a benchmark for the prevention and treatment of gallstone disease.Method:A retrospective case-control analysis was conducted on 262 patients admitted to the Third Hospital of Shanxi Medical University between April 2021 and June2022 and identified as new cases of cholelithiasis based on imaging reports.270 patients who were admitted to the hospital during the same period and did not have cholelithiasis were used as the control group to compare the general data and laboratory indicators of the two groups.The correlation between gallstone disease and NAFLD,as well as the risk factors for its development,was investigated using a multi-factor logistic regression analysis.All indices with a one-way analysis of P<0.05 were included in the multi-factor analysis.Results:1.Statistically significant differences in the GD group(AST,ALT,ALP,γ-GGT,LDL-c,HDL-c,TC,TBIL,FBG,SCr,BUN)were observed in general data such as age,gender,BMI,smoking history,alcohol consumption history,NAFLD history,hypertension history and laboratory parameters(P <0.05),and these were associated with the emergence of cholelithiasis.2.A statistically significant difference(P <0.05)was found between the GD group and other groups in terms of age,female BMI,smoking history,alcohol consumption history,hypertension,NAFLD,high AST,high ALT,high ALP,highγ-GGT,high LDL-c,high HDL-c,high TC,high TBIL,and high FBG levels,which could be indicative of the development of cholelithiasis.3.A multi-factor logistic regression analysis was conducted to determine if cholelithiasis was present or absent as the dependent variable,with the 16 statistically significant factors from the univariate regression analysis being taken into account as covariates,which showed that age(OR=1.044,95%CI:1.029-1.060,P<0.001),female(OR=1.575,95%CI:1.040-2.385,P=0.032),NAFLD(OR=1.992,95%CI:1.287-3.084,P=0.002),high ALP(OR=3.354,95%CI:1.441-7.804,P=0.005),high γ-GGT(OR=4.352,95%CI:2.443-7.752,P<0.001),high TC(OR=2.701,95%CI:1.665-4.380,P<0.001),and high TBIL(OR=1.809,95%CI:1.111-2.943,P=0.017)all increased the risk of gallstone disease and were independent risk factors for the development of GD.High HDL-c,with a negative correlation(OR=0.296,95%CI:0.185-0.475,P<0.001)to gallstone disease,was an independent protective factor against the onset of GD.4.Logistic regression analysis after stratification by gender suggested that(1)in men,NAFLD was not statistically significant for the development of cholelithiasis(OR=1.502,95%CI:0.887-2.542,P>0.05).The results showed that increasing age,high ALP,high γ-GGT,and high TC were independent risk factors for the development of GD in men,and high HDL-c was an independent protective factor.(2)In women,concomitant NAFLD was an independent risk factor for the development of GD(OR=2.697,95%CI:1.481-4.912),which was statistically significant(P<0.05).In addition to this,increasing age,high γ-GGT,and high TBIL were independent risk factors for the development of GD in women,and high HDL-c was an independent protective factor.5.Logistic regression analysis after stratification by age suggested that(1)NAFLD and cholelithiasis were not statistically significant in those <40 years of age(OR=0.297,95%CI:0.082-1.082,P>0.05).Results indicated that TC and TBIL,both high,were distinct risks for GD in individuals under 40 years of age,while HDL-c,high,was a protective factor.(2)At the age of 40-60 years,concomitant NAFLD was an independent risk factor for the development of GD(OR=3.276,95%CI:1.662-6.457),which was statistically significant(P<0.05).Besides,highγ-GGT,high ALP,and high FBG were independent risk factors for the development of GD in patients aged 40-60 years,and high HDL-c was an independent protective factor.(3)Among those aged 60 years and above,concomitant NAFLD was a statistically significant risk factor for the development of GD(OR=2.435,95%CI:1.206-4.914)(P<0.05).Patients aged 60 and over were identified as having a risk of developing GD due to a history of alcohol consumption,a high γ-GGT,and a high TC,while high HDL-c acted as a protective factor.6.By drawing ROC curve,the γ-GGT index was more valuable in predicting the incidence of GD alone.The area under the curve was 0.711,and the optimal critical value for predicting GD was 41.35IU/L.The combined prediction efficiency of γ-GGT,TC and TBIL was the best,with an AUC of 0.727(95%CI :0.687-0.765,P < 0.001),sensitivity and specificity of 83.7% and 53.82%,respectively.Conclusions:1.The development of cholelithiasis can be attributed to a combination of ageing,female,high ALP,high γ-GGT,high TC,and high TBIL,with high HDL-c acting as an independent protective factor.2.The association between NAFLD and GD is more pronounced in women and in people aged 40-60 years and 60 years or older.Therefore,in daily life this group of people should pay more attention to lifestyle intervention,actively adjust the diet structure,moderate exercise,and at the same time clinical work should improve the imaging diagnosis in early stage,timely detection and prevention of cholelithiasis.3.ALP,γ-GGT,TC and TBIL alone and in combination have certain value in predicting the incidence of GD,and the combined prediction of γ-GGT,TC and TBIL is the best.