PDF
ePub
Citation
Print
Abstract
Obesity is an important health problem in the world and related to many critical diseases, such as diabetes, cardiovascular disease, and metabolic syndrome. Obesity leads to fat infiltration of multiple organs and infiltrated adipose tissue produces many cytokines resulting in the dysfunction of organs such as the gallbladder. In the biliary diseases, obesity and overweight have been known as a major risk factor for gallstones. According to current studies, obesity, insulin resistance, hyperinsulinemia, and metabolic syndrome are related to various gallbladder diseases including gallbladder stones, cholecystitis, gallbladder polyps, and gallbladder cancers. We reviewed further literature on the obesity and gallbladder diseases, in aspects of epidemiology, mechanism, pathology and prevention.
References
1. Popkin BM, Doak CM. The obesity epidemic is a worldwide phenomenon. Nutr Rev. 1998. 56:106–114.
2. Uauy R, Albala C, Kain J. Obesity trends in Latin America: transiting from under- to overweight. J Nutr. 2001. 131:893S–899S.
3. Korean Ministry of Health and Welfare. The Third Korea National Health & Nutrition Examination Survey (KNHANES III). 2005. Seoul: Korea Ministry of Health and Welfare.
4. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003. 348:1625–1638.
5. Wolin KY, Carson K, Colditz GA. Obesity and cancer. Oncologist. 2010. 15:556–565.
6. Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Central adiposity, regional fat distribution, and the risk of cholecystectomy in women. Gut. 2006. 55:708–714.
7. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983. 67:968–977.
8. Ruhl CE, Everhart JE. Relationship of serum leptin concentration and other measures of adiposity with gallbladder disease. Hepatology. 2001. 34:877–883.
9. Bastard JP, Maachi M, Lagathu C, et al. Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw. 2006. 17:4–12.
10. Antuna-Puente B, Feve B, Fellahi S, Bastard JP. Adipokines: the missing link between insulin resistance and obesity. Diabetes Metab. 2008. 34:2–11.
11. Farrell GC, Larter CZ. Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology. 2006. 43:2 Suppl 1. S99–S112.
12. Greenberg AS, Obin MS. Obesity and the role of adipose tissue in inflammation and metabolism. Am J Clin Nutr. 2006. 83:461S–465S.
13. Schaffer JE. Lipotoxicity: when tissues overeat. Curr Opin Lipidol. 2003. 14:281–287.
14. Pou KM, Massaro JM, Hoffmann U, et al. Visceral and subcutaneous adipose tissue volumes are cross-sectionally related to markers of inflammation and oxidative stress: the Framingham Heart Study. Circulation. 2007. 116:1234–1241.
15. You T, Nicklas BJ. Chronic inflammation: role of adipose tissue and modulation by weight loss. Curr Diabetes Rev. 2006. 2:29–37.
16. Nepokroeff CM, Lakshmanan MR, Ness GC, Dugan RE, Porter JW. Regulation of the diurnal rhythm of rat liver beta-hydroxy-beta-methylglutaryl coenzmye A reductase activity by insulin, glucagon, cyclic AMP and hydrocortisone. Arch Biochem Biophys. 1974. 160:387–396.
17. Chait A, Bierman EL, Albers JJ. Low-density lipoprotein receptor activity in cultured human skin fibroblasts. Mechanism of insulin-induced stimulation. J Clin Invest. 1979. 64:1309–1319.
18. Hendel HW, Højgaard L, Andersen T, et al. Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects. Int J Obes Relat Metab Disord. 1998. 22:294–302.
19. Nakeeb A, Comuzzie AG, Al-Azzawi H, Sonnenberg GE, Kissebah AH, Pitt HA. Insulin resistance causes human gallbladder dysmotility. J Gastrointest Surg. 2006. 10:940–948.
20. Tran KQ, Goldblatt MI, Swartz-Basile DA, Svatek C, Nakeeb A, Pitt HA. Diabetes and hyperlipidemia correlate with gallbladder contractility in leptin-related murine obesity. J Gastrointest Surg. 2003. 7:857–862.
21. Al-Azzawi HH, Mathur A, Lu D, Swartz-Basile DA, Nakeeb A, Pitt HA. Resistin-like molecule alpha reduces gallbladder optimal tension. J Gastrointest Surg. 2007. 11:95–100.
22. George J, Baillie J. Biliary and gallbladder dyskinesia. Curr Treat Options Gastroenterol. 2007. 10:322–327.
23. Bennion LJ, Grundy SM. Effects of obesity and caloric intake on biliary lipid metabolism in man. J Clin Invest. 1975. 56:996–1011.
24. Marzio L, Capone F, Neri M, Mezzetti A, De Angelis C, Cuccurullo F. Gallbladder kinetics in obese patients. Effect of a regular meal and low-calorie meal. Dig Dis Sci. 1988. 33:4–9.
25. Carey MC. Pathogenesis of gallstones. Am J Surg. 1993. 165:410–419.
26. Sarles H, Gerolami A, Cros RC. Diet and cholesterol gallstones. A multicenter study. Digestion. 1978. 17:121–127.
27. Sampliner RE, Bennett PH, Comess LJ, Rose FA, Burch TA. Gallbladder disease in pima indians. Demonstration of high prevalence and early onset by cholecystography. N Engl J Med. 1970. 283:1358–1364.
28. Nervi F, Covarrubias C, Bravo P, et al. Influence of legume intake on biliary lipids and cholesterol saturation in young Chilean men. Identification of a dietary risk factor for cholesterol gallstone formation in a highly prevalent area. Gastroenterology. 1989. 96:825–830.
29. Sarles H, Chabert C, Pommeau Y, Save E, Mouret H, Gérolami A. Diet and cholesterol gallstones. A study of 101 patients with cholelithiasis compared to 101 matched controls. Am J Dig Dis. 1969. 14:531–537.
30. Nakayama F, Miyake H. Changing state of gallstone disease in Japan. Composition of the stones and treatment of the condition. Am J Surg. 1970. 120:794–799.
31. Kwon OJ, Park YH, Kim JP. A clinical study of cholelithiasis in Korea. J Korean Surg Soc. 1982. 24:1052–1057.
32. Kim SW, Park YH, Choi JW. Clinical and epidemiological analysis of 10-year experienced 1,719 gallstone patients. Korean J Gastroenterol. 1993. 25:159–167.
33. Park YH, Kim SW, Chang MC, Kim KW, Yun YB. Clinical and epidemiological analysis of 15-year experience of 2,759 patients with gallstone. Korean J Gastroenterol. 1998. 31:100–106.
34. Park YH, Park SJ, Jang JY, et al. Changing patterns of gallstone disease in Korea. World J Surg. 2004. 28:206–210.
35. Nagase M, Hikasa Y, Soloway RD, Tanimura H, Setoyama M, Kato H. Gallstones in Western Japan. Factors affecting the prevalence of intrahepatic gallstones. Gastroenterology. 1980. 78:684–690.
36. Zhu X, Zhang S, Huang Z. The trend of the gallstone disease in China over the past decade. Zhonghua Wai Ke Za Zhi. 1995. 33:652–658.
37. Völzke H, Baumeister SE, Alte D, et al. Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence. Digestion. 2005. 71:97–105.
38. Everhart JE, Yeh F, Lee ET, et al. Prevalence of gallbladder disease in American Indian populations: findings from the Strong Heart Study. Hepatology. 2002. 35:1507–1512.
39. Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep. 2005. 7:132–140.
40. Stampfer MJ, Maclure KM, Colditz GA, Manson JE, Willett WC. Risk of symptomatic gallstones in women with severe obesity. Am J Clin Nutr. 1992. 55:652–658.
41. Schafmayer C, Hartleb J, Tepel J, et al. Predictors of gallstone composition in 1025 symptomatic gallstones from Northern Germany. BMC Gastroenterol. 2006. 6:36.
42. Friedrich N, Völzke H, Hampe J, Lerch MM, Jørgensen T. Known risk factors do not explain disparities in gallstone prevalence between Denmark and northeast Germany. Am J Gastroenterol. 2009. 104:89–95.
43. Sasazuki S, Kono S, Todoroki I, et al. Impaired glucose tolerance, diabetes mellitus, and gallstone disease: an extended study of male self-defense officials in Japan. Eur J Epidemiol. 1999. 15:245–251.
44. Diehl AK. Cholelithiasis and the insulin resistance syndrome. Hepatology. 2000. 31:528–530.
45. Ruhl CE, Everhart JE. Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology. 2000. 31:299–303.
46. Pagliarulo M, Fornari F, Fraquelli M, et al. Gallstone disease and related risk factors in a large cohort of diabetic patients. Dig Liver Dis. 2004. 36:130–134.
47. Shebl FM, Andreotti G, Rashid A, et al. Diabetes in relation to biliary tract cancer and stones: a population-based study in Shanghai, China. Br J Cancer. 2010. 103:115–119.
48. Méndez-Sánchez N, Chavez-Tapia NC, Motola-Kuba D, et al. Metabolic syndrome as a risk factor for gallstone disease. World J Gastroenterol. 2005. 11:1653–1657.
49. Wright D, Sutherland L. Antioxidant supplemention in the treatment of skeletal muscle insulin resistance: potential mechanisms and clinical relevance. Appl Physiol Nutr Metab. 2008. 33:21–31.
50. Portincasa P, Di Ciaula A, vanBerge-Henegouwen GP. Smooth muscle function and dysfunction in gallbladder disease. Curr Gastroenterol Rep. 2004. 6:151–162.
51. Wan YL. Polypoid lesions of the gallbladder. Zhonghua Wai Ke Za Zhi. 1989. 27:450–453. 507
52. Yang HL, Sun YG, Wang Z. Polypoid lesions of the gallbladder: diagnosis and indications for surgery. Br J Surg. 1992. 79:227–229.
53. Lee KF, Wong J, Li JC, Lai PB. Polypoid lesions of the gallbladder. Am J Surg. 2004. 188:186–190.
54. Jørgensen T, Jensen KH. Polyps in the gallbladder. A prevalence study. Scand J Gastroenterol. 1990. 25:281–286.
55. Shinchi K, Kono S, Honjo S, Imanishi K, Hirohata T. Epidemiology of gallbladder polyps: an ultrasonographic study of male self-defense officials in Japan. Scand J Gastroenterol. 1994. 29:7–10.
56. Segawa K, Arisawa T, Niwa Y, et al. Prevalence of gallbladder polyps among apparently healthy Japanese: ultrasonographic study. Am J Gastroenterol. 1992. 87:630–633.
57. Chen CY, Lu CL, Chang FY, Lee SD. Risk factors for gallbladder polyps in the Chinese population. Am J Gastroenterol. 1997. 92:2066–2068.
58. Shim SG, Lee KT, Lee JK, et al. Prevalence and risk factors of gallbladder polyps in health screening subjects. Korean J Med. 1999. 57:1014–1020.
59. Lim SH, Kim DH, Park MJ, et al. Is metabolic syndrome one of the risk factors for gallbladder polyps found by ultrasonography during health screening? Gut Liver. 2007. 1:138–144.
60. Holzbach RT, Marsh M, Tang P. Cholesterolosis: physical-chemical characteristics of human and diet-induced canine lesions. Exp Mol Pathol. 1977. 27:324–338.
61. Tilvis RS, Aro J, Strandberg TE, Lempinen M, Miettinen TA. Lipid composition of bile and gallbladder mucosa in patients with acalculous cholesterolosis. Gastroenterology. 1982. 82:607–615.
62. Goldblatt MI, Swartz-Basile DA, Al-Azzawi HH, Tran KQ, Nakeeb A, Pitt HA. Nonalcoholic Fatty gallbladder disease: the influence of diet in lean and obese mice. J Gastrointest Surg. 2006. 10:193–201.
63. Mathur A, Al-Azzawi HH, Lu D, et al. Steatocholecystitis: the influence of obesity and dietary carbohydrates. J Surg Res. 2008. 147:290–297.
64. Gilloteaux J, Tomasello LM, Elgison DA. Lipid deposits and lipo-mucosomes in human cholecystitis and epithelial metaplasia in chronic cholecystitis. Ultrastruct Pathol. 2003. 27:313–321.
65. Renehan AG, Soerjomataram I, Tyson M, et al. Incident cancer burden attributable to excess body mass index in 30 European countries. Int J Cancer. 2010. 126:692–702.
66. Hsing AW, Sakoda LC, Rashid A, et al. Body size and the risk of biliary tract cancer: a population-based study in China. Br J Cancer. 2008. 99:811–815.
67. Engeland A, Tretli S, Austad G, Bjørge T. Height and body mass index in relation to colorectal and gallbladder cancer in two million Norwegian men and women. Cancer Causes Control. 2005. 16:987–996.
68. Jee SH, Yun JE, Park EJ, et al. Body mass index and cancer risk in Korean men and women. Int J Cancer. 2008. 123:1892–1896.
69. Larsson SC, Wolk A. Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr. 2007. 86:556–565.
70. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008. 371:569–578.
71. Wistuba II, Gazdar AF. Gallbladder cancer: lessons from a rare tumour. Nat Rev Cancer. 2004. 4:695–706.
72. Miller G, Jarnagin WR. Gallbladder carcinoma. Eur J Surg Oncol. 2008. 34:306–312.
73. Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer. 2006. 118:1591–1602.
74. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002. 420:860–867.
75. Kawanishi S, Hiraku Y, Pinlaor S, Ma N. Oxidative and nitrative DNA damage in animals and patients with inflammatory diseases in relation to inflammation-related carcinogenesis. Biol Chem. 2006. 387:365–372.
76. Sawa T, Ohshima H. Nitrative DNA damage in inflammation and its possible role in carcinogenesis. Nitric Oxide. 2006. 14:91–100.
77. Kanoh K, Shimura T, Tsutsumi S, et al. Significance of contracted cholecystitis lesions as high risk for gallbladder carcinogenesis. Cancer Lett. 2001. 169:7–14.
78. Kitasato A, Tajima Y, Kuroki T, et al. Inflammatory cytokines promote inducible nitric oxide synthase-mediated DNA damage in hamster gallbladder epithelial cells. World J Gastroenterol. 2007. 13:6379–6384.
79. Liu B, Balkwill A, Spencer E, Beral V. Million Women Study Collaborators. Relationship between body mass index and length of hospital stay for gallbladder disease. J Public Health (Oxf). 2008. 30:161–166.
80. Amaral JF, Thompson WR. Gallbladder disease in the morbidly obese. Am J Surg. 1985. 149:551–557.
81. Aidonopoulos AP, Papavramidis ST, Zaraboukas TG, Habib HW, Pothoulakis IG. Gallbladder findings after cholecystectomy in morbidly obese patients. Obes Surg. 1994. 4:8–12.
82. Csendes A, Burdiles P, Smok G, Csendes P, Burgos A, Recio M. Histologic findings of gallbladder mucosa in 87 patients with morbid obesity without gallstones compared to 87 control subjects. J Gastrointest Surg. 2003. 7:547–551.
83. Dittrick GW, Thompson JS, Campos D, Bremers D, Sudan D. Gallbladder pathology in morbid obesity. Obes Surg. 2005. 15:238–242.
84. Liew PL, Wang W, Lee YC, Huang MT, Lin YC, Lee WJ. Gallbladder disease among obese patients in Taiwan. Obes Surg. 2007. 17:383–390.
85. Di Ciaula A, Wang DQ, Wang HH, Bonfrate L, Portincasa P. Targets for current pharmacologic therapy in cholesterol gallstone disease. Gastroenterol Clin North Am. 2010. 39:245–264.
86. Lee SK, Kim MH. Updates in the treatment of gallstones. Expert Rev Gastroenterol Hepatol. 2009. 3:649–660.
87. Broomfield PH, Chopra R, Sheinbaum RC, et al. Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight. N Engl J Med. 1988. 319:1567–1572.
88. Wang HH, Portincasa P, Mendez-Sanchez N, Uribe M, Wang DQ. Effect of ezetimibe on the prevention and dissolution of cholesterol gallstones. Gastroenterology. 2008. 134:2101–2110.
89. Zúñiga S, Molina H, Azocar L, et al. Ezetimibe prevents cholesterol gallstone formation in mice. Liver Int. 2008. 28:935–947.
90. Mathur A, Walker JJ, Al-Azzawi HH, et al. Ezetimibe ameliorates cholecystosteatosis. Surgery. 2007. 142:228–233.
91. Jonkers IJ, Smelt AH, Ledeboer M, et al. Gall bladder dysmotility: a risk factor for gall stone formation in hypertriglyceridaemia and reversal on triglyceride lowering therapy by bezafibrate and fish oil. Gut. 2003. 52:109–115.
92. Yago MD, González V, Serrano P, et al. Effect of the type of dietary fat on biliary lipid composition and bile lithogenicity in humans with cholesterol gallstone disease. Nutrition. 2005. 21:339–347.
93. Min YI, Lee SK, Kim MH, et al. A study of the dietary factors in the formation of biliary stones: analysis according to the location and composition of the stones. Korean J Gastroenterol. 1997. 29:805–814.
94. Leitzmann MF, Giovannucci EL, Rimm EB, et al. The relation of physical activity to risk for symptomatic gallstone disease in men. Ann Intern Med. 1998. 128:417–425.
95. Leitzmann MF, Rimm EB, Willett WC, et al. Recreational physical activity and the risk of cholecystectomy in women. N Engl J Med. 1999. 341:777–784.
96. Syngal S, Coakley EH, Willett WC, Byers T, Williamson DF, Colditz GA. Long-term weight patterns and risk for cholecystectomy in women. Ann Intern Med. 1999. 130:471–477.
97. Torgerson JS, Lindroos AK, Näslund I, Peltonen M. Gallstones, gallbladder disease, and pancreatitis: cross-sectional and 2-year data from the Swedish Obese Subjects (SOS) and SOS reference studies. Am J Gastroenterol. 2003. 98:1032–1041.
98. Weinsier RL, Wilson LJ, Lee J. Medically safe rate of weight loss for the treatment of obesity: a guideline based on risk of gallstone formation. Am J Med. 1995. 98:115–117.
99. Vega KJ, Johnston DE. Exercise and the gallbladder. N Engl J Med. 1999. 341:836–837.
XML Download