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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Bidirectional associations among gallstone disease, non-alcoholic fatty liver disease, kidney stone disease
Guo-Heng Jiang, Sheng Li, Hong-Yu Li, Lin-Jun Xie, Shi-Yi Li, Zi-Tong Yan, Wen-Qian Yu, Jing Luo, Xuan Bai, Ling-Xi Kong, Yan-Mei Lou, Chi Zhang, Guang-Can Li, Xue-Feng Shan, Min Mao, Xin Wang
Guo-Heng Jiang, Sheng Li, Hong-Yu Li, Lin-Jun Xie, Shi-Yi Li, Zi-Tong Yan, Wen-Qian Yu, Jing Luo, Xuan Bai, Xin Wang, Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Ling-Xi Kong, Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Yan-Mei Lou, Department of Health Management, Beijing Xiaotangshan Hospital, Beijing 102211, China
Chi Zhang, Department of Prevention, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
Guang-Can Li, Department of Pharmacy, The People’s Hospital of Kaizhou District, Chongqing 405400, China
Xue-Feng Shan, Department of Pharmacy, Bishan Hospital of Chongqing Medical University, Chongqing 402760, China
Min Mao, Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Co-first authors: Guo-Heng Jiang and Sheng Li.
Co-corresponding authors: Min Mao and Xin Wang.
Author contributions: Jiang GH, Li S and Li HY contributed equally to this paper. Jiang GH, Li S and Li HY contributed to conceptualization, investigation, writing original draft, and revision; Xie LJ, Li SY and Yan ZT contributed to methodology, assisted in the conceptualization, and contributed to the draft writing; Yu WQ, Luo J and Bai X contributed to software, imaging analysis, and revision; Kong LX, Lou YM, Zhang C, Li GC and Shan XF contributed to the methodology, source, and data curation; Wang X and Mao M review and revise, supervision, validation, data curation, project administration. All authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81802508 and No. 81903398; Chongqing Natural Science Foundation Program, No. CSTC2019JCYJ-MSXMX0466 and No. CSTB2022NSCQ-MSX0206; The Research Start-up Fund for Introduction of Talents of Sichuan University, No. YJ2021112; Medical Youth Innovation Research Project of Sichuan Province, No. Q21016; Natural Science Foundation of Sichuan, No. 2023NSFSC1927; Sichuan Province Central Government Guide Local Science and Technology Development Project, No. 2023ZYD0097; and "From 0 to 1" Innovation Project of Sichuan University, No. 2023SCUH0026.
Institutional review board statement: The study was approved by the Ethics Committee of West China Fourth Hospital, West China School of Public Health, Sichuan University.
Informed consent statement: Informed consent was waived for this study.
Conflict-of-interest statement: The authors have no conflict of interest with the information presented.
Data sharing statement: Not applicable.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xin Wang, PhD, Associate Professor, Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, South Renmin Road, Wuhou District, Chengdu 610041, Sichuan Province, China.
wangxinmarine@126.com
Received: April 21, 2024
Revised: September 2, 2024
Accepted: September 27, 2024
Published online: December 14, 2024
Processing time: 214 Days and 3.6 Hours
BACKGROUND
A body of evidence has suggested bidirectional relationships among gallstone disease (GSD), non-alcoholic fatty liver disease (NAFLD), and kidney stone disease (KSD). However, the results are inconsistent, and studies on this topic in China are relatively few. Our goal is to explore the bidirectional associations among these three diseases through a multicenter study, systematic review, and meta-analysis.
AIM
To explore the bidirectional associations among these three diseases through a multicenter study, systematic review, and meta-analysis. The results may help to investigate the etiology of these diseases and shed light on the individualized prevention of these three diseases.
METHODS
Subjects who participated in physical examinations in Beijing, Tianjin, Chongqing in China were recruited. Multivariable logistic regression was employed to explore the bidirectional relationships among GSD, KSD, and NAFLD. Systematic review and meta-analysis were initiated to confirm the epidemiologic evidence from previous observational studies. Furthermore, trial sequential analysis (TSA) was conducted to evaluate whether the evidence was sufficient and conclusive.
RESULTS
Significant bidirectional associations were detected among the three diseases, independent of potential confounding factors. The pooled results of the systematic review and meta-analysis also corroborated the aforementioned results. The combined evidence from the multicenter study and meta-analysis was significant [pooled odds ratio (OR) = 1.42, 95%CI: 1.16-1.75, KSD → GSD; pooled OR = 1.48, 95%CI: 1.31-1.67, GSD → KSD; pooled OR = 1.31, 95%CI: 1.17-1.47, GSD → NAFLD; pooled OR = 1.37, 95%CI: 1.26-1.50, NAFLD → GSD; pooled OR = 1.28, 95%CI: 1.08-1.51, NAFLD → KSD; pooled OR = 1.21, 95%CI: 1.16-1.25, KSD → NAFLD]. TSA indicated that the evidence was sufficient and conclusive.
CONCLUSION
The present study presents relatively sufficient evidence for the positive bidirectional associations among GSD, KSD, and NAFLD. The results may provide clues for investigating the etiology of these three diseases and offer a guideline for identifying high-risk patients.
Core Tip: Recent reports have suggested significant associations among gallstone disease, non-alcoholic fatty liver disease, and kidney stone disease, but the results were inconsistent. Therefore, we first explored the reciprocal relationships among these three diseases using multicenter cross-sectional studies with a large sample size in the Chinese population. We then comprehensively assessed epidemiologic evidence from conventional observational studies regarding the strengths and the directions of associations among the three diseases using systematic review and meta-analysis. The results may help to investigate the etiology of these diseases and shed light on the individualized prevention of these three diseases.
