Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Fatty liver is an independent risk factor for gallbladder polyps
Dong-Won Ahn, Ji Bong Jeong, Jinwoo Kang, Su Hwan Kim, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, Sohee Oh, Soon Ho Yoon, Sang Joon Park, Doo Hee Lee
Dong-Won Ahn, Ji Bong Jeong, Jinwoo Kang, Su Hwan Kim, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
Dong-Won Ahn, Ji Bong Jeong, Jinwoo Kang, Su Hwan Kim, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
Sohee Oh, Department of Biostatistics, Medical Research Collaborating Center, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
Soon Ho Yoon, Sang Joon Park, Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, South Korea
Doo Hee Lee, Department of Research and Development, MEDICALIP Co. Ltd., Seoul 03127, South Korea
Author contributions: Ahn DW planned and design the study, performed acquisition, analysis, and interpretation of data, drafted the manuscript, made critical revisions related to important intellectual content, and approved the manuscript; Jeong JB planned and design the study, performed acquisition, analysis, and interpretation of data, made critical revisions related to important intellectual content, and approved the manuscript; Kang J and Kim SH performed acquisition, analysis, and interpretation of data; Oh S, Kim JW, Kim BG and Lee KL performed analysis and interpretation of data, made critical revisions related to important intellectual content, and approved the manuscript; Yoon SH performed imaging analysis, reviewed imaging of computed tomography, and finally confirmed the results of the review; Park SJ and Lee DH performed imaging analysis and reviewed imaging of computed tomography.
Institutional review board statement: The study was approved by the Institutional Review Board of Seoul National University Boramae Medical Center (IRB No. 30-2020-054).
Informed consent statement: The subjects in this study were not required to give informed consent due to retrospective nature of the study and utilization of anonymous data utilization.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ji Bong Jeong, MD, PhD, Associate Professor, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 20 Borame-ro 5-gil, Dongjak-gu, Seoul 07061, South Korea. jibjeong@snu.ac.kr
Received: August 11, 2020
Peer-review started: August 11, 2020
First decision: October 18, 2020
Revised: October 28, 2020
Accepted: November 13, 2020
Article in press: November 13, 2020
Published online: November 28, 2020
ARTICLE HIGHLIGHTS
Research background
The incidence of gallbladder polyps (GBPs) has been increasing in recent years. Because some GBPs have malignant potential and the prognosis of advanced gallbladder cancer is poor, it is important to detect GBPs before they reach advanced stages. Abnormal body fat distribution has received a lot of attention in clinical practice as possible risk factor for various adult diseases.
Research motivation
Considering the importance of early detection of GBP, determination of risk factors for GBP might have clinical significance. Although some studies have investigated the relationship between GBP and abnormal body fat distribution, those studies are not sufficient and have produced conflicting results.
Research objectives
In this study, we aimed to determine whether the development of GBP is associated with body fat distribution such as fatty liver, visceral obesity, or sarcopenia.
Research methods
This retrospective cross-sectional study was conducted using data from routine health checkups in a single tertiary center. Based on review of the medical records of subjects who underwent various laboratory tests, body composition measurement, and abdominal ultrasonography, 1405 subjects with GBPs were compared with 2810 age- and sex-matched controls.
Research results
Among the body fat distributions, only the presence of fatty liver was an independent risk factor for GBP [odds ratio (OR) 1.413; 95% confidence interval (CI) 1.218-1.638; P < 0.001). Furthermore, fatty liver showed both independent (OR 1.629; 95%CI, 1.335-1.988; P < 0.001) and dose-dependent (moderate to severe fatty liver; OR 2.137; 95%CI, 1.662-2.749; P < 0.001) relationship with large GBPs (≥ 5 mm). However, visceral obesity and sarcopenia were not significantly associated with GBP.
Research conclusions
Fatty liver was associated with an increased risk of GBP in a dose-dependent manner especially in larger GBPs.
Research perspectives
The results of our study suggest the need of careful assessment of GBP using abdominal ultrasonography in patients with severe fatty liver. Further studies are warranted to validate the results and to explain the pathogenesis of this relationship seen in our study.
