Title: To Find Incidence of Metabolic Syndrome in Patients with Gallstones  Admitted in Surgery Department

Authors: Bhan A, Chandel UK

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i1.27

Abstract

Background: Gallstone disease (GD) is a common condition worldwide. Gallstone disease (GSD) is a chronic disease that consumes a lot of economic and medical resources. Because of its high prevalence and elevated health costs, it is an important condition for which further research is needed. The aim of this study is to establish if there is an association between the presence of metabolic syndrome and the development of gallstone disease. If the risk factors of GSD can be identified, more interventions can be introduced earlier to prevent the disease.

Methods: A cross sectional study conducted at Indira Gandhi Medical College, Shimla, Himachal Pradesh on a sample size of 100 cases and 100 controls. The Body Mass Index, waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-Cholesterol levels of the patients were tested. National Cholesterol Education Program-Adult Treatment Panel III criteria modified for Asian subjects, was used for estimating the prevalence of Metabolic Syndrome.

Results: 27% of the cases and 15% of the controls were found to have Metabolic Syndrome. Out of the cases found to be affected with Metabolic Syndrome 81.42% were females and 18.52% were males.

Conclusion: Metabolic Syndrome can be considered to be associated with Gallstone disease and can be used as a predictor of Gallstone disease. It can be used as a screening tool.

References

1.      Stern M, Williams K, Gonzalez-Villalpando C et al. Does the metabolic syndrome improve identification of individuals at risk of type 2 diabetes and/or cardiovascular disease? Diabetes Care 2004;27(11):2676-81

2.      Hu G, Qiao Q, Tuomilehto J et al. Plasma insulin and cardiovascular mortality in non-diabetic European men and women: a meta-analysis of data from eleven prospective studies. The DECODE Insulin Study Group. Diabetologia2004;47:1245–56

3.      Carr DB, Utzschneider KM, Hull RL et al. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 2004;53(8):2087-94

4.      Mentes BB, Akin M, Irkörücü O, Tatlicioğlu E, Ferahköşe Z, Yildinm A, Maral I: Gastrointestinal quality of life in patients with symptomatic or asymptomatic cholelithiasis before and after laparoscopic cholecystectomy. SurgEndosc 2001, 15:1267–1272.

5.      Bennion LJ, Grundy SM. Risk factors for the development of cholelithiasis in man (first of two parts). N Engl J Med 1978; 299:1161-7.

6.      Bennion LJ, Grundy SM. Risk factors for the development of cholelithiasis in man (second of two parts). N Engl J Med 1978; 299:1221-7.

7.      Mendez-Sanchez N, Vega H, Uribe M, et al. Risk factors for gallstone disease in Mexicans are similar to those found in Mexican-Americans. Dig Dis Sci 1998; 43:935-9.

8.      Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. Lancet 2006; 368:230-9.

9.      Saad MF, Lillioja S, Nyomba BL et al. Racial differences in the relation between blood pressure and insulin resistance. New England Journal of Medicine 1991; 324:733-9

10.  Anderson PJ, Critchley JAJH, Chan JCN et al. Factor analysis of the metabolic syndrome: obesity vs insulin resistance as the central abnormality. International Journal of Obesity 2001;25:1782

11.  Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. Diabetic Medicine 1999;16:442-3

12.  Nakamura T, Tokunga K, Shimomura I et al. Contribution of visceral fat accumulation to the development of coronary artery disease in non-obese men. Atherosclerosis 1994;107:239-46

13.  The IDF consensus worldwide definition of the Metabolic Syndrome. International Diabetic Federation,2006

14.  Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J ClinEndocrinolMetab 2008; 93(11 Suppl 1):S9-30

15.  Misra A, Vikram NK. Clinical and pathophysiological consequences of abdominal adiposity and abdominal adipose tissue depots. Nutrition 2003; 19(5):457-66. 36.

16.  Avogaro P, Crepaldi G, Enzi G, et al. Associazione di iperlipemia, diabetem-ellito e obesità di mediogrado. ActadiabetolLat1967; 4: 36-41.

17.  Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. Jama 2002; 287: 356-359

18.  Méndez-Sánchez N, Chavez-Tapia NC, Motola-Kuba D, Sanchez-Lara K, Ponciano-Rodríguez G, Baptista H, Ramos MH, Uribe M. Metabolic syndrome as a risk factor for gallstone disease. World J Gastroenterol2005; 11: 1653-1657

19.  Nervi F, Miquel JF, Alvarez M, Ferreccio C, García-Zattera MJ, González R, Pérez-Ayuso RM, Rigotti A, Villarroel L. Gallbladder disease is associated with insulin resistance in a high risk Hispanic population. J Hepatol2006; 45: 299-305

20.  Shaffer EA. Gallstone disease: Epidemiology of gallbladder stone disease. Best Pract Res ClinGastroenterol2006; 20: 981-996

21.  Acalovschi M, Buzas C, Radu C, Grigorescu M. Hepatitis C virus infection is a risk factor for gallstone disease: a prospective hospital-based study of patients with chronic viral C hepatitis. J Viral Hepat2009; 16: 860-866

22.  Smelt AH. Triglycerides and gallstone formation. ClinChimActa2010; 411: 1625-1631

23.  Misra A, Wasir JS, Vikram NK. Waist circumference criteria for the diagnosis of abdominal obesity are not applicable uniformly to all populations and ethnic groups. Nutrition. 2005; 21(9):969-76.

24.  Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112:2735-52.

25.  Gaziano TA, Gaziano TM. Epidemiology of cardiovascular disease. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison's Principles of Internal Medicine. 18 th ed. New York: McGraw-Hill; 2012. p1811-6.  

26.  I-Ching Lin, Yu-Wen Yang, Mei-Feng Wu et al. The association of metabolic syndrome and its factors with gallstone disease. BMC Family Practice 2014, 15:138

27.  N Ata, M Kucukazman, B Yavuz, et al. the metabolic syndrome is associated with complicated gallstone disease. Can J Gastroenterol 2010;25(5):274-276.

28.  Méndez-Sánchez N, Chavez-Tapia NC, Motola-Kuba D, Sanchez- Lara K, Ponciano-Rodríguez G, Baptista H, Ramos MH, Uribe M. Metabolic syndrome as a risk factor for gallstone disease. World J Gastroenterol 2005; 11(11): 1653-1657

29.  Li-Ying Chen et al. Metabolic syndrome and gallstone disease. World J Gastroenterol 2012 August 21; 18(31): 4215-4220

30.  Sreenath et al. Metabolic syndrome among patients with gallstone disease - a strong risk factor for postoperative wound infection after cholecystectomy, a study from northeast India. International Journal of Current Research Vol. 6, Issue, 12, pp.11045-11050, December, 2014

31.  Chang Y, Sung E, Ryu S, Park YW, Jang YM, Park M. Insulin resistance is associated with gallstones even in non-obese, non-diabetic Korean Men. J Korean Med Sci 2008;23:644-50.

32.  Shaffer EA. Epidemiology and risk factors for gallstone disease: Has the paradigm changed in the 21st century? Curr Gastroenterol Rep 2005;7:132-40.

33.  Tazuma S. Gallstone disease: Epide-miology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Pract Res Clin Gastroenterol2006; 20:1075-1083

34.  Völzke H, Baumeister SE, Alte D, Hoffmann W, Schwahn C, Simon P, John U, Lerch MM. Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence. Digestion 2005; 71: 97-105

35.  Lai SW, Muo CH, Liao KF, Sung FC, Chen PC. Risk of acute pancreatitis in type 2 diabetes and risk reduction on antidiabetic drugs: a population-based cohort study in Taiwan. Am J Gastroenterol2011; 106: 1697-1704

36.  Novacek G. Gender and gallstone disease. Wien Med Wochenschr2006; 156: 527-533.

37.  Uhler ML, Marks JW, Voigt BJ, Judd HL .Comparison of the impact of transdermal versus oral estrogens on biliary markers of gallstone formation in postmenopausal women.J ClinEndocrinolMetab. 1998 Feb; 83(2):410-4

Corresponding Author

Bhan A

Final year MBBS Student, Indira Gandhi Medical College Shimla, H.P

Member of IMA-Student’s Wing Research 2015-16

Address: 2737-B, M.I.G. Super Flats, Sector-70 , Mohali, Punjab

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile: 9816816838