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Sogabe M, Okahisa T, Kagawa M, Kashihara T, Fujmoto S, Kawaguchi T, Yokoyama R, Kagemoto K, Tanaka H, Kida Y, Tomonari T, Sato Y, Nakasono M, Takayama T. Metabolic dysfunction-associated steatotic liver disease and gallbladder polyp development: an observational study. Sci Rep 2024; 14:22446. [PMID: 39341964 PMCID: PMC11439079 DOI: 10.1038/s41598-024-73429-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 09/17/2024] [Indexed: 10/01/2024] Open
Abstract
The influence of metabolic dysfunction-associated steatotic liver disease (MASLD) on gallbladder polyp development in both sexes remains elusive. Therefore, to clarify the role of MASLD in gallbladder polyp development, we investigated the longitudinal association between MASLD and gallbladder polyps. In this observational study, we included 5,527 gallbladder polyp-free patients who underwent > 2 health check-ups over > 2 years. Generalized estimation equations were used to analyze associations between MASLD and gallbladder polyp development according to repeated measures at baseline and the most recent stage. Gallbladder polyp development rates in men and women were 7.5% and 5.6% (p < 0.01), respectively. MASLD was not significantly correlated with gallbladder polyp development. Regarding the association between gallbladder polyp development (men: ≥6 mm and women: ≥5 mm) and the number of MASLD components following lifestyle habits, men and women with ≥ 4 MASLD components had odds ratios of 3.397 (95% confidence interval: 1.096-10.53) and 5.338 (1.054-27.04), respectively. Higher nonalcoholic fatty liver disease fibrosis scores were associated with significant risk of gallbladder polyp development in women (1.991, 1.047-3.785). Although MASLD influence on gallbladder polyp development differs by sex, close monitoring of patients with an increasing number of MASLD components is essential to prevent gallbladder polyp development. Specifically, men with ≥ 4 MASLD components should be monitored for gallbladder polyps measuring ≥ 6 mm.
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Affiliation(s)
- Masahiro Sogabe
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan.
- Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, 2233 Kawanoe-cho, Shikokuchuo, Ehime, 799-0193, Japan.
| | - Toshiya Okahisa
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
- Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, 2233 Kawanoe-cho, Shikokuchuo, Ehime, 799-0193, Japan
| | - Miwako Kagawa
- Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, 2233 Kawanoe-cho, Shikokuchuo, Ehime, 799-0193, Japan
| | - Takanori Kashihara
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
- Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, 2233 Kawanoe-cho, Shikokuchuo, Ehime, 799-0193, Japan
| | - Shota Fujmoto
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Tomoyuki Kawaguchi
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Reiko Yokoyama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Kaizo Kagemoto
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Hironori Tanaka
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Yoshifumi Kida
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Tetsu Tomonari
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Yasushi Sato
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Masahiko Nakasono
- Department of Internal Medicine, Tsurugi Municipal Handa Hospital, 234-1 Nakayabu, Handaaza, Tsurugi-cho, Mimagun, Tokushima, 779-4401, Japan
| | - Tetsuji Takayama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
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Wang K, Xu Q, Xia L, Sun J, Shen K, Liu H, Xu L, Li R. Gallbladder polypoid lesions: Current practices and future prospects. Chin Med J (Engl) 2024; 137:1674-1683. [PMID: 38420780 PMCID: PMC11268823 DOI: 10.1097/cm9.0000000000003019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Indexed: 03/02/2024] Open
Abstract
ABSTRACT Gallbladder polypoid lesions (GPLs) refer to any elevated lesion of the mucosal surface of the gallbladder wall, and the prevalence is estimated to be between 0.9% and 12.1%. GPLs include benign polyps and malignant polyps. Benign polyps are further classified as non-neoplastic polyps and neoplastic polyps. Cholesterol polyps are the most common benign polyps and adenocarcinoma is the main type of malignant polyp. Hepatitis B virus infection, liver function abnormalities, dyslipidemia, and obesity are the main risk factors for GPLs. Studies of biological mechanisms have focused on malignant gallbladder polyps, the development of which is regulated by hormone levels in vivo , gut microbiota, inflammation, oxidative stress, Salmonella typhimurium , and related molecules. Diagnostic modalities include chemical examination and imaging examination, with imaging examination currently being the mainstay. Treatment of patients with GPLs is based on the presence or absence of symptoms, age, size of the polyps, tendency of the polyp to increase, and risk factors for symptomatic malignancy to determine whether surgery should be performed.
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Affiliation(s)
- Kun Wang
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215026, China
| | - Qingpeng Xu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215026, China
| | - Lu Xia
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215026, China
| | - Jianing Sun
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215026, China
| | - Kanger Shen
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215026, China
| | - Haoran Liu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215026, China
| | - Linning Xu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215026, China
| | - Rui Li
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215026, China
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Kwon OS, Kim YK, Kim HJ. Retrospective Study of the Prevalence and Associated Factors of Gallbladder Polyps among Residents of Two Korean Cities. J Clin Med 2024; 13:2290. [PMID: 38673563 PMCID: PMC11051559 DOI: 10.3390/jcm13082290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Aims: Well-known risk factors for gallbladder polyps include metabolic syndrome, age, and dyslipidemia. Jeju Island is approximately 80 km from the Korean peninsula and is divided into two administrative regions (Jeju City and Seogwipo City), with Mount Halla intervening in the center. Jeju City has higher employment and birth rates than Seogwipo City. Age and alcohol consumption differ between the two regions, and these factors may affect the prevalence of gallbladder polyps (GBPs). Therefore, we investigated the prevalence of GBPs and compared various factors, including alcohol consumption habits and age, associated with GBPs among residents in the two regions. Methods: This study included 21,734 residents who visited the Health Screening and Promotion Center of Jeju National University Hospital between January 2009 and December 2019. We investigated the prevalence and associated factors of GBPs among residents of Jeju City and Seogwipo City. Results: The prevalence of GBPs in Jeju City and Seogwipo City was 9.8% and 8.9% (p = 0.043), respectively. The mean age and rate of high-risk alcohol intake were higher in Seogwipo City. The mean body mass index and levels of fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, aspartate aminotransferase, gamma-glutamyl transferase, and alkaline phosphatase were lower in Jeju City. Conclusions: This study demonstrated a significant difference in GBP prevalence between the two regions of Jeju Island. Age and alcohol consumption might contribute to this difference; however, further prospective cohort studies are warranted to confirm our findings.
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Affiliation(s)
- Oh-Sung Kwon
- Department of Medical Information, Jeju National University Hospital, Jeju-si 63241, Republic of Korea;
| | - Young-Kyu Kim
- Department of Surgery, Jeju National University Hospital, Aran 13gil 15, Jeju-si 63241, Republic of Korea
| | - Hyeon Ju Kim
- Department of Family Medicine, Jeju National University Hospital, Aran 13gil 15, Jeju-si 63241, Republic of Korea;
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Jiang X, Zhang B, Lan F, Zhong C, Jin J, Li X, Zhou Q, Li J, Yang N, Wen C, Sun C. Host genetics and gut microbiota jointly regulate blood biochemical indicators in chickens. Appl Microbiol Biotechnol 2023; 107:7601-7620. [PMID: 37792060 PMCID: PMC10656342 DOI: 10.1007/s00253-023-12814-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/14/2023] [Accepted: 09/22/2023] [Indexed: 10/05/2023]
Abstract
Blood biochemical indicators play a crucial role in assessing an individual's overall health status and metabolic function. In this study, we measured five blood biochemical indicators, including total cholesterol (CHOL), low-density lipoprotein cholesterol (LDL-CH), triglycerides (TG), high-density lipoprotein cholesterol (HDL-CH), and blood glucose (BG), as well as 19 growth traits of 206 male chickens. By integrating host whole-genome information and 16S rRNA sequencing of the duodenum, jejunum, ileum, cecum, and feces microbiota, we assessed the contributions of host genetics and gut microbiota to blood biochemical indicators and their interrelationships. Our results demonstrated significant negative phenotypic and genetic correlations (r = - 0.20 ~ - 0.67) between CHOL and LDL-CH with growth traits such as body weight, abdominal fat content, muscle content, and shin circumference. The results of heritability and microbiability indicated that blood biochemical indicators were jointly regulated by host genetics and gut microbiota. Notably, the heritability of HDL-CH was estimated to be 0.24, while the jejunal microbiability for BG and TG reached 0.45 and 0.23. Furthermore, by conducting genome-wide association study (GWAS) with the single-nucleotide polymorphism (SNPs), insertion/deletion (indels), and structural variation (SV), we identified RAP2C, member of the RAS oncogene family (RAP2C), dedicator of cytokinesis 11 (DOCK11), neurotensin (NTS) and BOP1 ribosomal biogenesis factor (BOP1) as regulators of HDL-CH, and glycerophosphodiester phosphodiesterase domain containing 5 (GDPD5), dihydrodiol dehydrogenase (DHDH), and potassium voltage-gated channel interacting protein 1 (KCNIP1) as candidate genes of BG. Moreover, our findings suggest that cecal RF39 and Clostridia_UCG_014 may be linked to the regulation of CHOL, and jejunal Streptococcaceae may be involved in the regulation of TG. Additionally, microbial GWAS results indicated that the presence of gut microbiota was under host genetic regulation. Our findings provide valuable insights into the complex interaction between host genetics and microbiota in shaping the blood biochemical profile of chickens. KEY POINTS: • Multiple candidate genes were identified for the regulation of CHOL, HDL-CH, and BG. • RF39, Clostridia_UCG_014, and Streptococcaceae were implicated in CHOL and TG modulation. • The composition of gut microbiota is influenced by host genetics.
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Affiliation(s)
- Xinwei Jiang
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Boxuan Zhang
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Fangren Lan
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Conghao Zhong
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Jiaming Jin
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Xiaochang Li
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Qianqian Zhou
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Junying Li
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Ning Yang
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Chaoliang Wen
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China.
| | - Congjiao Sun
- Department of Animal Genetics and Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China.
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Kim NH, Kim HJ, Kang JH. Impact of hepatitis B virus infection on the risk of gallbladder polyps: a cohort study. Korean J Intern Med 2023; 38:844-853. [PMID: 37848340 PMCID: PMC10636554 DOI: 10.3904/kjim.2023.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/22/2023] [Accepted: 06/16/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND/AIMS We aimed to determine whether hepatitis B virus (HBV) or hepatitis C virus (HCV) infection remains an important risk factor for gallbladder polyps (GBPs) in the current context of reduced prevalence of these infections. METHODS The cohort included 392,913 asymptomatic adults who underwent abdominal ultrasonography (US). RESULTS The prevalence of GBP sized ≥ 5 mm, ≥ 10 mm, and overall (< 5, 5-9 and ≥ 10 mm) was 2.9%, 0.1%, and 12.8%, respectively. The prevalence of hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis C antibody (anti-HCV) positivity was 3.2%, 26.7%, and 0.1%, respectively. The GBP risk was significantly increased in HBsAg-positive individuals, with an adjusted odds ratio of 1.66 (95% confidence interval, 1.49-1.85) for GBP ≥ 5 mm, 2.39 (1.53-3.75) for GBP ≥ 10 mm, and 1.49 (1.41-1.59) for overall, whereas there was no significant association between anti-HCV positivity and GBP risk. The GBP risk did not increase significantly in individuals who tested negative for HBsAg but positive for HBcAb. CONCLUSION The presence of HBsAg may be an independent risk factor for GBP development in the current context of a indecreasing prevalence of HBsAg positivity. A more comprehensive evaluation of GBP during abdominal US surveillance of HBsAg-positive individuals may be necessary.
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Affiliation(s)
- Nam Hee Kim
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hong Joo Kim
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hun Kang
- Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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Dong C, Xian R, Wang G, Cui L. Small Intestinal Bacterial Overgrowth in Patients with Gallbladder Polyps: A Cross-Sectional Study. Int J Gen Med 2023; 16:813-822. [PMID: 36883124 PMCID: PMC9985880 DOI: 10.2147/ijgm.s399812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/01/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose There is probably a high prevalence of small intestinal bacterial overgrowth (SIBO) in patients with gallbladder polyps (GBPs). To date, no study has evaluated the occurrence of SIBO in patients with GBPs. The aim of this study was to investigate the prevalence of SIBO in patients with GBPs and explore the possible association between these two conditions. Patients and Methods The hydrogen-methane breath test was used to diagnose SIBO, and patients were divided into GBPs and control groups based on whether GBPs were found under ultrasound. Clinical and paraclinical factors were compared between the two groups. Results A total of 297 subjects were included in this study. The prevalence of SIBO was significantly higher in the GBPs group than in the control group (50.0% vs.30.8%, p<0.01). Multivariate logistic regression analysis showed that male (OR=2.26, 95% CI=1.12-4.57, p=0.023), SIBO (OR=3.21, 95% CI=1.69-6.11, p<0.001), fatty liver (OR=2.91, 95% CI= 1.50-5.64, p=0.002) and BMI (OR=1.13, 95% CI=1.01-1.26, p=0.035) were independently associated with GBPs. And by subgroup analysis, we found that the association between SIBO and GBPs was stronger in females than in males (p for interaction< 0.001). In addition, SIBO (OR=5.11, 95% CI=1.42-18.36, p=0.012) and fasting glucose (OR=3.04, 95% CI=1.27-7.28, p=0.013) were found to be associated with solitary polyps. Conclusion SIBO was highly prevalent in patients with GBPs, and this association seemed to be stronger among females.
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Affiliation(s)
- Changhao Dong
- Department of Gastroenterology, School of Medicine, South China University of Technology, Guangzhou, People's Republic of China.,Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, People's Republic of China
| | - Rui Xian
- Department of Gastroenterology, School of Medicine, South China University of Technology, Guangzhou, People's Republic of China.,Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, People's Republic of China
| | - Guangxiang Wang
- Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, People's Republic of China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China
| | - Lihong Cui
- Department of Gastroenterology, School of Medicine, South China University of Technology, Guangzhou, People's Republic of China.,Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, People's Republic of China
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Li Q, Xu S, Yuan Z, Zhang Y, Lu Q, Qian L, Xu J, Song Y, Zhao L, Chen T. Combining polyp diameter and polyp-to-bile ratio by dynamic contrast-enhanced CT scanning can improve the diagnostic specificity of gallbladder neoplastic polyps. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2022. [PMID: 36528866 DOI: 10.1002/jhbp.1300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/28/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aimed to distinguish between cholesterol and neoplastic gallbladder polyps using dynamic contrast-enhanced CT. METHODS The dataset retrospectively comprised 222 cases, including 106 cases of cholesterol polyps and 116 cases of neoplastic polyps (59 adenoma and 57 adenocarcinoma). The perception and Hounsfield units of the polyps and gallbladder bile were assessed by contrast-enhanced CT, and the polyp-to-bile ratio (PBR) was calculated. Receiver operating characteristic (ROC) curves and area under the curve analyses were used to assess the diagnostic value of the diameter and PBR for neoplastic polyps. RESULTS The diameter of cholesterol polyps was significantly smaller than that of neoplastic polyps. The proportion of perceived cholesterol polyps in the plain and arterial phases of CT were significantly lower than those of neoplastic polyps (p < .001). On the contrary, the CT values of gallbladder bile of cholesterol polyps were always significantly higher than those of neoplastic polyps (p < .001). The median PBR values of cholesterol polyps were significantly lower than those of neoplastic polyps (p ≤ .001). ROC analysis showed that diameter and a plain phase PRB had better diagnostic value for neoplastic polyps. Polyp diameter ≥ 11.95 mm and the plain phase PBR ≥1.48 were the optimal cut-off values for diagnosis of neoplastic polyps. Combining a diameter ≥ 12 mm and a PBR in the plain phase ≥1.48 further improved neoplastic polyp diagnostic specificity and positive likelihood ratio (10.453). CONCLUSIONS Polyp-to-bile ratio in contrast-enhanced CT scanning is a new and convenient index for identifying cholesterol and neoplastic gallbladder polyps.
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Affiliation(s)
- Qiwei Li
- Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Sunwang Xu
- Department of Biliary-Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiqing Yuan
- Department of General Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yunhe Zhang
- Department of Critical Care Medicine, Shanghai East Hospital, Tongji University of School Medicine, Shanghai, China
| | - Qing Lu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lijun Qian
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanyan Song
- Department of Biostatistics, Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Zhao
- Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Tao Chen
- Department of Biliary-Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Lin SH, Wu KT, Chiu YC, Wang CC, Chiu KW. Risk factors for gallbladder polyps observed through second-look abdominal sonography in patients with fatty liver disease. Medicine (Baltimore) 2022; 101:e29643. [PMID: 35905261 PMCID: PMC9333503 DOI: 10.1097/md.0000000000029643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 01/10/2023] Open
Abstract
FLD, older age group, and alcohol consumption are major risk factors of GBP formation in Taiwanese population. The presence of GBPs might be revealed in second-look examinations of abdominal sonographies.
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Affiliation(s)
- Shu-Hsien Lin
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kun-Ta Wu
- Division of General Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Yi-Chun Chiu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Chi Wang
- Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Liver Transplantation Centre, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - King-Wah Chiu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Liver Transplantation Centre, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Kwon OS, Kim YK. Are there modifiable risk factors affecting the prevalence of gallbladder polyps or those 5 mm or larger? A retrospective cross-sectional study. Medicine (Baltimore) 2021; 100:e27115. [PMID: 34477153 PMCID: PMC8415951 DOI: 10.1097/md.0000000000027115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/14/2021] [Indexed: 02/07/2023] Open
Abstract
Gallbladder polyps (GBPs), especially GBPs ≥5 mm in diameter, are clinically important because they can progress to gallbladder cancer. The known modifiable risk factors for GBP are obesity, metabolic syndrome, and dyslipidemia; however, there is limited evidence regarding specific modifiable risk factors for GBPs ≥5 mm in diameter. Therefore, this study is aimed to investigate the existence of modifiable risk factors affecting the prevalence of GBPs and GBPs ≥5 mm in diameter in a Korean population.A total of 10,119 subjects who visited a single health-screening center at Jeju National University Hospital between January 2009 and December 2019 was included in this study. Binary logistic analyses were performed to identify risk factors affecting the prevalence of GBPs and GBPs ≥5 mm in diameter.The overall prevalence of GBPs and GBPs ≥5 mm in diameter were 9.0% and 4.1%, respectively. Multivariable analysis identified male gender as an independent risk factor affecting the prevalence of GBPs. Moreover, multivariable analysis revealed age and high-density lipoprotein cholesterol levels as independent risk factors for GBPs ≥5 mm in diameter.This study showed that gender was a risk factor affecting the prevalence of GBPs and that age and high-density lipoprotein-cholesterol levels were risk factors for the presence of GBPs ≥5 mm in diameter. High-density lipoprotein cholesterol levels could be a modifiable risk factor affecting the prevalence of large-diameter GBPs.
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Affiliation(s)
- Oh-Sung Kwon
- Department of Medical Information, Jeju National University Hospital, Jeju-si, Jeju Special Self-Governing Province, Republic of Korea
| | - Young-Kyu Kim
- Department of Surgery, Jeju National University School of Medicine, Aran 13gil 15 (Ara-1Dong) Jeju-si, Jeju Special Self-Governing Province, Republic of Korea
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Deng Z, Xuan Y, Li X, Crawford WJ, Yuan Z, Chen Z, Brooks A, Song Y, Wang H, Liang X, Chen T. Effect of metabolic syndrome components on the risk of malignancy in patients with gallbladder lesions. J Cancer 2021; 12:1531-1537. [PMID: 33531998 PMCID: PMC7847661 DOI: 10.7150/jca.54617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Gallbladder lesions have become more common nowadays. But there is limited evidence-based guidance on surveillance of these patients for malignancy. Predicting malignancy could help clinicians better manage this condition and improve the prognosis. We evaluated the independent and joint effects of metabolic syndrome components on the risk of malignancy among patients with gallbladder lesions. Methods: Using a multicenter database, consecutive patients with pathologically confirmed gallbladder lesions between 2012 and 2019 were identified. Univariate and multivariate logistic regression analyses were used to evaluate the effects of metabolic syndrome components (diabetes, hypertension, dyslipidemia and obesity) as additive or combined indicators for the risk of malignancy. Unadjusted and adjusted odds ratios were calculated. Results: Of the 625 patients, 567 patients were identified with benign gallbladder lesions and 58 patients with gallbladder cancer (GBC). GBC group had less obesity but more dyslipidemia. Among all metabolic syndrome components, only dyslipidemia was significantly associated with GBC (odds ratio 2.674, 95% confidence interval 1.173-6.094). Dyslipidemia was an independent risk factor for malignancy (adjusted odds ratio 2.164, 95% confidence interval 1.165-4.021), regardless of whether the other risk factors and metabolic syndrome components were combined. Patients with decreased high-density lipoprotein had 3.035-fold higher risk of malignancy (adjusted odds ratio 3.035, 95% confidence interval 1.645-5.600). Conclusions: Dyslipidemia is associated with a 2.674-fold increase in the risk of malignancy in patients with gallbladder lesions. Dyslipidemia is an independent risk factor for malignancy, regardless of the presence of the other risk factors and metabolic syndrome components.
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Affiliation(s)
- Zheng Deng
- Department of General Surgery, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 201112, China
| | - Yan Xuan
- Department of Endocrinology, Luwan Branch, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200020, China
| | - Xinxing Li
- Department of Gastroenterological Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.,Department of General Surgery, Changzheng Hospital, The Second Military Medical University, Shanghai, 200003, China
| | - William J Crawford
- Department of Medical Sciences, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Zhiqing Yuan
- Department of General Surgery, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 201112, China
| | - Zhoukan Chen
- Department of General Surgery, Luwan Branch, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200020, China
| | - Anastasia Brooks
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, 4102, Australia.,Gallipoli Medical Research Institute, Greenslopes Private Hospital, Brisbane, QLD, 4120, Australia
| | - Yanyan Song
- Department of biostatistics, clinical research institute, School of Medine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - Haolu Wang
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, 4102, Australia.,Gallipoli Medical Research Institute, Greenslopes Private Hospital, Brisbane, QLD, 4120, Australia
| | - Xiaowen Liang
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, 4102, Australia.,Gallipoli Medical Research Institute, Greenslopes Private Hospital, Brisbane, QLD, 4120, Australia
| | - Tao Chen
- Department of General Surgery, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 201112, China.,Department of Biliary-Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
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11
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Ahn DW, Jeong JB, Kang J, Kim SH, Kim JW, Kim BG, Lee KL, Oh S, Yoon SH, Park SJ, Lee DH. Fatty liver is an independent risk factor for gallbladder polyps. World J Gastroenterol 2020; 26:6979-6992. [PMID: 33311944 PMCID: PMC7701938 DOI: 10.3748/wjg.v26.i44.6979] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/28/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gallbladder polyps (GBPs) are known to be associated with obesity and metabolic diseases. However, to date, the relationship between GBPs and abnormal body fat distribution, such as fatty liver, visceral obesity, or sarcopenia, has not yet been established.
AIM To evaluate whether GBPs are associated with fatty liver, visceral obesity, or sarcopenia.
METHODS We retrospectively reviewed the medical records of subjects who underwent various laboratory tests, body composition measurement with a non-invasive body composition analyzer, and abdominal ultrasonography during health checkups. A total of 1405 subjects with GBPs were compared with 2810 age- and sex-matched controls.
RESULTS The mean age of the subjects was 46.8 ± 11.7 years, and 63.8% were male. According to multiple logistic regression analysis, the presence of fatty liver [odds ratio (OR) 1.413; 95% confidence interval (CI) 1.218-1.638; P < 0.001] was an independent risk factor for GBP, together with low levels of alanine aminotransferase (OR 0.993; 95%CI 0.989-0.996; P < 0.001). Additionally, 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). The presence of sarcopenia and high visceral fat area were not significantly associated with GBPs.
CONCLUSION Fatty liver was found to be closely associated with GBPs irrespective of sarcopenia and visceral obesity.
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Affiliation(s)
- Dong-Won Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Ji Bong Jeong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Jinwoo Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Su Hwan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Ji Won Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Byeong Gwan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Kook Lae Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- 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
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, South Korea
| | - 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
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Analysis of risk factors for gallbladder polyp formation - A retrospective study based on serial ultrasounds. Eur J Gastroenterol Hepatol 2020; 32:1154-1159. [PMID: 32541237 DOI: 10.1097/meg.0000000000001814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM To evaluate gallbladder polyp (GBP) formation related risk factors based on serial ultrasounds (US). METHODS Risk factors related GBP formation were retrospectively investigated among participants, who had US reexamination and interval >180 days in 5 years. After groups were divided based on US, we compared final data and initial data in GBP new incidence group. Then compared the data in GBP new incidence group and GBP(-) group. RESULTS Overall 20 447 participants were recruited, including 18 243 in GBP (-) group and 2204 in GBP group. The mean diameters of polyps were 0.455 ± 0.198 mm in initial and 0.420 ± 0.180 mm in final examination. GBP new incidence group included 797 participants. Percentage of GBP new incidence participants was higher than GBP resolved (36.16% vs. 11.71%). Participants in middle age were more likely have GBP size increase or new incidence, and participants in old age (≥60 years old) were with GBP size decrease or resolved. In GBP new incidence group, participants in final US showed higher FBG, higher LDL, lower HDL, higher ALT and higher AST than initial US. Compared with GBP (-) group and, same risk factors, in addition with age, were shown in GBP new incidence group, Logistic regression analysis show that higher LDL, lower HDL and higher AST were risk factors for GBP formation. CONCLUSION Participants in middle age were more likely to have GBP new incidence. Higher LDL, lower HDL and higher AST were independently risk factors for GBP formation.
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13
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Zhao X, Zheng H, Shan S, Wang K, Zhang M, Xie S, Liu C. Association between the non-HDL-cholesterol-to-HDL-cholesterol ratio and the risk of gallbladder polyp formation among men: a retrospective cohort study. Lipids Health Dis 2020; 19:146. [PMID: 32576257 PMCID: PMC7313103 DOI: 10.1186/s12944-020-01322-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 06/12/2020] [Indexed: 12/30/2022] Open
Abstract
Background Dyslipidaemia and male sex are associated with gallbladder polyp (GBP) formation. However, the potential relation between the non-high-density lipoprotein-cholesterol-to-high-density lipoprotein-cholesterol (non-HDL-c/HDL-c) ratio and GBPs in men is unclear. Methods A total of 1866 eligible subjects were selected for this retrospective cohort study from Wuhan Union Hospital between April 1, 2013, and November 30, 2014. Clinical and laboratory data of subjects were collected. Patients with GBPs or cholecystectomy at baseline, with missing data for baseline lipid profiles, following abdominal ultrasonography or taking lipid-lowering drugs were excluded. The patients were divided into five groups based on their non-HDL-c/HDL-c ratios, and descriptive analyses of the baseline data were performed. A Cox proportional hazards model was applied to estimate the relationship between the non-HDL-c/HDL-c ratio and GBPs. Results After a median follow-up of 1 year, 7.34% (n = 137) of the subjects developed GBPs. Compared with subjects without GBPs, those who developed GBPs after follow-up had significantly higher triglyceride (TG) levels and non-HDL-c/HDL-c ratios. The prevalence of GBPs showed a linearity increment with age, peaked in the 30–39 years group, 40–49 years group and 50–59 years group, and then declined slightly. The results of univariate analysis showed that the non-HDL-c/HDL-c ratio (hazard ratio (HR) = 1.29, 95% confidence interval (CI), 1.05–1.60, P = 0.0159) was positively correlated with GBPs. In the fully adjusted Cox regression model, the HRs were 2.24 for quintile 2 (95% CI: 1.13–4.44, P = 0.0203), 1.50 for quintile 3 (95% CI: 0.73–3.10, P = 0.269), 2.52 for quintile 4 (95% CI: 1.26–5.01, P = 0.0087) and 2.13 for quintile 5 (95% CI: 1.04–4.37, P = 0.0397). No interaction was found among the subgroups. Conclusions A higher non-HDL-c/HDL-c ratio is independently related to a higher risk of GBP formation in Chinese men. Further research is needed to investigate whether this association exists in different regions and races.
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Affiliation(s)
- Xiaofang Zhao
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Huabo Zheng
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shengshuai Shan
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Kun Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Meng Zhang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Songpu Xie
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Chengyun Liu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. .,The First People's Hospital of Jiangxia District, Wuhan City & Union Jiangnan Hospital, HUST, Wuhan, 430200, China.
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14
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Chen CH, Lin CL, Kao CH. The risk of coronary heart disease after diagnosis of gallbladder polyp: a retrospective nationwide population-based cohort study. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:753. [PMID: 32042769 DOI: 10.21037/atm.2019.11.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background To assess the subsequent risk of coronary heart disease (CHD) after the diagnosis of gallbladder polyp (GP). Methods We identified 2,815 GP patients aged ≥20 years from the Longitudinal Health Insurance Database between 2000 and 2011 and followed up the patients until the occurrence of CHD or the end of 2011, the patient would be censored in the occurrence of death, missed information, or withdrawal from the NHI. We selected 11,260 non-GP subjects by 4:1 randomly matching with the case cohort according to age, sex, and index date of GP diagnosis. Results GP cohort had greater risk of CHD than the control cohort [11.1 vs. 8.07 per 1,000 person-y, adjusted HR (aHR) of 1.28, 95% confidence interval (CI), 1.07-1.53] after adjusting age, sex, hypertension, diabetes, hyperlipidemia, gallstone, chronic obstructive pulmonary disease, and arrhythmia. The risk of CHD was significantly higher in the non-cholecystectomy cohort of GP patients than that in the non-GP cohort (10.9 vs. 8.07 per 1,000 person-y; aHR =1.28; 95% CI, 1.06-1.55). However, the risk of CHD contributed by GP was not significant after cholecystectomy (12.3 vs. 8.07 per 1,000 person-y; aHR =1.24; 95% CI, 0.83-1.85). Compared with the non-GP cohort without hypertension, the risk of CHD increased for GP cohort without (aHR =1.48; 95% CI, 1.18-1.87) or with hypertension (aHR =3.00; 95% CI, 2.30-3.92). Compared with the non-GP cohort without diabetes, the risk of CHD increased for GP cohort without diabetes (aHR =1.46; 95% CI, 1.21-1.76) or with diabetes (aHR =2.07; 95% CI, 1.35-3.18). Compared with the non-GP cohort without hyperlipidemia, the risk of CHD increased for GP cohort without (aHR =1.37; 95% CI, 1.10-1.70) or with hyperlipidemia (aHR =2.63; 95% CI, 2.01-3.44). Compared with the non-GP cohort without arrhythmia, the risk of CHD for GP patients increased without (aHR =1.40; 95% CI, 1.17-1.69) or with arrhythmia (aHR =2.88; 95% CI, 1.82-4.57). Conclusions GP is associated with increased risk of developing CHD, and the risk increases with the presence of coexisting hypertension, diabetes, hyperlipidemia, or arrhythmia.
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Affiliation(s)
- Chien-Hua Chen
- Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang Township, Changhua.,Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua.,Department of Food Science and Technology, Hungkuang University, Taichung
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung.,College of Medicine, College of Medicine, China Medical University, Taichung
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung.,Department of Nuclear Medicine and PET Center, and Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung
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15
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Abstract
OBJECTIVE Unlike adults, gallbladder polyps (GPs) are rare in childhood. The aim of this study was to evaluate patients with a GP diagnosis. METHODS Patients who were diagnosed with GP via ultrasonography from October 2012 to October 2017 were retrospectively evaluated in terms of sociodemographic characteristics and laboratory findings. RESULTS The study included 19 patients diagnosed with GP and followed up in our department. The patients comprised 14 (73.6%) girls with a mean age of 13.9 ± 4.1 years and a mean follow-up period of 10.2 ± 5.4 months (range, 3-26 months). The most common presenting symptom of the patients (n = 15, 78.9%) for ultrasonography was abdominal pain without biliary symptoms. Location of the polyps was in the corpus in 55% of patients, and either in the fundus (20%) or the neck of the gallbladder (25%). The average diameter of the polyps was 4.5 ± 1.6 mm (range, 2-9 mm). Multiple polyps were observed in 3 patients. No significant change in the number or size of polyps was noted at the end of the follow-up periods. Cholecystectomy was applied to 1 patient who had >5 polyps with a rapid increase in size, and the pathology report was hamartomatous polyp. There was no remarkable change in the clinical or laboratory findings of other patients during the follow-up period. CONCLUSION In this study, GPs could be seen in young children as young as 16 months of age and ultrasonography is sufficient for follow-up in stable and asymptomatic patients.
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16
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Sun Y, Yang Z, Lan X, Tan H. Neoplastic polyps in gallbladder: a retrospective study to determine risk factors and treatment strategy for gallbladder polyps. Hepatobiliary Surg Nutr 2019; 8:219-227. [PMID: 31245402 DOI: 10.21037/hbsn.2018.12.15] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Preoperative differentiation of malignant and premalignant gallbladder polyps (GBPs) from benign lesions is a key imperative to guide treatment decision-making. We aimed to characterize the various types of GBPs and sought to identify the risk factors for neoplastic polyps. Our findings may help optimize treatment strategy. Methods Retrospective analysis of 686 patients with post-cholecystectomy pathologically-proven GBPs between January 2003 and December 2016. The patients were classified into non-neoplastic polyp group, benign neoplastic polyp group, and adenoma canceration group. Clinical features, ultrasound findings, and results of laboratory investigations and histopathological examination were reviewed and compared between the groups. Results Out of 686 patients, 542 (79.0%) had non-neoplastic polyps, 134 (19.5%) had neoplastic polyps, and 10 (1.5%) had adenoma canceration. The mean age was 46.06±12.12 years; 383 (55.8%) patients were female. The median (25th percentile, 75th percentile) time between diagnosis and surgery in the cholesterol polyp group [24 (3.5, 60) months] was significantly longer than that in adenoma [12 (2, 60) months] and adenoma canceration [5 (0.475, 12) months] groups. The mean diameter was 1.14±0.61 cm (range, 0.5-8.4 cm). Three hundred twelve (45.5%) patients had solitary polyps and intralesional blood flow was observed in 41 (6.0%) patients. On univariate analysis, age >49.5 years, polyp size >1.15 cm, solitary polyp, intralesional blood flow, absence of symptoms, and lack of cholecystitis showed a significant association with adenoma. On multivariate analysis, polyp size (>1.15 cm), intralesional blood flow, and lack of cholecystitis were independent predictors of adenoma. Conclusions Polyp size >1.15 cm, intralesional blood flow, and lack of cholecystitis were predictors of neoplastic polyps. Malignant transformation of adenoma may occur over a relatively short time.
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Affiliation(s)
- Yongliang Sun
- Department of General Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Zhiying Yang
- Department of General Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Xu Lan
- Department of Comprehensive Internal Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Haidong Tan
- Department of General Surgery, China-Japan Friendship Hospital, Beijing 100029, China
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Yamin Z, Xuesong B, Guibin Y, Liwei L, Fei L. Risk factors of gallbladder polyps formation in East Asian population: A meta-analysis and systematic review. Asian J Surg 2019; 43:52-59. [PMID: 31109764 DOI: 10.1016/j.asjsur.2019.03.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 02/21/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023] Open
Abstract
To perform Meta-analysis to identify risk factors associated with gallbladder polyps (GBP) formation in east Asian population. Three English electronic bibliographic databases includes PubMed, Embase and Medline, with reviewed researches from 1986 to 2017. All possible risk factors of GBP formation were recorded. Meta-analyses were performed by Review Manager Software. Pooled odds ratios (OR) or the mean difference (MD) were used to determine risk factors. Sixteen studies and 227021 people were recruited, including 17261 people with GBP and 209760 without GBP. For categorical variables evaluated by OR test., risk factors of GBP formation were male gender (OR, 1.63; 95%CI, 1.42-1.87) and positive HBsAg. GBP formation were not correlated with age <50 years old, hypertension, DM, BMI ≥ 25kg/m2, smoking, drinking, HDL decrease, TC increase, TG increase, fatty liver and GBS. For continuous variables evaluated by MD test, risk factors of GBP formation were DBP (MD, 1.08; 95%CI, 0.15-2.02), mean BMI (MD,0.19; 95%CI,0.02-0.35), waist circumference (MD,1.780; 95%CI, 0.17,3.40), mean LDL (MD,0.89; 95%CI,0.03-1.75), mean HDL (MD,-1.87; 95%CI,-3.21 to -0.52). GBP formation were not correlated with mean age, SBP, mean TC, mean TG, ASL and ALT. In conclusion, risk factors of gallbladder polyp formation included male gender, higher BMI, higher waist circumference, higher DBP, higher LDL, lower HDL and positive HBsAg in east Asian population. GBP formation was not correlated with age, hypertension, DM, smoking, drinking, fatty liver, GBS, TC, TG, SBP, ASL and ALT. The mechanism of Dyslipidemias causing GBP needs deeper study in future.
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Affiliation(s)
- Zheng Yamin
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Bai Xuesong
- Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, Beijing, China
| | - Yao Guibin
- Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, Beijing, China
| | - Liu Liwei
- Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, Beijing, China
| | - Li Fei
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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18
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Heitz L, Kratzer W, Gräter T, Schmidberger J. Gallbladder polyps - a follow-up study after 11 years. BMC Gastroenterol 2019; 19:42. [PMID: 30885181 PMCID: PMC6423886 DOI: 10.1186/s12876-019-0959-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 03/07/2019] [Indexed: 12/16/2022] Open
Abstract
Background The aim of our study was to investigate the prevalence and natural long-term progression of gallbladder polyps in a random sample of the general population. Methods Four hundred and thirteen subjects (190 women, 223 men; aged 29–75 years) were studied first in 2002 and again eleven years later in 2013. All subjects were interviewed using a standardised questionnaire, anthropometric data were recorded, and an abdominal ultrasound scan was carried out. Results The prevalence of gallbladder polyps was 6.1% (115/1880) in the 2002 study and 12.1% (50/413) in the 2013 follow-up study. After eleven years, 36 subjects (8.7%, 36/413) had developed new polyps, thirteen subjects (48.1%, 13/27) no longer had gallbladder polyps, and 14 subjects (51.9%, 14/27) still had polyps. The number of polyps had increased in six of these subjects (43%, 6/14), decreased in a further six (43%, 6/14), and remained unchanged in two (14%, 2/14). The mean polyp size was 4.7 mm (± 2.2 mm, range 2–20 mm) in 2002 and 4.0 mm (± 1.9 mm, range 0.5–11 mm) at follow-up. A decrease in polyp size was noted in seven (50%) of the 14 subjects, an increase in size in five subjects (35.7%), and no change in two subjects (14.3%). The shape of the polyps had changed from pedunculated to sessile in two subjects (14.3%, 2/14) and from sessile to pedunculated in one subject (7.1%, 1/14). Conclusions In long-term follow-up, the prevalence of gallbladder polyps increased, with new lesions developing in 8.7% of the population. Polyps persisted in 51.9% of the subjects who had them in the original study and disappeared in the other 48.1%.
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Affiliation(s)
- Linda Heitz
- Centre for Internal Medicine, Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Wolfgang Kratzer
- Centre for Internal Medicine, Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
| | - Tilmann Gräter
- Department of Diagnostic and Interventional Radiology, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Julian Schmidberger
- Centre for Internal Medicine, Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
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19
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Yamin Z, Xuesong B, Zhen Z, Yue H, Liwei L, Fei L. Correlation of dyslipidemias and gallbladder polyps-A large retrospective study among Chinese population. Asian J Surg 2019; 43:181-185. [PMID: 30879905 DOI: 10.1016/j.asjsur.2019.01.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/14/2019] [Accepted: 01/24/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Aim to explore the association of dyslipidemias with GBP prevalence, number and size in a large Chinese population in Beijing. Dyslipidemias include hypercholesterolemia, hypertriglyceridemia, increased low density lipoprotein (LDL) and decreased high density lipoproteins (HDL). METHODS Prevalence of GBP and its association with dyslipidemias were retrospectively investigated among subjects who underwent check-up at Health Screening Center of Xuanwu Hospital between January 2014 and December 2017. RESULTS This study enrolled 97117 participants. Prevalence of GBP was 7.3%. There were significant differences in increased LDL (595/7107 vs 6004/90010, P = 0.000) and increased cholesterol (TC) (403/7107 vs 4846/90010,P = 0.000) between GBP group and control group, but not in decreased HDL and increased triglyceride (TG). Logistic regression analysis showed that gender, age, BMI, SBP, DBP and LDL were independently associated with GBP. People with increases LDL had 1.488 times higher risk for GBP formation. Trend of dyslipidemias prevalence change according to age was similar with that of GBP. Increased LDL group had higher GBP prevalence rate (9.0% vs 7.2%, p = 0.000), multiple GBP proportion (2.9% vs 2.2%, p = 0.000) and large polyps with diameter ≥ 5 mm proportion (3.7% vs 2.6%,p = 0.000). Comparing with control group, there was higher proportion of large polyps in Increased TC group (3.2% vs 2.7%, p = 0.019) and decreased HDL group (3.0% vs 2.6%,p = 0.028). Increased TG group had not difference with its control group in GBP prevalence, number or size. CONCLUSION Dyslipidemias is associated with GBP formation. Dyslipidemias change according to age is consistent with GBP prevalence. Increased LDL was a more related risk factor rather than decreased HDL, increased TC or TG.
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Affiliation(s)
- Zheng Yamin
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Bai Xuesong
- Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, Beijing, China.
| | - Zhou Zhen
- School of Biomedical Engineering, Capital Medical University, Beijing, China.
| | - Huang Yue
- Information Center of Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Liu Liwei
- Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, Beijing, China.
| | - Li Fei
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
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Liu HW, Chen CY. Ovo-lactovegetarian diet as a possible protective factor against gallbladder polyps in Taiwan: A cross-sectional study. Tzu Chi Med J 2019; 31:29-34. [PMID: 30692829 PMCID: PMC6334569 DOI: 10.4103/tcmj.tcmj_16_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/01/2017] [Accepted: 11/14/2017] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Gallbladder polyps (GBPs) are an increasingly common incidental finding and 3% to 8% of GBPs become malignant. A poor prognosis is expected in patients with gallbladder cancer. No studies have considered the relationship between diet and the development of GBPs in the Taiwanese population. The objective of this study was to investigate whether a vegetarian diet protects against GBP development. MATERIALS AND METHODS This cross-sectional study included 11,717 individuals who received a health checkup at Taipei Tzu Chi Hospital (New Taipei City, Taiwan) between October 2011 and October 2016. All individuals completed questionnaires that collected data about their characteristics, dietary patterns, and lifestyle. Physical examinations were conducted, and blood chemistry tests were performed. The presence of GBPs was determined using ultrasonography. We subsequently evaluated the association between diet and GBP prevalence using multivariate analysis. RESULTS The prevalence of GBPs for the entire group was 8.3%. GBPs were significantly less common in the vegetarian groups (vegans 9.0%, ovo-lacto vegetarians 7.5%, and semi-vegetarians 7.2%) compared with the omnivore group (9.6%) (P = 0.002). Step-wise logistic regression revealed that an ovo-lacto vegetarian diet was a possible protective factor (odds ratio = 0.83, P = 0.015). CONCLUSIONS The study findings showed a strong negative association between an ovo-lacto vegetarian diet and GBP occurrence.
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Affiliation(s)
- Hao-Wen Liu
- Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Cheng-Yu Chen
- Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
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Wu T, Sun Z, Jiang Y, Yu J, Chang C, Dong X, Yan S. Strategy for discriminating cholesterol and premalignancy in polypoid lesions of the gallbladder: a single-centre, retrospective cohort study. ANZ J Surg 2018; 89:388-392. [PMID: 30497105 DOI: 10.1111/ans.14961] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/09/2018] [Accepted: 10/18/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND The present study aimed to assess the risk factors of cholesterol and premalignancy in polypoid lesions of the gallbladder (PLGs) and to establish an appropriate treatment strategy. METHODS Data from patients who underwent cholecystectomy at the First Affiliated Hospital, School of Medicine, Zhejiang University, between January 2011 and July 2017, were collected retrospectively. RESULTS A total of 1561 patients were included in the present study. The cohort comprised of 636 (40.7%) males and 925 (59.3%) females, with a mean age of 49.5 (range 16-88) years; 65.6% (1024/1561) demonstrated cholesterol lesions in this cohort, among which cholesterol polyps accounted for 81.0%. Age younger than 50 years and multiple number of polyps were found to be independent predictive variables for cholesterol lesions (odds ratio (OR) 3.461, 95% confidence interval (CI) 2.058-5.820, P < 0.001 and OR 3.321, 95% CI 1.988-5.547, P < 0.001, respectively). The presence of polyp growth was associated with premalignancy (OR 5.366, 95% CI 1.466-19.637, P = 0.011), and the presence of clinical symptoms indicated benign non-cholesterol lesions (OR 0.368, 95% CI 0.153-0.885, P = 0.026). CONCLUSION In the case of patients ≥50 years old with single asymptomatic polyp, cholecystectomy was recommended if the polyp presented growth at a rate above 3-4 mm within 6 months. If not, trimonthly ultrasound follow up was recommended, and clinicians should carefully assess the risk factors for premalignancy in PLGs.
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Affiliation(s)
- Tianchun Wu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China.,State Key Laboratory and Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhongquan Sun
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China.,State Key Laboratory and Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuancong Jiang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China.,State Key Laboratory and Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinbei Yu
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chengdong Chang
- Department of Pathology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaogang Dong
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Xinjiang, China
| | - Sheng Yan
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China.,State Key Laboratory and Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Metabolic status and lifestyle factors associated with gallbladder polyps: a covariance structure analysis. BMC Gastroenterol 2018; 18:159. [PMID: 30382815 PMCID: PMC6211420 DOI: 10.1186/s12876-018-0882-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/11/2018] [Indexed: 02/06/2023] Open
Abstract
Background Gallbladder Polyps (GBP) are highly prevalent in China; however, the etiology of GBP has not been clearly defined. This study explored the associations between lifestyle factors and GBP and whether it mediated by metabolic factors or not. Methods A total of 487 newly diagnosed GBP cases and 502 healthy controls were involved in this study. A questionnaire was used to investigate the socio-demographic characteristics and lifestyle factors. Food Intake Frequencies Questionnaire was used to obtain the food intake frequencies of seven food categories. Blood was tested for lipid profiles, fasting blood glucose and blood urine acid. A Covariance Structure Analysis was used in the analysis to explore the possible pathways between socio-demographic characteristics, lifestyle factors, metabolic factor and GBP. Results The Covariance Structure Analysis showed that a higher BMI and elevated triglyceride level mediated the association between age and GBP. Lifestyle factors (smoking and drinking) and higher intake frequencies of fatty food (meat and viscera) also linked to higher BMI and higher triglyceride level, respectively, which were associated with GBP. Conclusion In conclusion, age and lifestyle factors might be indirectly related with GBP through BMI and the triglyceride pathway.
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Gallbladder Polypoid-Lesions: What Are They and How Should They be Treated? A Single-Center Experience Based on 1446 Cholecystectomy Patients. J Gastrointest Surg 2017; 21:1804-1812. [PMID: 28695432 DOI: 10.1007/s11605-017-3476-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 06/12/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIM Gallbladder polypoid-lesions (GPs) are commonly seen on ultrasonography (USG), but several aspects of this problem are ill-defined. This study aimed to analyze clinic and pathologic characteristics of 1446 USG-detected GPs, identify predictive factors for cholesterol lesions and malignancy, and provide comments and recommendations on specific aspects of GPs. METHODS We retrospectively analyzed clinic files of 1446 patients who underwent cholecystectomy for USG-detected GPs between 2008 and 2015 in Gallbladder Diseases Center, East Hospital of Tongji University. RESULTS For the 1446 patients, the F: M ratio and the mean age were 1.06: 1 and 45 years, and most of them were asymptotic (80.3%) and had multiple polyps (62.5%). All the 1446 GPs were classified into three categories: cholesterol, benign non-cholesterol, and malignant lesions, with respective proportion of 87.1% (1260), 11.2% (162), and 1.7% (24). Over half of benign non-cholesterol lesions, of which most were premalignant neoplasm (adenoma), were less than 10 mm. Multiple number and the presence of lipid abnormalities were significantly more associated with cholesterol than non-cholesterol lesions, with odd ratios (OR) of 2.9 (P < 0.001) and 1.6 (P = 0.023), respectively. Age ≥50 years, present symptoms, size ≥10 mm and concurrent gallstones were independent predictive factors to discriminate malignant polyps from premalignant lesions, with ORs of 16.5 (P < 0.001), 6.3 (P = 0.013), 41.5 (P = 0.014), and 18.0 (P = 0.002), respectively. CONCLUSIONS According to our proposed classification, the vast majority of GPs were cholesterol lesions without malignant potential and associating with metabolic diseases. We strongly recommend that risk factors of GPs be investigated by subtypes, and patients with GPs be treated with personalized and differentiated strategies.
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Xu A, Hu H. The gallbladder polypoid-lesions conundrum: moving forward with controversy by looking back. Expert Rev Gastroenterol Hepatol 2017; 11:1071-1080. [PMID: 28837358 DOI: 10.1080/17474124.2017.1372188] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Gallbladder polypoid-lesions (GPs) are found in 5-10% of the general population. Although the majority of GPs are asymptomatic and benign in nature, some of them can develop into cancer, which carries a poor prognosis. Currently, the risk factors, natural history and classification of GPs remain unclear, differentiation of benign from malignant or premalignant GPs based on available diagnostic modalities and/or features of patients and GPs remain difficult, and there are still no evidence-based guidelines to dictate when and how GPs of varying sizes and subtypes should be managed. All of these facts have left GPs in uncertainty. Areas covered: A literature search was performed using the terms 'gallbladder polyps' AND 'polypoid lesion of gallbladder' in the PubMed database from January 2000 to September 2016. Original and review articles on almost all aspects of GPs in humans, especially diagnosis, treatment and surveillance, were reviewed and analyzed. Reference lists of reviews and original articles were also examined for relevant publications. Expert commentary: The present article summarizes almost all aspects of GPs, analyzes the controversies, and outlines our data and comments. It is the authors' purpose that this article be beneficial for scientific, accurate and appropriate management of GPs.
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Affiliation(s)
- Anan Xu
- a Gallbladder Diseases Center , East Hospital of Tongji University , Shanghai , China
| | - Hai Hu
- a Gallbladder Diseases Center , East Hospital of Tongji University , Shanghai , China
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25
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Correlations Between Serum Apolipoprotein A-I and Formation of Vocal Cord Polyp. J Voice 2017; 31:380.e1-380.e6. [DOI: 10.1016/j.jvoice.2016.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 11/17/2022]
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Abstract
The article provides an overview of current views on the involvement of the liver, gallbladder, and pancreas in patients with overweight and obesity. It considers the general issues of the pathogenesis of these conditions, their clinical features and diagnostic methods.
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Lee JK, Hahn SJ, Kang HW, Jung JG, Choi HS, Lee JH, Han IW, Jung JH, Kwon JH. Visceral Obesity Is Associated with Gallbladder Polyps. Gut Liver 2016; 10:133-9. [PMID: 26260756 PMCID: PMC4694745 DOI: 10.5009/gnl14506] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background/Aims Gallbladder polyps (GBP) are a common clinical finding and may possess malignant potential. We conducted this study to determine whether visceral obesity is a risk factor for GBP. Methods We retrospectively reviewed records of subjects who received both ultrasonography and computed tomography with measurements of the areas of visceral adipose tissue and total adipose tissue (TAT) on the same day as health checkups. Results Ninety-three of 1,615 subjects (5.8%) had GBP and were compared with 186 age- and sex-matched controls. VAT (odds ratio [OR], 2.941; 95% confidence interval [CI], 1.325 to 6.529; p=0.008 for the highest quartile vs the lowest quartile) and TAT (OR, 3.568; 95% CI, 1.625 to 7.833; p=0.002 for the highest quartile vs the lowest quartile) were independent risk factors together with hypertension (OR, 2.512; 95% CI, 1.381 to 4.569; p=0.003), diabetes mellitus (OR, 2.942; 95% CI, 1.061 to 8.158; p=0.038), hepatitis B virus positivity (OR, 3.548; 95% CI, 1.295 to 9.716; p=0.014), and a higher level of total cholesterol (OR, 2.232; 95% CI, 1.043 to 4.778; p=0.039 for <200 mg/dL vs ≥240 mg/dL). Body mass index and waist circumference were not meaningful variables. Conclusions Visceral obesity measured by VAT and TAT was associated with GBP irrespective of body mass index or waist circumference.
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Affiliation(s)
- Jun Kyu Lee
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Suk Jae Hahn
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Hyoun Woo Kang
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Jae Gu Jung
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Han Seok Choi
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Jin Ho Lee
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - In Woong Han
- Department of Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Jin-Hee Jung
- Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Jae Hyun Kwon
- Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
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Bhatt NR, Gillis A, Smoothey CO, Awan FN, Ridgway PF. Evidence based management of polyps of the gall bladder: A systematic review of the risk factors of malignancy. Surgeon 2016; 14:278-86. [PMID: 26825588 DOI: 10.1016/j.surge.2015.12.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 11/29/2015] [Accepted: 12/04/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND There are no evidence-based guidelines to dictate when Gallbladder Polyps (GBPs) of varying sizes should be resected. AIM To identify factors that accurately predict malignant disease in GBP; to provide an evidence-based algorithm for management. METHODS A systematic review following PRISMA guidelines was performed using terms "gallbladder polyps" AND "polypoid lesion of gallbladder", from January 1993 and September 2013. Inclusion criteria required histopathological report or follow-up of 2 years. RTI-IB tool was used for quality analysis. Correlation with GBP size and malignant potential was analysed using Euclidean distance; a logistics mixed effects model was used for assessing independent risk factors for malignancy. RESULTS Fifty-three articles were included in review. Data from 21 studies was pooled for analysis. Optimum size cut-off for resection of GBPs was 10 mm. Probability of malignancy is approximately zero at size <4.15 mm. Patient age >50 years, sessile and single polyps were independent risk factors for malignancy. For polyps sized 4 mm-10 mm, a risk assessment model was formulated. CONCLUSIONS This review and analysis has provided an evidence-based algorithm for the management of GBPs. Longitudinal studies are needed to better understand the behaviour of polyps <10 mm, that are not at a high risk of malignancy, but may change over time.
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Affiliation(s)
- Nikita R Bhatt
- Department of Surgery, University of Dublin, Trinity College, at the Adelaide and Meath Hospital, Tallaght, Dublin, Ireland
| | - Amy Gillis
- Department of Surgery, University of Dublin, Trinity College, at the Adelaide and Meath Hospital, Tallaght, Dublin, Ireland
| | - Craig O Smoothey
- School of Mechanical and Materials Engineering, University College Dublin, Ireland
| | - Faisal N Awan
- Department of Hepatobiliary Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - Paul F Ridgway
- Department of Surgery, University of Dublin, Trinity College, at the Adelaide and Meath Hospital, Tallaght, Dublin, Ireland.
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Abstract
Gallbladder polyp (GP) and stroke share several metabolic disorders as risk factors. We assessed the association between GP and subsequent stroke risk. From 2000 to 2011, patients with GP aged >20 years were identified from the Longitudinal Health Insurance Database 2000. Of the 15,975 examined patients, 12,780 and 3195 were categorized into the non-GP and GP cohorts, respectively. The relative risks of stroke were estimated using the Cox proportional hazard model after adjusting for age, sex, and comorbidities. The overall incidence of stroke was higher in the GP cohort than in the non-GP cohort (6.66 vs 5.20/1000 person-yr), with an incidence rate ratio (IRR) of 1.28 (95% confidence interval [CI] = 1.15-1.42). The risk of stroke was 1.32-fold (95% CI = 1.06-1.63) in patients with GP compared with patients without GP after adjusting for age, sex, income level, urbanization level, occupation and comorbidities of gallstone, alcohol-related illness, diabetes, hyperlipidemia, hypertension, obesity, COPD, coronary heart disease, and asthma. Furthermore, the stroke risk was higher among elderly patients (with 1-yr intervals; adjusted HR [aHR] = 1.06, 95% CI = 1.05-1.07), the male sex (aHR = 1.62, 95% CI = 1.35-1.96), lower income level (aHR = 1.37, 95% CI = 1.02-1.85 for level I; aHR = 1.62, 95% CI = 1.25-2.10 for level II), living in second urbanized areas (aHR = 1.28, 95% CI = 1.00-1.63), alcohol-related illness (aHR = 1.56, 95% CI = 1.07-2.28), diabetes (aHR = 1.78, 95% CI = 1.41-2.24), and hypertension (aHR = 2.74, 95% CI = 2.19-3.42). GP is associated with stroke; however, GP may be less influential than other risk factors are, such as male sex, lower income level, alcohol-related illness, diabetes, and hypertension, on stroke development. Additional studies are required to clarify whether GP is a risk factor for or an epiphenomenon of stroke development.
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Affiliation(s)
- Chien-Hua Chen
- From the Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua (C-HC); Hungkuang University, Taichung (C-HC); Meiho University of Technology, Pingtung (C-HC); School of Medicine, China Medical University (C-LL); Management Office for Health Data, China Medical University Hospital (C-LL); Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University (C-HK); Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK)
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Guo J, Wu G, Zhou Z. Polypoid lesions of the gallbladder: report of 160 cases with special reference to diagnosis and treatment in China. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:11569-11578. [PMID: 26617893 PMCID: PMC4637709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 08/23/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND The preoperative diagnosis of gallbladder polypoid lesions is difficult, justifying the lack of consensus on the appropriate treatment. OBJECTIVE The aim of this study was to identify the characteristics of each type of polypoid lesion of the gallbladder and the indications for surgery. METHODS Between January 1999 and December 2012, clinical data were retrospectively correlated with the histopathologic characteristics of polypoid lesions in 160 patients who underwent cholecystectomy. RESULTS A total of 160 patients with benign polypoid lesions (including 49 tumor-like lesions and 75 adenomas) and 14 patients with malignant polypoid lesions (including 2 adenocarcinomas and 12 adenomas with malignant changes) were included in this study. One hundred and five (65.6%) of the patients had associated symptoms, and 70 (43.8%) had gallstones. Of the 49 patients with tumor-like lesions, 49 (100%) were correlated with chronic cholecystitis. A total of 72 (83.8%) patients with neoplasms had a single polyp compared with 25 (59.5%) of those with non-neoplastic polyps. The mean age of the patients with malignancy was 59.07 ± 13.465 years, and 12 (85.7%) of these patients were over 50 years of age. The mean diameters of the benign and malignant polyps were 1.0 ± 0.77 cm and 2.15 ± 1.16 cm, respectively. Ten (100%) of the patients with malignancy had polyps of over 1 cm in size, as shown by ultrasound. CONCLUSION Our findings indicate that tumor-like lesions, adenomas, and adenocarcinomas are the most common polypoid lesions of the gallbladder. Cholecystecomy should be done in patients with symptoms. The risk of malignancy is high in patients over 50 years of age; those with polyps with diameters of greater than 10 mm; and those with single polypoid lesions. The remainder of PLG patients without cholecystectomy should be followed up at regular intervals.
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Affiliation(s)
- Jingjing Guo
- Department of General Surgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Gang Wu
- Department of General Surgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Zhongwen Zhou
- Department of Pathology, Huashan Hospital, Fudan UniversityShanghai 200040, China
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Babu BI, Dennison AR, Garcea G. Management and diagnosis of gallbladder polyps: a systematic review. Langenbecks Arch Surg 2015; 400:455-62. [PMID: 25910600 DOI: 10.1007/s00423-015-1302-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/13/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Recommendation for management of gallbladder polyps (GBPs) >1 cm is cholecystectomy. No consensus exists on management of GBPs <1 cm. This systematic review examines current evidence on management of GBPs. METHODS MEDLINE, EMBASE and Cochrane library databases were searched from January 1991 to June 2013 using specified terms. A predefined protocol for data extraction was used to retrieve specified end points. RESULTS Literature search yielded 43 manuscripts with a dataset of 11,685 patients with GBPs. M:F ratio was 1.3:1. Average age (range) was 49 years (32-83). Patients with malignant GBPs had an average (range) age of 58 (50-66) years with M:F ratio of 0.78:1. Cholesterol polyps constituted 60.5% of GBPs followed by adenomas (15.2%) and cancer (11.6%). Malignant GBPs ≥1 cm, <1 cm and <5 mm constituted 8.5, 1.2 and 0% of GBPs, respectively. Majority of patients requiring surgical intervention had laparoscopic cholecystectomy. CONCLUSIONS Presently employed policy of cholecystectomy for GBPs >1 cm is appropriate. For GBPs <1 cm, the authors propose (accepting existence of differing proposals) the following: 1. Surveillance may not be needed for GBPs <5 mm. 2. For GBPs between 5 and 10 mm, two scans at six monthly intervals is suggested and after that, tailor surveillance to age, growth and ethnicity. In the non-Asian population, if GBP remains the same size or number, discontinuation of surveillance may be considered. In the Asian population, if GBPs remain the same, yearly surveillance is continued for a suggested period of 3 years. 3. Discontinue surveillance if GBPs is/are smaller/ disappeared. Cholecystectomy is advised where size increases to >10 mm.
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Affiliation(s)
- Benoy I Babu
- Leicester HPB Unit, University Hospitals of Leicester, Gwendolen Road, LE5 4PW, Leicester, UK,
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Li Q, Ge X, Xu X, Zhong Y, Qie Z. Comparison of the gene expression profiles between gallstones and gallbladder polyps. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:8016-8023. [PMID: 25550845 PMCID: PMC4270579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 11/01/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Gallstones and gallbladder polyps (GPs) are two major types of gallbladder diseases that share multiple common symptoms. However, their pathological mechanism remains largely unknown. The aim of our study is to identify gallstones and GPs related-genes and gain an insight into the underlying genetic basis of these diseases. METHODS We enrolled 7 patients with gallstones and 2 patients with GP for RNA-Seq and we conducted functional enrichment analysis and protein-protein interaction (PPI) networks analysis for identified differentially expressed genes (DEGs). RESULTS RNA-Seq produced 41.7 million in gallstones and 32.1 million pairs in GPs. A total of 147 DEGs was identified between gallstones and GPs. We found GO terms for molecular functions significantly enriched in antigen binding (GO:0003823, P=5.9E-11), while for biological processes, the enriched GO terms were immune response (GO:0006955, P=2.6E-15), and for cellular component, the enriched GO terms were extracellular region (GO:0005576, P=2.7E-15). To further evaluate the biological significance for the DEGs, we also performed the KEGG pathway enrichment analysis. The most significant pathway in our KEGG analysis was Cytokine-cytokine receptor interaction (P=7.5E-06). PPI network analysis indicated that the significant hub proteins containing S100A9 (S100 calcium binding protein A9, Degree=94) and CR2 (complement component receptor 2, Degree=8). CONCLUSION This present study suggests some promising genes and may provide a clue to the role of these genes playing in the development of gallstones and GPs.
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Affiliation(s)
- Quanfu Li
- Department of Hepatobiliary Surgery, The Second Hospital of BaodingBaoding 071051, China
| | - Xin Ge
- National Hepatobiliary and Enteric Surgery, Central South UniversityChangsha 410008, China
| | - Xu Xu
- Department of Hepatobiliary Surgery, The Second Hospital of BaodingBaoding 071051, China
| | - Yonggang Zhong
- Department of Hepatobiliary Surgery, The Second Hospital of BaodingBaoding 071051, China
| | - Zengwang Qie
- Department of Hepatobiliary Surgery, The Second Hospital of BaodingBaoding 071051, China
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Sarkut P, Kilicturgay S, Ozer A, Ozturk E, Yilmazlar T. Gallbladder polyps: Factors affecting surgical decision. World J Gastroenterol 2013; 19:4526-4530. [PMID: 23901228 PMCID: PMC3725377 DOI: 10.3748/wjg.v19.i28.4526] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 03/19/2013] [Accepted: 04/29/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine the factors affecting the decision to perform surgery, and the efficiency of ultrasonography (USG) in detecting gallbladder polyps (GP).
METHODS: Data for 138 patients who underwent cholecystectomy between 1996 and 2012 in our clinic with a diagnosis of GP were retrospectively analyzed. Demographic data, clinical presentation, principal symptoms, ultrasonographic and histopathological findings were evaluated. Patients were evaluated in individual groups according to the age of the patients (older or younger than 50 years old) and polyp size (bigger or smaller than 10 mm) and characteristics of the polyps (pseudopolyp or real polyps). χ2 tests were used for the statistical evaluation of the data.
RESULTS: The median age was 50 (26-85) years and 91 of patients were female. Of 138 patients who underwent cholecystectomy with GP diagnosis, only 99 had a histopathologically defined polyp; 77 of them had pseudopolyps and 22 had true polyps. Twenty-one patients had adenocarcinoma. Of these 21 patients, 11 were male, their median age was 61 (40-85) years and all malignant polyps had diameters > 10 mm (P < 0.0001). Of 138 patients in whom surgery were performed, 112 had ultrasonographic polyps with diameters < 10 mm. Of the other 26 patients who also had polyps with diameters > 10 mm, 22 had true polyps. The sensitivity of USG was 84.6% for polyps with diameters > 10 mm (P < 0.0001); however it was only 66% in polyps with diameters < 10 mm.
CONCLUSION: The risk of malignancy was high in the patients over 50 years old who had single polyps with diameters > 10 mm.
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Mao YS, Mai YF, Li FJ, Zhang YM, Hu KM, Hong ZL, Zhu ZW. Prevalence and risk factors of gallbladder polypoid lesions in Chinese petrochemical employees. World J Gastroenterol 2013; 19:4393-4399. [PMID: 23885152 PMCID: PMC3718909 DOI: 10.3748/wjg.v19.i27.4393] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 06/04/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the prevalence and risk factors of polypoid lesions of the gallbladder (PLGs) in petrochemical employees in Ningbo, Zhejiang Province, China.
METHODS: All active and retired employees aged 20-90 years (n = 11098) of a refinery and chemical plant in eastern China were requested to participate in a health survey. The participants were subjected to interview, physical examination, laboratory assessments and ultrasonography. All the participants were invited to have a physical examination after a face-to-face interview. Fasting blood samples were obtained from the antecubital vein, and the samples were used for the analysis of biochemical values. Abdominal ultrasonography was conducted.
RESULTS: A total of 10461 (7331 men and 3130 women) current and former petrochemical employees attended for screening. The overall prevalence of post-cholecystectomy, gallstones and PLGs was 0.9%, 5.2% and 7.4%, respectively. Compared with the increased prevalence of either gallstones or post-cholecystectomy in older persons, PLGs were more common in the middle-aged, peaking in those aged 40-59 years. Excluding the patients with gallstones, gallstones mixed with PLGs, or those who had undergone cholecystectomy, in the remaining 9828 participants, the prevalence of PLGs in men (8.9%) was significantly higher than that in women (5.5%, P < 0.001). The analyzed risk factors with increased OR for the development of PLGs were male gender (OR = 1.799, P < 0.001), age ≥ 30 years (OR = 2.699, P < 0.001) and hepatitis B surface antigen (HBsAg) positivity (OR = 1.374, P = 0.006).
CONCLUSION: PLGs are not rare among Chinese petrochemical employees. Male gender, HBsAg positivity, and middle age are risk factors for developing PLGs.
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